Yes, Cariad, dealing with drug addicts is a very frustrating and unfruitful venture. However, that does not in the least mean I have a biased view that does not have any validity.
If there are patients that have a true need but likewise refuse a trial of marinol, I would not ever resort to an illegal substance not approved by the DEA. Sorry, but that is the way it is plain and simple.
Quote from: Hemodoc on November 30, 2011, 10:26:37 PMYes, Cariad, dealing with drug addicts is a very frustrating and unfruitful venture. However, that does not in the least mean I have a biased view that does not have any validity.Peter, I never, not once in this discussion, have said that your view or anyone else's 'does not have any validity'. I did not say that nor do I believe that. So there's the back half of your statement negated. The first part of that sentence is so completely gobsmacking that I scarcely know where to begin. Here is a plain and simple conjugation for you to illustrate the point:I am biased.You, Peter, are biased.He (the author of this piece) is biased.We ALL are biased.You all who are having this discussion with me are biased.They who disagree with you are biased.Bias is a given in my ba-zillion years of social science work and study, to the point that defining all of the different types of bias is a study unto itself, including a term for what you are doing, falling victim to a bias blind spot (you can easily look this up). This is so utterly fundamental that if we cannot agree that all people everywhere, including you, are biased, then we have no logical basis with which to proceed. Bias is a reason that studies are double blinded when possible. Bias in no way translates to invalid statements nor research. That is a blatant misunderstanding of what we are talking about here. Noahvale said there was a bias to the piece - that statement is even more obvious than 'alcohol and substance abuse are the same thing' or however he put it. He then wrote that the writer had an ‘agenda’ which is going to be more difficult to prove unless you can claim to be a mind reader, but then I think noahvale has an agenda as well, and the first item on that agenda is to try in any way possible to discredit the author. He used the word bias as if that immediately invalidates anything that the author wrote, when in fact that argument is ludicrous.Quote from: Hemodoc on November 30, 2011, 10:26:37 PMIf there are patients that have a true need but likewise refuse a trial of marinol, I would not ever resort to an illegal substance not approved by the DEA. Sorry, but that is the way it is plain and simple. You have stated that you do not want to see marijuana legalized, and that is informing your opinion - you are biased against medical marijuana users because in your experience marijuana users are by and large manipulative liars. You have set up this little test that you believe can weed out (HA!) the honest from the frauds. That is what transplant evals try to do, and I truly believe that they fail more often than they succeed. We do not know if the subject of the story tried Marinol, but then that misses the point because he had already been allowed to use medical marijuana and is not seeking it from these doctors anyway. Your experience cannot be substituted for information about this person, nor can mine. Recognizing one’s own biases actually strengthens an argument, not to mention any research one does, which is why journalists and scientists are trained to address, control for, and minimize those biases. Note I said minimize, one can never eliminate them. It is not possible. If you believe otherwise, you are wrong. Sorry, but that is the way it is, plain and simple.
Dear Cariad, thank you for your response, but I never said I didn't have a bias, just that my views even if biased are not invalidated.
I would point out that you brought up the issue of bias and accused me of having a biased view.
Lastly, I cannot point to any studies in the US or elsewhere showing other active substances in pot that has medicinal values beyond THC. What are these so called therapeutic substances? What are they called, and what is their chemistry? Where is the evidence above and beyond anecdotal evidence for any of these claims. Sorry, I just don't see that anywhere.
So instead of getting into emotional and personal issues, what is the evidence that pot is superior to Marinol above and beyond purely anecdotal evidence. In addition, how will you separate drug seeking, fraudulent "medical marijuana" patients from patients with legitimate needs. Please remember that is a requirement of all doctors who prescribe controlled substances. Please advise how you would address this legal mandate if you had the opportunity to prescribe "medical marijuana."
I would point out that the Medical Board of CA does not license me to issue controlled substances. That is entirely under the province of the DEA alone. CA can declare it legal as much as they want, but their jurisdiction does not supersede the Feds on this limited issue. Until the time that the DEA legalizes marijuana, all that the states are doing is setting up continued conflicts with the Feds. The last time I looked, the Feds are aggressively enforcing these regulations.I would further advise you to take a look at the number of doctors prosecuted for prescribing legal controlled substances every year let alone illicit and illegal substances declared legal by these individual states yet not by the Feds. SCOTUS upheld the DEA's right to declare marijuana illegal in 2005 I believe. It is settled matter of law even if society has not settled this issue in a limited number of states.
I decided to answer my own question and did a search for prosecutions of doctors in california for prescribing medical marijuana. It came up with this Wikipedia article: http://en.wikipedia.org/wiki/Legal_and_medical_status_of_cannabisIt states: There is a split between the U. S. federal and many state governments over medical marijuana policy. On June 6, 2005, the Supreme Court, in Gonzales v. Raich, ruled in a 6-3 decision that Congress has the right to outlaw medicinal cannabis, thus subjecting all patients to federal prosecution even in states where the treatment is legalizedAll the articles denouncing the law for intimidating and pursuing doctors were old - 2005 or thereabouts. It would seem that it is patients who currently bear the risk of accepting this treatment. I don't think there should be any risk at all, but I've stated that countless times. It is cruel to condemn someone to chronic pain if they can be helped with marijuana, crueler still to deny them a transplant and condemn them to death.
Sorry, I never had any patient condemned to chronic pain that we did not go to extensive lengths to help in any manner we had available. I liberally consulted with pain management specialists who never once resorted to Marinol let alone pot for pain relief. The majority of patients had significant improvement in their symptoms. Just never had a situation where pot was the recommended treatment of choice in 20 years of practice.The patient in question actually was not "condemned to death" for marijuana use. He failed to keep a drug test. Big difference despite the fact that everyone is focussing on the medical marijuana issue. He failed to keep an agreed upon condition of the transplant list at Cedars. He alone bears responsibility for his own actions. He is free to seek help at USC, UCLA, Loma Linda or the centers in San Diego if he doesn't agree with the program at Cedars. His situation is not without remedy even after dismissal from Cedars.
Peter I think your data is incomplete. There have been discoveries recently, the most interesting the discovery of the the cannabinoid receptors which "are a class of cell membrane receptors under the G protein-coupled receptor superfamily." Marinol is a drug that undoubtedly has some uses but it isn't cannabis. Patients report cannabis works better. Cannabis has a long history of medical use by humans and it has an unfortunate political history in the US.This recent letter to the editor puts the politics of cannabis in context. I thought this was particularly well said:"one might characterize U.S. policies as harm maximization — turning substance with relatively few intrinsic dangers into one that carries many externally imposed dangers." Yes one might, if one wished to describe the world as it is. One externally imposed danger is that use could lead to exclusion! by transplant programs. The decision by transplant groups to focus on pot use, is not justified by the science, it is the result of the politics. Distorted, crippled, unscientific, politics.