The US Supreme Court recently "just said no" to marijuana becoming a legally prescribed drug in our country. This is a topic that has always intrigued me, since I personally believe that legitimate patients should be able to access bona fide medication for their problems, if it is in their best interest medically and no current drug exists to ease their pain and suffering.
Of course, the question with marijuana is whether or not the motive behind those that are singing the praises of its medicinal value is to ultimately allow it to become more easily available for their own personal desire to "get high." There have been many legitimate patients, however, that claim that smoking cannabis increases their appetites or relieves their pain.
Throughout my 37-plus years in law enforcement, I have felt that marijuana may be the most underestimated drug of addiction. There is no question it is the most abused controlled substance that exists, with prescription drugs in a distant second place. It has a lasting residual effect in the human body, and will show up on urine screens weeks, and even months, after its use in the heaviest of abusers.
I have seen many examples of people addicted to marijuana, not just casual users. One recent experience my task force had was with a married couple who was growing marijuana outdoors on their farmseveral pounds of it every year. Although they both held down good jobs, they told my investigators that they smoke marijuana literally from the time they get home every day until they go to bed usually a 6-to 7-hour stintand this was a 365-day-a-year occurrence.
I also have made it a point to query the many health professionals I have had the pleasure of meeting over the years about their opinion of the legitimacy of marijuana as a potential prescription drug. Marinol (dronabinol) is cited by many of these unofficial survey-takers as a superior substitute for the actual plant. They also mentioned the fact that they could never approve of a drug that you must inhale as potentially deadly smoke into your lungs. The vast majority of health professionals I have spoken to about this issue are decidedly against legalizing marijuana for medical purposes.
One dissenting professional response was from a physician who said he was not concerned about the smoking issue, since the patients he would prescribe marijuana for were terminal anyway, and were not going to die due to the complications of smoking. Besides, he added, people could consume the hallucinogen by baking it in brownies, without inhaling the dangerous smoke. Another opinion from a pain management physician was that many of these current medical marijuana users were patients who were not receiving proper pain relief that could be accomplished through adequate prescription pain medication.
One thing that has been decided for now is that marijuana will not become a legal substance any time soon. State laws allowing for marijuana use cannot override federal law, making their local legislations null and void. This is a blow for the many people who want to smoke marijuana just to get high, and for those who legitimately feel that marijuana is the only substance that can make their illness bearable.
Although the debate rages on with the pros and cons of marijuana use for medical purposes, pharmacists will not have to deal with the potential abuse issue of dispensing it to patients. Meanwhile, I plan to continue exploring this issue through my unofficial survey of health professionals and patients, and I am always interested in other professional opinions as well.
John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement. For information, he can be reached by e-mail at firstname.lastname@example.org, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.
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