Brookhiser on Medical Marijuana

Radley Balko | November 29, 2006

Brian's post below reminds me of something Rick Brookhiser wrote at National Review Online last year:

Chemotherapy, which I had in 1992, wasn't all bad. I looked very cool bald; it gave a nice grey perm when my hair came back (why couldn't it bring more hair back? can't they cut it with menoxydil?); and it did stop my unpleasant visitor.

But the nausea was not cool, and only the illegal drug worked once the legal ones had failed.

[ONDCP Director] John Walters says there is no medical evidence for marijuana's effects. He is a liar or an ignoramus, probably both.

Brookhiser, a credentialed conservative, has in fact long been an eloquent supporter of medicinal marijuana. I like this quote, pulled from Wikipedia, that apparently came from Congressional testimony he gave in 1996:

My support for medical marijuana is not a contradiction of my principles, but an extension of them. I am for law and order. But crime has to be fought intelligently and the law disgraces itself when it harasses the sick. I am for traditional virtues, but if carrying your beliefs to unjust ends is not moral, it is philistine."

Given that according to our unnamed Weekly Standard writer, marijuana "provides no health benefits, especially for sick people," and that supportera of medical marijuana laws are nothing more than corn chip-munching, Cheech & Chong-watching radical hippies, I wonder what he'd say to a guy like Brookhiser? Would the Weekly Standard argue that Brookhiser was wrong about his own illness? That it was all in his head? That they, more than he, know what made his nausea go away?

Perhaps they'll argue what drug warriors usually fall back on when they run out of arguments -- that he's part of an elaborate scheme concocted by George Soros.

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Timothy|11.29.06 @ 5:51PM|#

We'd know a lot more about pot's medicinal effects if researchers in the US weren't barred from looking into the medical possibilities by the FDA. Of course, any doctor who wants to investigate is probably lazy and munching on corn chips.

|11.29.06 @ 5:52PM|#

Am I the only one that wonders what the unpleasant visitor was?

Soros Schmoros,
It's all headed by Peter Lewis and you know it!! Medical Marijuana is a plot by Big Insurance!

|11.29.06 @ 5:54PM|#

Mo, I think cancer was the visitor. Took me a bit of re-reading to figure out that indeed Rick was not posting from a female perspective

|11.29.06 @ 6:01PM|#

Has anybody else ever noticed that there are only 2 types of people saying the medical marijuana issue is about whether marijuana cures cancer: Potheads and DEA officials.

Potheads have an excuse.

|11.29.06 @ 6:03PM|#

Seriously though, barring personal use, how is Medical Marijuana not conservative in nature? Is it because it smacks of 60's counterculture, perhaps too much like homeopathy and other "whacky" psuedo-medicine? The conservative philosophy is supposedly one of personal responsibility and empowerment by limiting government interference. Using the government powers to ban MMJ is the antitheisis of conservative.

Timothy, good point but you are wrong. The FDA knows the answer to the efficacy and safety of MMJ, why else do you think they allowed GW Pharma to push Sativex into Phase III clinical trials without any preliminary testing? Sativex is just an alchol extract of whole plant cannabis containing measured quantities of THC and CBD. I can make the exact same shit at home, or rather I could if it were legal to grow here. It's like allowing vitamin C tablets but outlawing oranges.

|11.29.06 @ 6:04PM|#

Has anybody else ever noticed that there are only 2 types of people saying the medical marijuana issue is about whether marijuana cures cancer: Potheads and DEA officials.

I don't know anyone (pothead or other) who believes the weed "cures" cancer.

But feel free to point to any evidence that contradicts me

When I was at the peak of my pot smoking days, all I ever had were unpleasant visitors.

|11.29.06 @ 6:12PM|#

I don't know anyone (pothead or other) who believes the weed "cures" cancer.

Not here, but there is evidence that it helps prevent alzheimers disease.

http://news.bbc.co.uk/2/hi/health/4286435.stm

|11.29.06 @ 6:19PM|#

As an aside, if the FDA were truly concerned with the safety of plants grown at home, they would have outlawed Datura, Oleander, Castor, Rhubarb, Daphne, Lantana, Yew and with the holiday's fast approaching, Mistletoe. All of these plants can be fatal, many with the ingestion of just a few grams. Safety isn't the concern, control is.

|11.29.06 @ 6:24PM|#

have outlawed Datura, Oleander, Castor, Rhubarb, Daphne, Lantana, Yew and with the holiday's fast approaching, Mistletoe. All of these plants can be fatal, many with the ingestion of just a few grams.

Rhubarb??? Really??

My neighbors used to grow TONS of Rhubarb and always made pie and jam out of it. IS there something in the process of making pie/jam that makes it safe?? I never new I was that close to danger.

Safety isn't the concern, control is.
I agree with this sentiment. I remmeber seeing Jesee "The Body/Governor" Ventura on Real Time with Bill Maher a year or two ago who basically said that the big problem with legalizing weed is that people can grow there own in their back yard and the government and pharma companies can't make any money off of it that way. That is why they will approve things like Sativex but not the plant from which it is made.

|11.29.06 @ 6:29PM|#

The pharma companies aren't making any money off the stuff now!

|11.29.06 @ 6:32PM|#

The pharma companies aren't making any money off the stuff now!

Yet....once products like Sativex hit the market though...it's not like these kinds of drugs aren't in the pipeline.

And I have to wonder if the number of people who take other prescription drugs for things like depression change if they could get high...cuz i've gotten high a lot when I was feeling blue and it always made me feel better. ;)

"Not here, but there is evidence that it helps prevent alzheimers disease."

I don't know if that's true or not, but the subjects didn't get uptight about forgetting.

Xmas|11.29.06 @ 6:32PM|#

Rhubarb!

http://www.rhubarbinfo.com/rhubarb-poison.html

Danimal|11.29.06 @ 6:34PM|#

Kwix, I believe Timothy is referring to the National Institute on Drug Abuse's refusal to provide marijuana to researchers seeking to conduct FDA-approved studies into marijuana's medical benefits. Unlike every other drug (LSD, heroin, etc.), which researchers can access through private suppliers, NIDA remains the sole source for research marijuana in this country. NIDA will not provide this marijuana for research into the plant's medical benefits, as the agency claims this runs counter to its stated mission of researchering the harms of drug abuse. Lyle Craker, a well-respected professor at UMASS Amherst, has long been petitioning the DEA for permission to grow marijuana for use by other scientists in FDA-approved studies into the plant's medical efficacy. These researchers already have FDA approval, but they can't get any marijuana to use in the studies because NIDA won't give it to them. Professor Craker is seeking to provide an alternative, private source for research marijuana - again, something that has long existed for all other drugs. Craker is currently awaiting a ruling on his petition from a DEA administrative law judge - this ruling would then go to the head of the DEA, Karen Tandy, who would make the final call.

|11.29.06 @ 6:47PM|#

C-Tom: I've only seen potheads claiming marijuana curing cancer on the internets, being as how I don't actually know any (many?) potheads, and the Bullshit! episode on the War on Drugs had a clip showing John Walters saying "There is no proof marijuana cures cancer." Given other idiot statements by other drug monkeys, it's not hard to see them making similar statements.

I'm just saying, it's not about whether or not it cures cancer but 2 types of people don't understand this.

|11.29.06 @ 6:48PM|#

Timothy|11.29.06 @ 6:51PM|#

Kwix: I was wrong, it's the DEA that opposes private research in to medical pot, the FDA will grant some licenses for controlled substance. You can read the DEA's agitprop here. Motherfucking fascists, I hope they all get cancer. And AIDS (from a blood transfusion in Africa, because they don't deserve to get laid). And cataracts.

Timothy|11.29.06 @ 6:55PM|#

As a primary care physician I have enough trouble with narcotic seeking patients who want Vicodin, Oxy Contin, Methadone, (fill in the drug)and will lie like rugs to obtain it. It makes it tough for the people who need the drugs legitimately to have to jump through the hoops we hold to get relief. If marijuana is legalized for medical purposes other than cancer ( chronic fatigue, Gulf War Syndrome, fibromyalgia or another fringe diagnosis) watch for every dope smoking slacker in the world to be driving to the office of the local MD to get their pot prescribed. I have no problem if they want to lie around stoned; but I'm damned if I'll be their connection.

Doc, this is why those of us in the legalization camp are against the odious policy of the DEA busting physicians for "over prescribing" medication. Like the assholes at the OCC and SEC have made banks responsible for enforcement of draconian economic laws, the evil monkeys at the DEA are making doctors responsible for their draconian drug laws. Bastards.

|11.29.06 @ 7:00PM|#

If marijuana is legalized for medical purposes other than cancer ( chronic fatigue, Gulf War Syndrome, fibromyalgia or another fringe diagnosis) watch for every dope smoking slacker in the world to be driving to the office of the local MD to get their pot prescribed.

So what?

And why is anyone who wants to get high a "dope smoking slacker"?? I think this is a big part of the problem....people's pre-conceived notions of who pot-smokers are. Every single one of my pot smoking friends are all young professionals in fields like technology / IT, investment banking, real estate and some are artists.

I have also gotten high with successful CEOs and president's of many of the companies I have worked for. Not to mention countless salespeople and VPs.

None of them were slackers. You know who the slackers are??? The ones who use broad brush strokes to paint others in a negative light based on their own prejudices, and haven't bothered to get educated about who many of these users really are.

I have no problem if they want to lie around stoned; but I'm damned if I'll be their connection.

WHich would you prefer....you being the connection or some street thug being the connection??

|11.29.06 @ 7:05PM|#

I sure loves me some rhubarb pie. Now that I know the plant is poisonous I somehow like it even more now.

I can't stand it though when people dilute the rhubarb with stawberries. Rhubarb pie shouldn't be sweetly pleasant. It needs some sweetening of course, but it should give you puckered whiskey-face with every bite.

|11.29.06 @ 7:12PM|#

Kwix, don't forget about poinsettias. Those are poisonous as well.

|11.29.06 @ 7:14PM|#

DrDCS | November 29, 2006, 6:48pm | #

Maybe if pot were just plain legalized it would be one less thing for you to worry about.

Then you could just decide if marijuana was efficacious for your patient's malady and act accordingly.

The slacker stoners would make their own decisions and suffer what ever consequences.

QUESTION: Have you ever had to treat a patient for marijuana poisoning?

|11.29.06 @ 7:16PM|#

Most pot dealers I've known of aren't "street thugs" but normal folks earning a little extra on the side. Stop conflating them with crack or meth slingers

Has it it occurred to you that "crack or meth slingers" are just "normal folks earning a little extra on the side" under just a little different circumstances?

|11.29.06 @ 7:19PM|#

Most pot dealers I've known of aren't "street thugs" but normal folks earning a little extra on the side. Stop conflating them with crack or meth slingers

So true. I have found that the purchase of some quality weed was a social occasion with a little business on the side. You don't have people running in and out all day long like crack houses. When done properly, a marijuana purchase requires at least a half hour visit.

|11.29.06 @ 7:24PM|#

Has it it occurred to you that "crack or meth slingers" are just "normal folks earning a little extra on the side" under just a little different circumstances?

That's a valid point. But the marijuana deal has always appeared to me to be a more congenial, less stressful, transaction than crack, blow or meth.

|11.29.06 @ 7:36PM|#

Only rhubarb leaves are poisonous, right? I think the stalks are fine.
Our house came with a healthy rhubarb plant in the back. We did a bit of research before we cooked with it. I was still a little leery of eating it, because I read that some rhubarb varieties are used medicinally as laxatives. The first time my wife made a rhubarb coffee cake, I didn't try it until she had fed some to her co-workers.

Green potatoes are poisonous too.

|11.29.06 @ 7:43PM|#

"Karen Tandy" and "final call" should never be in the same sentence.

|11.29.06 @ 8:28PM|#

Sorry for being remiss on this thread. I am well aware that Timothy was referring to Dr. Craker's work. I am also aware of the hassles that he has had to go through to attempt and obtain reliable quality samples for testing, as well as the problems the Americans for Safe Access have had in changing the scheduling of MJ from Class I to something that can be prescribed. DEA says the NIH handles it, the NIH says the FDA handles it, the FDA says the DEA has last word, and every agency involved keeps extending the "review" process ad infinitum 90 days at a time.

My initial statement was simply disgust that the FDA and DEA are well aware of the efficacy and safety of cannabis but refuse to allow the sick and dying to make decisions regarding thier own health unless a pharma company steps in offering a packaged drug and likely kickbacks (donations, corporate taxes, etc.).

Again, too much government leads to corporate influence and political corruption.

|11.29.06 @ 8:45PM|#

Regarding Rhubarb:
Only the stalks are edible, and then only because the poison in question, oxalic acid, is found in far less concentrated amounts. Oxalic acid draws calcium out of your bloodstream and can, in a large enough dose for a long enough time, deposit calcium oxalate crystals in the kidneys(kidney stones) and brain, upsetting the neural system. Death is very rare, but still possible. I put this one on here mostly as a "look, some food is more poisonous than pot". I forgot about the raw potatoes.

The others, particularly castor beans, can be very dangerous. Though, with the exception of recreational use of Datura, none are commonly ingested (castor oil is separated from the water soluble ricin and is not poisonous).

|11.29.06 @ 9:12PM|#

So how is an injestible pill like Sativex supposed to work when it's trying to cure nausea? If you're extremely nauseous from chemo, wouldn't you just throw the pill back up?

I guess the solution is a suppository, but I ain't sticking reefer in my bum. Do I look like a drug mule to you?

|11.29.06 @ 10:18PM|#

Poor Dr DCS,

Rent seeking is *so* hard. He really must be suffering.

The problem is that doctors have made this bed, and they damn well had better lie in it.

From its inception, the AMA has sought to ensure that aleopaths (practicing ones anyway) were able to rake in money by shielding them from competition and forcing people to do business with them.

Part of this was the enactment of laws requiring a doctor's prescription before people could buy certain substances. Of course, then people have to go an pay the aleopath for the visit and the consult, which is quite a nice revenue stream.

Once again, the solution to the problems caused by government oppression (doctor shortages, prescription drug laws) is not more government oppression (tougher drug laws, fewer permitted medicines), but rather ending the original oppression.

Then they can go about treating sick people who *want* their help rather than being besieged by supplicants who are told to go to you to get the stuff they want.

* A couple of notes. The early AMA was quite blatant in its desire to put homeopaths, osteopaths and I think one other class of medical practitioner that I can't remember out of business. think this is reprehensible and condemn them for it. However, this does not mean that I think aleopathy is wrong. I don't know much about osteopathy, so I can't speak to it, but I know that homeopathy has been thoroughly discredited scientifically through repeated experiments. I think the aleopaths are, for the most part, on the right track.

** I assert that people have a moral right to put whatever they want into their bodies, just as you have a moral right to put whatever you want, including water into your gas tank. This is not an argument that people should avoid seeking expert advice on how to treat ailments.

|11.29.06 @ 11:08PM|#

Most pot dealers I've known of aren't "street thugs" but normal folks earning a little extra on the side. Stop conflating them with crack or meth slingers

Well when my regular guy is dry have to resort to buying dime bags on a corner in the West side from someone who I can assure you is most definitely a street thug.

Just because the ones *YOU* know aren't thugs doesn't mean they never are. Trust me -- there are lots of thugs that sell weed as well as crack (dunno about meth)

|11.29.06 @ 11:32PM|#

I hate when the marijuana debate is framed as a medicinal issue, because it considers just a small fraction of what's wrong with prohibiting that particular drug. The real question is not whether marijuana has enough medical benefits for the government to deem it good enough for you to consume, but whether the government is the one that should be making that call in the first place.

Robert Goodman|11.30.06 @ 12:41AM|#

"So how is an injestible pill like Sativex supposed to work when it's trying to cure nausea? If you're extremely nauseous from chemo, wouldn't you just throw the pill back up?"

It's not a pill. You spray it under your tongue. Absorbed a lot faster than swallowing, though still a little slower than inhalation, but without the smoke.

Anyway, it's going to be a long process, but here's how it should go. It will first be licensed for a narrow range of indications. Then the sponsor will get marketing approval for more label indiciations, and there will be pressure on doctors to prescribe it more widely. Slowly, over many years, its use will increase. In maybe 20 years it will have piled up a remarkable record of safety. At that point, its sponsor, seeking to capture a wider market for a drug gone off patent, will seek to have it converted from Rx to OTC. That will actually require an act of Congress, for cannabis is written into the FFDCA as a drug ingredient requiring a prescription. Possibly FDA will act on an application for OTC marketing contingent on a bill's being signed into law, in which case FDA's favorable review will spur Congress to act. However, if FDA says they won't act on such an application until Congress & the prez allow OTC marketing, the whole process may halt, because then Congress won't have FDA's stamp on the evidence. Even after all that, individual states will have to change their laws to allow OTC sales.

The whole process will take several decades, but once it's done, doctors will no longer be pestered for cannabis scrips. Until then, expect them to be squeezed very hard between the large number of patients who will want Sativex, etc., especially once the TV & magazine ads start -- much larger than the number who want narcotics or the TV-advertised sleeping pills, and the state & federal controlled substances authorities who will be looking for overprescribing. This will be a very contentious issue, much more than it is with narcotic analgesics, and expect the epndulum to swing back & forth for years, with doctors never on firm ground as to whether they'll be considered to be underprescribing or overprescribing Sativex and other cannabis preps.

Steve in Clearwater|11.30.06 @ 2:16AM|#

"If marijuana is legalized for medical purposes other than cancer ( chronic fatigue, Gulf War Syndrome, fibromyalgia or another fringe diagnosis) watch for every dope smoking slacker in the world to be driving to the office of the local MD to get their pot prescribed."

SH: Maybe. If that's the method used (cannabis moved to Schedule II) then yeah, probably all kinds of folks will do what all kinds of folks do any time a legal drug is made available.

Think Paxil, Celebrex, Prozac, Viagra, Cialis, Ambien....

Since it's clear that Americans (and most everyone else) just Love Drugs, we can choose to support a system which cedes control of production and commercial distribution to known and regulated dealers, or we can just leave it on the street and completely uncontrolled.

For 99.9% of the pharmacopia, we elect to use the former system.

For about a dozen other in-demand substances (ranging in popularity from cannabis down through strong amphetamines) the response for now is to just leave it all on the street uncontrolled.

The resulting societal damage is tragic.

Cops, Judges Say, "Legalize Drugs" - Find Out Why at LEAP's website in my Name hyperlink

|11.30.06 @ 6:49AM|#

DrDCS, the difficulties you face in your practice with patients badgering you for narcotics are a very strong argument to abolish the drug laws. If addicts can get what they want without your help, then you can concentrate on treating people with real pain-remediation needs. Just imagine how hellish your day would be if you were the only way your patients could get a drink!

-jcr

|11.30.06 @ 6:53AM|#

Tarran, for the record: homeopaths and chriopractors are quacks. The AMA is right to oppose them. What the AMA is *not* right to do, is enforce a legislatively-supported cartel limiting the number of people who can enter the medical profession.

-jcr

|11.30.06 @ 8:15AM|#

Mr. Randolph.

If the AMA were to try to persuade people to avoid non-aleopaths I would not only have no problem with it, I would probably help disseminate their literature!

However, they were quite clear that they wanted to eliminate competition because it was driving their prices too low, and used the state to accomplish this. They didn't care whether they were quacks or not! (As evidence I submit the impossibility of getting a doctor in MA to testify against another doctor in MA. For some reason they seem to fear retribution from the licensing board if they rat on one of their brothers.)

Let's say a man is selling cigarettes next door to me. If I show up at his door with a base-ball bat and threaten to beat the shit out of him if he keeps selling "those cancer-sticks", would I be in the right? I don't think so.

|11.30.06 @ 9:48AM|#

You'd think the DEA would be all FOR medical pot. Then they could arrest doctors for writing prescriptions just like they bust doctors for writing Oxycontin prescriptions.

|11.30.06 @ 11:58AM|#

Just because the ones *YOU* know aren't thugs doesn't mean they never are. Trust me -- there are lots of thugs that sell weed as well as crack (dunno about meth)

One of the features of drugs being illegal is that criminals get into the drug trade. Also the environment is one of criminality.

And, yes, I know, some of them are really nasty scumbags.

But some of them are just guys trying to get by who have to resort to strongarm stuff for self-protection. It may not justify it but it goes a long way toward explaining it.

|11.30.06 @ 2:02PM|#

"lowly, over many years, its use will increase. In maybe 20 years it will have piled up a remarkable record of safety. At that point, its sponsor, seeking to capture a wider market for a drug gone off patent, will seek to have it converted from Rx to OTC."

Don't hold you breath. Sativex will have remarkable record of safety in the sense that it will be shown not to kill anyone or cause any serious adverse health effects, but it has a high prevalence of "side effects" -- anxiety, difficulty in concentration, dry mouth, reddened eyes and such, which I predict will prevent it from ever being sold OTC. In fact, I dont think it will be too long till you have grandma take a few squirts from her Sativex sublingual, get totally baked and have a panic attack, and you'll never hear the end of the dangers of Sativex. . .

Robert Goodman|11.30.06 @ 6:12PM|#

Actually the allopaths (a term coined by the homeopaths and which I don't like but is convenient) made peace with the homeopaths and the osteopaths in stages, leaving rump groups behind. In the case of the homeopaths, some homeopathic institutions (Hahneman Medical College prominently) merged into allopathic medicine, leaving a large rump group that continues to this day, especially in Europe. With the osteopaths, the merger came much later, just a few decades ago, leaving a small rump of "orthodox" osteopaths.

What has tended to happen is that over time after these mergers, the peculiarities of the sectarian schools of medicine have been diluted out by the pragmatic thinking of allopathic medicine. That did not happen with the earlier merger between the physicians and the surgeons, because both schools in that case were pragmatic enough.

What I mean by pragmatic (which AIUI is at least close to the traidional meaning of pragmatism) is that such schools are based primarily on empiricism rather than a priori thinking. Of course there's plenty of theorizing, but over time, sometimes slowly, what I'm calling pragmatic medicine has tended to adjust in the face of actual evidence, while schools based on an early germ of evidence (such as homeopathy) tended to become set in their theories, so coloring their interpret'n of data as to make them unadjustable. So traditional homeopathy became a take-it-or-leave-it proposition, while other homeopaths fell into the mainstream.

We see the merger process ongoing also with midwifery splitting into "traditional" midwifery & nurse-midwifery.

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