2013-08-08

If All Drugs Were Marijuana, No One Would Be Left Untreated

Today at CNN.com, Dr. Sanjay Gupta, celebrity doctor, has a lengthy piece apologizing to I'm-not-sure-whom about his old views on medicinal marijuana:
Long before I began this project, I had steadily reviewed the scientific literature on medical marijuana from the United States and thought it was fairly unimpressive. Reading these papers five years ago, it was hard to make a case for medicinal marijuana. I even wrote about this in a TIME magazine article, back in 2009, titled "Why I would Vote No on Pot." 
Well, I am here to apologize. 
I apologize because I didn't look hard enough, until now. I didn't look far enough. I didn't review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.
My regular readers know that I am in favor of legalization - of everything, not just marijuana - but greatly abhor recreational drug (I consider the latter part of what I have termed "whore culture").

Like the Gupta of old, my own look into the research pertaining to medicinal marijuana has yielded decidedly ho-hum conclusions. It appears to work well as a mild pain-killer with antidepressant and anticonvulsant qualities. This is precisely as to be expected, once you understand marijuana's basic impact on the human brain.

What's interesting about medicinal marijuana is that there are better pain-killers out there, better anti-depressants, and better anti-convulsants. Cannabis is interesting in that it possesses all three qualities, but basically uninteresting in that it is not particularly excellent at any of them. The medicinal marijuana campaign, then, can mostly be seen as a marketing campaign and political lobby whose real goal is legalization of its recreational use. I have no objection to this; as I said above and elsewhere, I am in favor of legalization.

What does irritate me about this campaign is that cannabis advocates have a bizarre tendency to try to spook us about tobacco. Here's Gupta, from the same article:
We now know that while estimates vary, marijuana leads to dependence in around 9 to 10% of its adult users. By comparison, cocaine, a schedule 2 substance "with less abuse potential than schedule 2 drugs" hooks 20% of those who use it. Around 25% of heroin users become addicted. 
The worst is tobacco, where the number is closer to 30% of smokers, many of whom go on to die because of their addiction.
The problem is that tobacco's active ingredient, nicotine, actually has a large number of well-documented medical benefits. For example,
In modern times, science has documented health benefits in tobacco's compounds. For example, a study performed at Stanford concluded that nicotine can boost the growth of new blood vessels and might lead to novel treatments for poor circulation in diabetics. In addition, Duke University scientists found that nicotine patches could help depression.
And furthermore:
The new study investigated whether nicotine could help people with mild cognitive impairment -- the stage before dementia when people have mild memory or thinking problems but are not disabled. The Vanderbilt University School of Medicine study involved 74 research subjects with an average age of 76 who had mild cognitive impairment and who didn't smoke. Half of the group received a 15 mg. nicotine patch daily for six months while the other half of the study participants received a placebo. At the start of the study, the research subjects were given tests of their memory and thinking ability and these tests were repeated again at three and six months after they were placed on either the nicotine or dummy patch. 
At the end of six months, the results were dramatic. Although the placebo group's mental abilities had decreased by 26 percent over this time period, the nicotine-treated group had regained a remarkable 46 percent of normal performance for age on long-term memory. 
Of course, receiving nicotine therapy in the form of a patch easily side-steps the many spooky scare-stories about lung cancer. If you're still curious about nicotine, its Wikipedia article is highly informative, in my opinion.

I'm not trying to promote nicotine, nor cannabis for that matter. The point I'm trying to make is that cannabis is not the only spooky recreational substance that has valid medical uses. In fact, many street drugs started out their lives as potential medical treatments. What we must always keep in mind is that most chemicals that mankind is interested in have valid uses. They should not be banned.

What I would like to see from the mainstream media is two things. First, if they wish to promote legalization of marijuana, I wish they would do it without making tobacco seem destructive. Nicotine has as much medicinal potential as cannabis. Second, I would like marijuana legalization advocates to start considering how many other chemicals exist out there with medical potential.

In the health care industry, the major issue is access to medicine. That is to say that cannabis may not be a particularly great pain-killer, anti-depressant, or anti-convulsant, but who am I to make that decision for everyone? Each patient should be able to gain access to the specific treatment he or she prefers, as an individual with individual preferences. So, if someone prefers cannabis therapy, that person should be allowed to have it. 

But this is likewise true of everything other than cannabis. What legalization advocates should consider is how many other substances we should deregulate, legalize, and increase access to in order to provide the highest number of treatment options to the largest number of patients.