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Medical marijuana: Where’s clinical proof?

By on February 26, 2019 in Columnist with 2 Comments
Jim Brown

By Jim Brown, M.D.

There is a lot of hype these days about so-called medical marijuana. 

Currently, half of our states have legalized medical marijuana in some form. Undoubtedly, one reason is it is extremely profitable for the suppliers, and there are tax benefits for the states as well. 

In Arizona alone, it is estimated that the sale of medical pot increased 42 percent last year at a cost of $400 million dollars in revenue. 

In Arizona the medical marijuana sales are subject to the state’s 5.6 percent sales tax, which brought in about $22.3 million of revenue. 

On top of that, city and county taxes ranging from 0.25 percent to 4 percent brought in more. What politician would say no to tax revenues like that? 

Medical marijuana states experience a wide spectrum of wholesale prices for medical marijuana flower due to supply and demand.

Medical marijuana is made  from the cannabis flower. In 2014, in Colorado a wholesale pound of indoor grown marijuana flower was selling for $4,000 per pound.  In the past year it has been selling for $900-$1,300 depending on quality. 

In New Mexico it is selling for $2,800-$3,000, up from $2,200 last year. Due to supply in Arizona the price has fallen from $1,500-$2,600 to $900-$2,000  a pound of cannabis flower. 

These are wholesale prices. I have no idea what the cost is retail or how much is it sold for per ounce now days since that is not readily available. 

It just seems to me this is a hefty price to pay for something not proven to be of medical value.

Many physicians, including myself, are skeptical of the claims made for medical marijuana since it has not undergone the same kind of clinical trials modern pharmaceutical medicines are required to do for the safety of the patients. 

There are a lot of anecdotal claims about the benefits to taking medical marijuana. Many claim it reduces anxiety, chronic pain, inflammation, arthritis pain and more. 

You may wonder why so little research has been done on medical marijuana. 

For one thing, the U.S. Drug Enforcement Administration (DEA) considers marijuana to be a schedule 1 drug, the same as heroin, LSD and Ecstasy and likely to be abused and lacking in medical value. Researchers need a special license to even study its safety.

Medical marijuana uses the marijuana plant chemicals to treat a variety of conditions. The marijuana plant contains more than 100 different chemicals called cannabinoids. Each one has a different affect on the body. 

THC or tetrahydrocannabinol produces the “high” people feel if they smoke it or eat foods containing it. 

Cannabidiol (CBD) is the non-psychoactive component that is used in many so-called medical marijuana products. The FDA has approved a drug, Epidcolex, made from CBD as therapy for severe seizures. The FDA has also approved two man-made drugs comprised of CBD to treat nausea and vomiting related to chemotherapy. 

A concern of physicians is the FDA generally doesn’t oversee marijuana medications like it does prescription medicine. The strength of and the ingredients put into medical marijuana can differ widely depending on where it is bought or produced. 

A study of medical marijuana sold as brownies or lollipops in California and Washington showed they contained much less marijuana than they claimed to contain.

Hemp oil, a cannabinoid extract of the marijuana plant, supposedly contains no psychoactive effects. Hemp and hemp derived extracts are considered food-based products. They are not sold as drugs in the U.S. and are legal across the nation. 

The sellers of hemp oil, at least in Arizona, claim that it “provides relief from a wide variety of symptoms — soothing discomfort, promoting healthy living, improving mood and much more.” 

The suppliers say the claim is backed up by clinical trials but never mention when or where these trials took place. I am sorry, but I am a skeptic of unsubstantiated claims like this. 

There are a lot of things that are legal in our world but not necessarily healthy or medically beneficial, including alcohol and cigarettes that cause millions of deaths annually in our country. 

I don’t necessarily put medical marijuana in that category, but I would advise caution in believing the hyped claims that the suppliers of these products make. 

They may not be harmful, but they can be very expensive considering there is little proof of their efficacy. 

Jim Brown, M.D., is a retired gastroenterologist who has practiced for 38 years in the Wenatchee area. He is a former CEO of the Wenatchee Valley Medical Center.

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There Are 2 Brilliant Comments

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  1. James S Russell says:

    Thanks, Jiim. It’s helpful to get information and reminders abut marijuana and the way it’s being sold. We need to patiently keep monitoring how to regulate these new product thriving on unsubstantiated claims.

  2. Gary Thomas says:

    Hi Jim,
    I appreciate your opinion in this area, and I share your skepticism about unregulated cannabis products and the rampant, unsubstantiated claims about commercial CBD products.

    However, I feel like the article was not really a balanced assessment of potential cannabis usage in clinical practice. First, while it is acceptable for lay people to use the slang term “marijuana,” health care professionals are moving away from that derogatory term in favor of using the genus name cannabis, which has significantly less baggage.

    Second, I am not sure why you state that, “little research has been done on medical marijuana.” While it is true that search results for research on “marijuana” may be limited because it is a slang term, a Google Scholar search on cannabidiol returns 32,200 results.

    Third, there is no discussion about the endocannabinoid system in the body, which is the basis of potential therapeutic interventions by medical professionals. This deprives the reader of understanding that there is an actual basis for efficacious medical usage of standardized, controlled cannabis interventions. A Google Scholar search on this term generates 50,900 results.

    In summary, I certainly respect your right to publish an opinion piece. However, if you are going to write a piece concerning “clinical proof,” I think you would agree that the resulting article needs to measure up to a more objective standard than just your clearly biased opinion.

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