28 March 2017

Mary Jane the Pharmaceutical Rep

The Background: In the United States, the production, sale, possession, and use of marijuana is illegal.

But certain states have legalized marijuana for medicinal or even recreational purposes.

Yes, but no, technically they did not, and cannot do that. The legal breakdown of the United States says that in the event of a contradiction between state and federal law, federal law takes priority. Thus, all technicalities aside, marijuana is illegal throughout all of the United States, period.

The Controversy: But why? Marijuana is safe and has been shown to have medicinal uses.

The Typical Options:
A.    Keep it illegal (I mean just think of the children)
B.    Legalize it for medicinal uses only (because that will stop people from abusing it)
C.    Legalize it for any use but with restrictions (so you admit it’s not harmless)
D.    Legalize it without restriction (What could possibly go wrong)

My Thoughts:
E.    Option C but not B with additional provision F that makes it illegal to smoke

This is why I hate dichotomies. Okay, let’s break it down.

            First, on the spectrum of libertarian to authoritarian, I would fall more on the libertarian side, but I find myself walking a thin line between, “you can’t tell me what to do” and “please tell that person that they simply cannot do that,” particularly when the thing that they are doing could kill me. Example, gun control (much more on this topic later). The argument for lax gun control is that it infringes on personal freedoms, such as the right to own and use a gun. The argument for stricter gun control is that it presents a very real threat to human lives, as guns can be used (very easily) to kill other humans, and we as a society are pretty much in agreement at this point, that killing is bad. We must then decide which is more important, the right to own the gun, or the protection of humans from that gun owner. In light of this, my views tend to come out on the “do whatever you want as long as it doesn’t endanger me in any way” side.
            How does any of this relate to marijuana? It is actually a very similar issue, at least in my mind. Let us default to the “does this endanger me?” question. Despite the propaganda of days past, marijuana does not typically promote violent behavior in the way that some other illicit substances have been known to do. However, there is a wealth of evidence that second hand smoke can kill you. You can probably see where I am going with this, but I will spell it out for you none the less (is there really any other way to communicate through writing?).
I have long felt that smoking should be illegalized, and I do not just mean tobacco cigarettes. The entire act should be banned. There is a very real danger that comes with exhaling smoke into your surroundings, and despite what some marijuana advocates might tell you, smoking marijuana is just as bad as tobacco, or even green tea leaves for that matter. It is not the substance but the chemical products of the combustion process that are harmful when inhaled, so there is really no getting around it.
The reason that some view marijuana in such a better light than tobacco likely stems from the anti-tobacco initiatives that most everyone of the past generation was subjected to in school. Opponents of tobacco have done a wonderful job of educating people about the dangers of tobacco smoking, but have created a kind of stigma, that big tobacco companies have taken the innocent tobacco cigarette and made it harmful on our lungs through injecting deadly toxins into the product. The reality is that manufactured cigarettes are probably better for your lungs than a hand rolled cigarette, due to the inclusion of filters. So, in summary, let them have their marijuana and eat it too, just don’t smoke it.
What about the children though? Okay, another hard truth but hear me out, marijuana is a drug. Some will argue against this, but anyone who is not completely ignorant will recognize that the definition of a drug is pretty far reaching, and includes such substances as caffeine, nicotine, ethanol, and, yes, even components of the marijuana plant. So, should there be restrictions on who can and cannot purchase marijuana in this crazy hypothetical world where it is legal for purchase? Yes, yes, a million times yes. Just like how children should not be drinking alcoholic beverages or smoking tobacco cigarettes, the use of marijuana would very likely affect their development.
Marijuana has very real effects, both short and long term, and children are simply not mature enough to make an informed decision about the risks versus benefits of using such a product.
This brings us to why I oppose medicinal marijuana. Marijuana has shown some promise as a medicinal product, however, we are simply too naïve at present to utilize it in my opinion.  When a new drug product is seeking approval from the FDA it must undergo rigorous trials to be proven both safe and effective. Marijuana, however, is still illegal, as previously stated, and is therefore not FDA approved for any use, or even under consideration for approval at current.
Let’s break it down further. The simplest idea is giving patients the ability to purchase crude marijuana, that is the plant itself. This is just plain barbaric. Imagine a scenario, if you would, wherein a patient complains to their physician of a headache, and are subsequently instructed to go purchase a small amount of willow bark and chew upon it until their pain subsides. Imagine now that this patient is you and brainstorm for a minute all of the accusations you would make against said quack physician. With your head throbbing from the 10 minutes of straight screaming at this doctor, take a few minutes to calm down and chew on some willow bark. What’s this? It actually works. Who knew. Well, the ancient Greeks for one. You see, natural chemicals found within willow bark have analgesic properties, but these chemicals have since been isolate, refined, and purified. Now we produce a synthetic, pure, optimized product known as aspirin.
This is how modern medicine works. We take crude remedies and we optimize them. News reports of pharmaceutical companies looking to traditional eastern medicines for new remedies has created this idea that maybe botanical products can be superior to our “synthetic drugs.” But make no mistake, those companies are not looking for a botanical product. They are looking for lead chemical compounds, from which they can derive new synthetic drugs.
Okay, so let’s take marijuana and make a new drug containing its active constituents. Yes, I am on board. Cannabidiol, in particular has shown great promise in being used medicinally, and with much fewer side effects than the psychoactive component THC (sorry stoners). But let us not forget to test it. Again, research to date is limited. It is still illegal after all, and studies on illicit substances can prove quite challenging to get approved. However, if a purified product based on active components from marijuana is produced, subjected to clinical trials, approved by the FDA, and put on the market, then I am all for physicians prescribing it and pharmacies providing it. But until, that time comes, maybe leave the marijuana to the recreational users, and let the afflicted use clinically proven products for their ailments.

-AMS

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