Medical cannabis: Be informed and challenge the myths

Medical cannabis: Be informed and challenge the myths

Medical cannabis is a treatment option with a low risk of dependence, minimal side effects, and few detrimental health effects, that has the potential to help hundreds of thousands of people suffering from various debilitating symptoms. Medical cannabis has gotten a bad rap over the past several decades in the United States due to laws put into place in the early-mid 20th century based on false information, politics/economics, and racist factors.

However, acceptance for medical cannabis as a viable treatment for a variety of conditions and symptoms, and the number of calls for increased research, are growing.It is the responsibility of the medical community to not only be prepared for this change and properly informed on the issues, but also to demand such change as soon as possible, for the sake of our patients.

Cannabis has been used as medicine for thousands of years by various cultures, and was included in the U.S. Pharmacopeia as a medicinal substance until 1942. There are numerous health benefits of medical cannabis, and possible uses are as follows:

  • assists in decreasing nausea, vomiting, and pain, increases appetite, assists patients with insomnia, produces short-term reduction of intraocular eye pressure, has anti-anxiety properties, decreases spasticity, tremor, rigidity, and seizures, may assist in decreasing inflammation and treating cancerous growth
  • treatment of these symptoms is beneficial for patients with HIV/AIDS, multiple sclerosis, cancer, epileptic conditions, movement disorders (e.g. possibly useful for treating Parkinson’s disease symptoms, etc.), anorexia (the symptom, not anorexia nervosa which is a psychologically-based eating disorder), glaucoma, arthritis, PTSD, some gastrointestinal disorders such as Crohn’s disease, and more

Whole plant cannabis-based medicine (CBM) is necessary in order to receive full therapeutic benefits for some conditions, and this phenomenon is known as the “entourage effect.” Cannabinoids work on the endocannabinoid system and help to maintain homeostasis, assist in stabilization of nerve cells, can help to prevent inflammatory responses, and more.

Medications that have been formulated with components of medical cannabis (such as dronabinol or marinol) are inadequate for many conditions in comparison to the whole plant compound:

  • tetrahydrocannabinol (THCin the absence of other cannabinoids can be extremely anxiety-inducing
  • other cannabinoids in cannabis, such as cannabidiol (CBD) and cannabinol (CBN), produce many of the health benefits of medical cannabis
  • effects are felt much more slowly, and dosage is therefore more difficult to control for the patient, than in smoked or vaporized form

Unlike many other legal medications, cannabis has never resulted in a death from overdose, because it is a virtually impossible occurrence. However, cannabis does have the potential to exacerbate symptoms of underlying conditions, such as certain cardiac issues, so use is only recommended under supervision of a health care provider who understands the patient’s full medical history.

Contrary to some people’s beliefs, medical cannabis does not cause mental illness, and a recent study conducted at Harvard Medical School shows that cannabis use does not cause schizophrenia specifically. However, due to the possible exacerbation of psychotic mental illness that medical cannabis can cause, these studies do assist in identifying another reason why medical cannabis should only be used under prescription and supervision by a physician, who is aware of the patient’s full physical and mental health history.

Despite its comparatively clean record, cannabis is not a completely harmless plant. Some sensitive tests have shown that severe chronic use of cannabis can affect select functions of the brain negatively long-term, although others have shown no such long-term impairments or have shown that such impairments are reversible with abstinence. Smoking cannabis heavily and chronically over several years can cause damage to the lungs and a decrease in lung function.

However, a recent study found that at low to moderate levels of use, smoking cannabis does not result in a decrease in lung function. Chances of physical and psychological dependence are possible but very low, and withdrawal symptoms are minimal. Smoking burnt plant material can cause respiratory tract cell abnormalities, which may lead to cancer, although no evidence to date has shown a definitive link between cancer development and cannabis useWhile cannabis and tobacco smoke contain many of the same carcinogens, some research has suggested that nicotine in tobacco promotes these carcinogenic effects, while THC found in cannabis counteracts them. Additionally, measures can be taken to reduce the possible negative long-term impacts of medical cannabis use, such as avoidance of severe chronic use, use of vaporized medical cannabis, and use of oral delivery methods.

All medications have negative side effects, and according to the 1999 medical cannabis report produced by the Institute of Medicine (IOM), “For certain patients, such as the terminally ill or those with debilitating symptoms, the long-term risks [associated with smoking] are not of great concern … except for the harms associated with smoking, the adverse effects of marijuana use are within the range of effects tolerated for other medications.”

It is important, now more than ever, to research and utilize alternatives to dangerous prescription medications. Every day, approximately 100 Americans die from drug overdose. In 2008, the majority of these overdoses were caused by approved prescription medications. Medical cannabis is a safe treatment option to be used in concert with other medications in order to reduce the chance of dependence on and tolerance to medications with a high potential for dependence.

Millions of patients in the United States suffer unnecessarily every day from debilitating symptoms caused by disease due to the lack of support for research on medical cannabis and due to its state or federal illegal status. Become informed, understand the facts, and question and challenge the long-standing notions of medical cannabis. Notify your legislators of your support for medical cannabis legalization, Schedule modification, and increased research (find your local legislators’ contact information here).

Fight for the right to medicine. After all, this is a matter of patients, compassion, medicine, science, and quality of life improvement, not opinions, personal morals, religious ideals, taboo, or politics.

Thank you to Dr. Mitch Earleywine, PhD, who authored the main reference of this article and provided additional feedback, Dr. Sunil K. Aggarwal, MD, PhD, who provided feedback for the original version and this piece, editor Will Jaffee and editor-in-chief Ajay Major, who edited the original article on in-Training, and to Abbas Mulla, who also edited this piece.

Author’s note: The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to her medical school, in-Training, or any affiliated organization.

Arielle Gerard is a medical student.

Comments are moderated before they are published. Please read the comment policy.

  • RuralEMdoc

    Honestly, I hate the whole “medical” pot discussion.

    Yes it does have some indications for certain medical conditions, but it is hardly first line therapy for any of them.

    Can we call a spade a spade. When you smoke weed, you just sit on the couch playing video games for three hours before ordering a pizza.

    If you want to smoke weed, then smoke weed. I also think that Mary Jane should be a legal substance to those of a certain age, not a criminal offense, but please please please stop wasting time and resources trying to justify a recreational drug as a medical therapy.

    • DeceasedMD1

      but it’s certainly creative….
      Sorry for the sarcasm.

    • guest

      I so agree with this. Smoke pot if you want to smoke pot. But for Pete’s sake, stop trying to push it as some cure-all magic all natural organic super med. Just like gay marriage, let each state slowly legalize it until every state legalizes it and 50 years from now we wonder why on earth people had a problem with legal weed.

      • Arielle Gerard

        Medical cannabis is not a “cure-all, magic super med”. Medical cannabis advocates with a strong science background would never claim it to be so. I also do not equate “natural” or “organic” with “good medicine” in many cases. Cannabis is a plant which has been shown to be relatively safe, especially in comparison to many other commonly used treatments, with a low risk of dependence. Studies have shown its effectiveness for various symptoms, but it is by no means a panacea. Additionally, the issues surrounding medical and recreational cannabis legalization are quite different. For more information on some of the scientific evidence gathered on cannabis as medicine, please see the following: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358713/

  • SteveCaley

    Quickly – what do these diseases have in common?

    cancer; glaucoma; multiple sclerosis; damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity; epilepsy; positive status for human immunodeficiency virus or acquired immune deficiency syndrome; admission into hospice care in accordance with rules promulgated by the Department; or any other medical condition, medical treatment or disease as approved by the Department which results in pain, suffering or debility for which there is credible evidence that medical use cannabis could be of benefit.

    They are all legislatively-approved diagnoses for which medical cannabis can be used. There is no precedent for Treatment-By-Legislature; look for this to become a booming industry.

    • DeceasedMD1

      “There is no precedent for Treatment-By-Legislature; look for this to become a booming industry.”

      Seems like it already has. But all kidding aside. I see your point. It seems that the MIC (medical industrial complex) and gov’t legislatures will be the new physicians. Changing the subject a bit, even with the recent mass murders, the police are becoming the new “mental health” experts. (as you have heard on the news, the police made the determination of safety without involving family, treating psychiatrists, or even just looking at a youtube video that clearly showed he was a danger to others.) Sorry I digress….

  • SteveCaley

    This part of the argument is horrible:

    It is important, now more than ever, to research and utilize alternatives to dangerous prescription medications. Every day, approximately 100 Americans die from drug overdose.
    In 2008, the majority of these overdoses were caused by approved prescription medications. Medical cannabis is a safe treatment option to be used in concert with other medications in order to reduce the chance of dependence on and tolerance to medications with a high potential for dependence.

    IS cannabis a legitimate substitute for narcotic analgesia? NO.
    IS it a safer alternative than abusing prescription narcotics? YES.
    Do people die from accidental overdose ingestion of prescription narcotics? YES.
    Do people die from accidental overdose ingestion of digitalis? Not a heck of a lot.
    Our goal is not to make getting high from prescriptions even safer, now, is it? I hope not.
    Is our drug industry to set the goal for the next 10 years of creating THE NEW SOMA (see Brave New World)? Honestly, yeah, I think so. Party on.

    • Arielle Gerard

      Thank you for commenting.

      I do not claim or believe that medical cannabis is a “substitute” for narcotic analgesia. While whole-plant medical cannabis and isolated cannabinoids may be used as stand-alone treatment in some cases, using them as adjunct therapies is also beneficial (especially in cases of chronic pain) in order to reduce tolerance to and amount needed of other medications which have a high abuse potential and are toxic.

      I do not think or suggest that we should make “getting high from prescriptions even safer”. I am saying that our patients are dying in the thousands due to medications that are supposed to heal them, and we need to do our best to minimize our prescription and patient use of these medications by looking for other alternatives.

      The fact that death by medical cannabis usage is virtually impossible (along with consideration of its benefits) is an important one that should be strongly considered by medical professionals.

  • Arielle Gerard

    Thank you for your comment; you bring up some very important points. I appreciate your concern regarding bias. This article does indeed entail inherent bias due to the fact that I am a proponent of the study of medical cannabis and its medical legalization, with use under supervision by a medical professional. I do my best to minimize this bias by bringing attention to the negative aspects of cannabis use, as well. These points have indeed been made before; I do not claim novelty. This is why I have so many annotations in the article and discuss a main reference. Medical cannabis is infrequently discussed in the medical community, and my goal is merely to spread information and stimulate conversation, in an attempt to have physicians and other healthcare professionals begin to look at this plant from an objective stance.

    Using medical cannabis in inhaled form provides a swifter delivery method than oromucosal administration. Oromucosal administration provides effects more rapidly than medications which require the swallowing of a pill. When we know the potency of cannabis and typical inhalation volume based on the patient and device used, dosage of inhaled cannabis can be well-estimated.

    I do not claim that smoking is an optimal delivery method for some patients, but inhaled forms are a good option for those who need quick results (e.g. people who need to quickly dampen their symptoms before they become a larger problem– for example, patients experiencing the beginnings of neuropathic pain or spasticity early on in the day). Vaporization is the current ideal for patients who would benefit from an inhaled method of delivery, but cost of efficient vaporization devices can be a limiting factor in their procurement. As we continue to research medical cannabis, even safer inhalation methods will likely be developed. I promote the use of the best method of delivery as determined by the medical professional recommending the use of medical cannabis. If a provider is not comfortable recommending smoking as a method of delivery, then they shouldn’t. But it should be an option, and a choice made at the discretion of the provider. If we can trust our providers to prescribe dangerous medications when medically necessary, we should trust their judgment in this case, as well.

    Length of duration of effects is indeed an important issue. Duration of effects varies between patients– using an inhalation delivery method, some patients only need to medicate one or two times a day. For conditions such as glaucoma, effects do only last a few hours, which is why (along with the existence of other safe treatments for glaucoma) medical cannabis may not be an optimal therapy for this condition. Ingested medical cannabis does indeed have effects of longer duration, but as mentioned, inhalation delivery methods have their own benefits, as well. Ingested forms of medical cannabis are optimal for many patients. However, smoking should remain an option, although it is not the optimal method of delivery for some patients. Increased research on medical cannabis, which will be expedited by the reclassification of medical cannabis out of the Schedule I category, will help to make ingested forms of medical cannabis more readily available for patients.

    Regarding the lack of a definitive link between cancer and cannabis use, please see this study by Hashibe et al. http://www.ncbi.nlm.nih.gov/pubmed/17035389. While it is of course ethically and morally unfeasible to study the definitive link between smoked cannabis use and cancer risk in the human population, this study highlights a major difference we see between cannabis use and cancer development vs. tobacco/nicotine use and cancer development. There is some evidence to suggest that THC may have provide protective effects against cancerous growth. More research is needed in order to gain more information on this topic. In order to minimize harmful effects of medical cannabis use, inhalation as a method of delivery should only be used when particularly beneficial over ingested forms.

    Regarding medical cannabis and mental health, I was not able to report fully on this topic here due to space limitations. In the original article I wrote, I also included the following. “Due to the fact that some cannabis users with mental disorders such as depression or psychotic mental disorders choose to self-medicate with cannabis, and to the fact that certain psychotic illnesses may be exacerbated by cannabis use, results of [studies using recreational users as participants] which supposedly support the fact that medical cannabis causes psychotic disorders and schizophrenia have severe confounding variables. Therefore, they do not provide valid evidence that cannabis causes psychotic symptoms in patients… My note that “… due to the possible exacerbation of psychotic mental illness that medical cannabis can cause, these
    studies do assist in identifying another reason why medical cannabis should only be used under prescription and supervision by a physician, who is aware of the patient’s full physical and mental health history” is an important one that I encourage providers to consider. For the full original Part 2 of the article, please see: http://in-training.org/medical-cannabis-matter-patients-politics-part-23-6151.

    Thank you again for your comment.

    • justin70

      I think you can support a side without being biased. The article includes cherry picked studies and dismisses conflicting research. Maybe there isn’t enough room to include everything. At the end of the day, however, your article would more appropriately conclude we don’t know enough about cannabis’ effects on psychosis or cancer to say one way or the other. Anything else is pandering to the pro-cannabis base.

      Did you really link to a huffington post article to refute the stats about cannabis dependence?? The article isn’t a good resource for this; the article basically says we don’t know what the stats are but they’re “likely” less than we think (then it gives someone’s opinion about why the rate is less than we think…it’s not backed up by anything else); it does not say the rate of cannabis dependence is low. http://www.huffingtonpost.com/sunil-kumar-aggarwal/cannabis-depedency-drug-war-bad-science_b_4675961.html

      These kinds of pseudo references are placed into articles like this to give the appearance of legitimacy, but when you follow them, it’s clear the author is digging for anything to support the thesis, no matter the quality.

      • Arielle Gerard

        I think it would be fairly difficult to hold a certain viewpoint strongly and be completely without bias; we’re all human, after all. The minute someone knows that I am a self-proclaimed medical cannabis advocate, that will automatically lead them to assuming bias, anyway. If I am forthright with this information (although I needn’t be explicitly, given the article), it keeps the conversation honest and hopefully (at least partially) removes the negative impact of said bias from objective consideration of the topic.

        Additionally, the bias only matters if I’m claiming something that is incorrect or I am intentionally leaving important parts of the discussion out which disprove my stance (if you have a specific element that you would like me to address, I would be happy to do so). I am working towards medical cannabis legalization, reclassification, and a research increase on medical cannabis in the U.S. People have heard plenty of information in opposition to medical cannabis legalization, and I present the other side and work to dispel the myths.

        I think it’s extremely important to look at the valid positive AND negative effects of medical cannabis (I would not be a student of medicine/science if I thought otherwise), and to also keep all of the data we collect in context. And you are correct, it is not possible to discuss the entire breadth of knowledge on the subject in a blog post.

        The article to which I linked provides a very clear and well-argued explanation for why the “9.1%” statistic is not accurate, and is likely overestimated. As you will see in the article, the tool of the time used to measure dependence was not valid, which therefore significantly biased the percentages. Consequently, based on the points presented, it is reasonable to assume that cannabis dependence was overestimated at the time that the 9.1% statistic was measured. There are always degrees of uncertainty and lack of sureties in the world of science, which is why words such as “likely” are used. Another reason why the word “likely” was used in this case is that we haven’t measured dependence issues in a similar fashion with less biased measures in recent years, and cannot claim certainty. However, again, this article presents a strong argument in favor of overestimation.

        Also, an article’s publication on the Huffington Post does not necessarily imply a lack of reputability. If an article contains valid information, sound arguments, and proper annotation, that is what matters.

        For the full, original article which discussed medical cannabis in more detail, please see: http://in-training.org/author/arielle-gerard

  • ninguem

    And here’s a prescription pad for “medicinal” alcohol during Prohibition years.

    http://rosemelnickmuseum.wordpress.com/2010/04/07/medicinal-alcohol-and-prohibition/

    When alcohol was prohibited, there was a flurry of interest in “medicinal alcohol”. It was the same panacea this medical student claims marijuana to be.

    The interest in the medical properties of alcohol vanished…….instantly……with the repeal of Prohibition.

    We will see the same with marijuana. Its medical benefit is microscopic, although greater than zero.

    There should be interest in teasing out the individual cannabinoids for medicinal properties. There will be very, very little interest in that amongst the marijuana advocates, as their interest is in getting high, not symptom relief.

    Nothing wrong with getting high, just don’t insult my intelligence and say there’s a medical reason for it, and sure as heck don’t make me sign off on it.

    • Arielle Gerard

      Thank you for your comment.

      I reference the history of cannabis as medicine for illustrative purposes, not as scientific evidence for the medicinal properties of cannabis.

      Thank you for sharing this history. From the link you provided, I see no reference to actual studies which were ever done that showed that alcohol could be used for the myriad of symptoms for which it was used. It seems that the medicinal use of alcohol was purely based on “beliefs”. If you examine studies conducted on medical cannabis, you will see that evidence for the medicinal use of cannabis is based on science (including double-blinded, placebo-controlled, randomized trials), and not on “beliefs”.

      Legitimate medical cannabis advocates STRONGLY support the study of isolated cannabinoids, along with the study of whole-plant cannabis. I refer you to the American Academy of Cannabinoid Medicine: http://aacmsite.org/ . According to the website: “The AACM is a clinical medicine, scientific association. Its members are clinicians and researchers active in the field of endogenous, plant-derived and synthetic cannabinoids and those who support the medical use of cannabinoids. The American Academy of Cannabinoid Medicine is the gold standard for the education and dissemination of clinically relevant information in the emerging field of cannabinoid and endocannabinoid medicine.” Your statement that “there will be very, very little interest in [teasing out the individual cannabinoids for medicinal properties] amongst the marijuana advocates, as their interest is in getting high, not symptom relief” is merely speculative and is unfounded.

      I am a proponent of the use of high THC strains/varietals when necessary, of dronabinol when proven to be more efficacious than whole-plant cannabis and when THC is the necessary cannabinoid for treatment, of low THC/high CBD cannabis (i.e. a strain of cannabis that produces few to no psychoactive effects), and of other varietals and forms, when deemed to be beneficial.

      There is also a difference between “cannabis advocates” and “medical cannabis advocates”. The issues entailing each type of legalization are quite different. I have not educated myself fully on the issues surrounding full cannabis legalization because full legalization is not my personal goal as a future physician.

      It is not my goal as a future physician to get my patients “high”. If my goal was the recreational legalization of medical cannabis, I assure you, that is what I would write about. I take my duty as a future physician very seriously– to attempt to secure full cannabis legalization under the guise of promoting cannabis as medicine would be a major violation of the oath which I took and have vowed to uphold. Will some patients become intoxicated using cannabis with high levels of THC? Yes. But the same can be said for other commonly used medications, which are more dangerous. And if higher levels of THC safely help to reduce their unpleasant symptoms with minimal detrimental side effects, that is a medical success. If medical cannabis can be used as an adjunct therapy to reduce the amount of opiates we need to give our patients, that is a medical success. And there is evidence that non-psychoactive forms of medical cannabis may be hugely beneficial for many patients; I want these forms of cannabis to be researched and available for patients, as well. Once medical cannabis is legalized and research is allowed to increase on a federal level (i.e. the Schedule is changed), I consider my personal work largely complete.

      If medical cannabis is legal in your state and you don’t wish to prescribe it, that is your prerogative. No one is forcing providers to recommend medical cannabis– it is an option that should be researched and considered objectively, as any other substance or medication.

      I promote the reclassification of medical cannabis out of the Schedule I category in order to allow increase in the ease of research on medical cannabis in the United States. However, this will likely take some time to happen. In the meantime, patients who could benefit from the use of medical cannabis should not have to continue to suffer unnecessarily. That is why I promote immediate medical legalization for this medication which has a low risk of dependence, minimal detrimental health effects, and a low side-effect profile.

      Thank you again for your comment.

      • ninguem

        Did you ever read “The Great Gatsby”?

        How did Jay Gatsby make his fortune?

  • ninguem

    Actually, I would have great respect for someone who actually cared about investigating the medical use of marijuana.

    Someone who actually researched the evidence.

    Someone who would actually see and examine a patient.

    Someone who would provide a cogent, evidence-based medical rationale for the marijuana.

    Which would imply that, from time to time, that same doctor would find a patient who would NOT be helped by marijuana, or may be contraindicated, and would recommend AGAINST the treatment.

    Someone who recommends the marijuana, and actually follows the patient. To see if the marijuana is actually helping.

    A doctor who documents HOW it’s helping, the particular symptoms relieved, the improvement in glaucoma or nausea or pain, etc.

    A doctor who recommends that the marijuana be continued, for cogent medical reasons.

    That would also imply that, from time to time, that same doctor would find the marijuana is NOT helping, and recommends it be stopped.

    A doctor who feels that marijuana should be titrated like any other drug.

    In decades of practice, I have yet to meet such a doctor.

    I have to imagine such a doctor exists, but I have yet to meet one.

    Invariably……and I have yet to see an exception……they take the patient’s money, they sign an authorization, they never decline to sign an authorization, they NEVER see the patient again, except to renew the authorization, and they leave doctors like me to clean up the mess.

    • Arielle Gerard

      I greatly appreciate your view that cannabinoid medicine should be considered valid when approached scientifically, which it has been (and will continue to be in the U.S. if medical cannabis is rescheduled out of the Schedule I category). Medical cannabis advocates and medical professionals and scientists who support medical cannabis use WANT valid data. When medical cannabis doesn’t work, we don’t want it used. When it does work, we want it to be available. Valid scientific inquiry is as appreciated by medical professionals and scientists who support cannabinoid medicine as anyone else.

      The system which you discuss here appears to be similar to that of California. The California system is not one which is well-regulated, and is not one which I promote. The system that I would support is more along the lines of that which would be allowed in New York if the Compassionate Care Act (CCA) is passed this session. Please see the summary of the CCA here:

      http://www.compassionatecareny.org/wp-content/uploads/MMJ-bill-summary-7.8.131.pdf?092a61

      A few amendments have been made since the above link was published– the Senate version of the bill (S4406B) would only allow smoking as a delivery method for patients aged 21+, limits the amount of medical cannabis one can possess in a 30-day period to 2.5 ounces, and limits the conditions for which medical cannabis could be recommended. Please see the updated list here:

      http://open.nysenate.gov/legislation/bill/S4406B-2013

      The Compassionate Care Act would require use of I-STOP (Internet System for Tracking Over-Prescribing), which has reduced “doctor shopping” by 75%. “Since implementation of the new system [in New York]– Internet System for Tracking Over-Prescribing… the incidence of patients visiting multiple physicians to obtain controlled-substance medications has dropped dramatically.” (Journal of Medical Regulation, Volume 100, Number 1, 2014, pgs 27-28).

      As shared in my comment to you below, I refer you to the American Academy of Cannabinoid Medicine: http://aacmsite.org/. According to the website: “The AACM is a clinical medicine, scientific association. Its members are clinicians and researchers active in the field of endogenous, plant-derived and synthetic cannabinoids and those who support the medical use of cannabinoids. The American Academy of Cannabinoid Medicine is the gold standard for the education and dissemination of clinically relevant information in the emerging field of cannabinoid and endocannabinoid medicine.”

      Also mentioned by me in my comment to you below, and here reiterated: I promote the reclassification of medical cannabis out of the Schedule I category in order to allow increase in the ease of research on medical cannabis in the United States. However, this will likely take some time to happen. In the meantime, patients who could benefit from the use of medical cannabis should not have to continue to suffer unnecessarily. That is why I promote immediate medical legalization for this medication which has a low risk of dependence, minimal detrimental health effects, and a low side-effect profile.”

      Thank you for maintaining objectivity in your consideration of cannabis as medicine.

      • ninguem

        I could have lived my whole life a happy man without knowing that there is a “Journal of Medical Regulation”.

        I am only mildly surprised.

        • Arielle Gerard

          It’s certainly more interesting than I thought it would be– I’d actually recommend it!

          • ninguem

            I’d think that anatomy and physiology would be of more interest to a medical student, but that’s just me.

          • Arielle Gerard

            While anatomy and physiology provide the basis for a physician’s diagnostic work, their mastery alone does not foster the versatility necessary to succeed and effectively provide care in the field of “real world” medicine. I would hope that physicians would encourage medical students to look beyond their classroom work occasionally, in order that students may avoid missing the forest for the trees.

  • ninguem

    I found a cure for rickets and osteoporosis that’s being suppressed by the evil greedy capitalistic medical profession.

    https://scontent-b-sea.xx.fbcdn.net/hphotos-xpa1/t1.0-9/10349942_10204057485136938_6434823166228236015_n.jpg

  • A sick patient

    I thought this article was wonderful. I have been a patient and activist for over 14 years. It has worked wonders for me and helped me get off a more dangerous medication, oxicontin. I now have a much better quality of life. To me this is the most important part. When talking about oral as opposed to smoking it, (I use a vaporizer, is that when you are throwing up, its almost impossible to take a pill and wait about 20 minutes for it to work whereas inhaling it gives instant relief. I use cannabis as I need it for pain. I may not have to use it everyday. Here in California there are doctors who will give a recommendation to anyone, but in the same sense there are good doctors who do require and keep medical records and do follow up on patients, I have one of those doctors. From 1942 the government has been putting out propaganda regarding cannabis. Many of the studies done over the years have been bias as permission for studies have to go through the DEA for approval to use cannabis. My hopes are soon, cannabis will be able to be studied without the bias of a government who has lied to us about this for so long. Thank you for a hopeful article.

    • Arielle Gerard

      Thank you for sharing your story; I am so glad that you have been able to find relief using medical cannabis. Thank you for your groundwork in medical cannabis activism over the past several years, as well. Obviously, we wouldn’t be where we are today without activists and patient advocates like you.

      Also, thank you for bringing up another very important point for why patients need the option of an inhaled delivery method that has rapid results.

      I’m glad to hear that there are physicians in California who do prescribe medical cannabis responsibly and follow-up. This is especially important for patients on several medications and those with serious conditions.

      I hope that you continue to share your story with your legislators and people you know; I have been taught, and subsequently learned, that it is stories from patients that get these laws changed.

      If you’d like to read the full, original article, you can find it here: http://in-training.org/author/arielle-gerard

      Thank you for your comment, activism, and support.

  • SteveCaley

    Nope – isn’t that so….so 1984?

  • Arielle Gerard

    “STUDIES ON ORAL PREPARATIONS

    Oral preparations are available as synthetic THC… and a synthetic analog of THC… Absorption from the gut is slower and exhibits a delayed peak plasma concentration compared to smoking with bioavailability ranging from about 5-20% of dose; peak concentrations occur 1-6 hours after ingestion, with a magnitude approximately 10% of that achieved with smoking.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358713/