Making a difference one patient at a time

At Alternative Care Clinics we believe in serving our patients in a safe, comfortable and professional environment. Patients can be evaluated by a reliable, qualified and compassionate CA licensed physician to see if medical marijuana is right for them. Our goal is to provide patients with access to alternative therapies and accurate information regarding medical marijuana.

Tuesday, March 2, 2010

Medical marijuana debate is politics more than science

Science icon

Medical marijuana debate is politics more than science

By DAN GOLD • For the Tribune • March 2, 2010

The news is full of medical marijuana coverage. Not a week goes by in my practice that I am not approached by patients wanting my help in acquiring a permit to use the weed for "medicinal purposes."

I cannot help but notice that the process for approving pot use as a therapeutic drug is the reverse of what we usually see in scientific circles. Let's consider the development and licensure of sildenafil, or Viagra.

In the early 1990s, Pfizer pharmaceuticals researched sildenafil. The drug was under scrutiny to determine if it would control high blood pressure, or hypertension. Another assumed use of the medication was relief of angina, or chest pain associated with cardiac ischemia.

The researchers soon discovered that the drug did little for high blood pressure or chest pain. Surprisingly, the individuals in the study did report an increased incidence of penile erections. Studies of this phenomenon were undertaken, and the drug was approved and released to market circa 1997 as one of the first new treatments for erectile dysfunction in years. Certainly, it has been a big success.

The issue I raise is about process.

1. An investigational compound is isolated.

2. Scientists suspect it might have therapeutic uses and form a theory.

3. A study is designed to test this theory. (Sildenafil controls high blood pressure or chest pain).

4. The theory is disproved. (i.e. Sildenafil does not control high blood pressure or angina).

5. Scientific observations document a different effect from Sildenafil. (Increased erections in male test subjects).

6. A new theory is postulated and tested.

7. Scientific double-blinded studies confirm cause and effect.

8. Further research opens the way to bring sildenafil (Viagra) to market, and the FDA reviews the research and approves.

Note that there is a scientific approach here using research designed to prove cause and effect of this medication as well as safety. Notice the contrast with the political movement to force approval of marijuana as the drug of choice for those who prefer to smoke marijuana for their pain and suffering.

Now I am not without compassion for those in pain or are suffering. I have a rather large pain management practice within the confines of my employment. But it boggles my medical mind to have a huge population already using a medication known to be a euphoria-producing substance, and which is perhaps the most popular illegal recreational drug in the nation if not the world, suddenly demanding that government, not only permit the use of the drug, but that physicians prescribe it.

As a physician, I have no training, experience or confidence in this substance as being a safe and effective "medicine." Sure, there are thousands of people clamoring for it. That proves nothing scientifically.

Furthermore, how would you double blind such studies? "Here, smoke this. It is either real marijuana or oregano and we don't know which."

I suspect the user would know, and after one joint, demand the real thing.

I recently exchanged e-mails with a respected colleague in the field of pain management and he pointed out, "...most law enforcement and some judges pretty much would like to see it legalized/ regulated/ taxed."

Well, maybe, just maybe, if those first Viagra test-subjects in England had just happened to be judges, barristers and constables who experienced failed blood pressure control, but instead experienced increased erections, then Pfizer could have abandoned all the subsequent funding for research and brought Viagra straight to market! With apologies to my colleague, I jest of course.

However, I'm not sure I want lawyers and cops influencing which pharmaceuticals come to market, especially given the role that litigation has played in removing so many usable drugs from pharmacies.

In summary, the rush to use marijuana as a medical therapy seems to me an easy road fraught with peril. With the market already in place, and with so many people using the drug illegally, no retreat to scientific investigation for proof of efficacy and safety may be possible. This is not about medical science. This is pure politics.

Check out the original article here: http://www.greatfallstribune.com/article/20100302/LIFESTYLE/3020306
Reblog this post [with Zemanta]

No comments:

Post a Comment