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Health: Marijuana Goes Mainstream


Posted on November 7

Despite controversy, an increasing number of local patients are turning to medical marijuana.


It’s been 15 years since California voters passed Proposition 215, the Compassionate Use Act that gives patients with a doctor’s recommendation the right to use marijuana for medical purposes. Today, a growing number of Sacramentans are exercising those rights by legally carrying a medical marijuana card, and cannabis dispensaries are spreading like you know what.
 
It’s here, folks—and in a big way. Yet mainstream medicine doesn’t seem to want to talk about it.
 
That was my experience, anyway. As a medical journalist for this magazine for seven years, I have never had trouble finding experts to interview. 
 
This time was different. 
 
After contacting media reps at the Big  Four—Sutter, Kaiser Permanente, UC Davis and CHW/Mercy—only UCD was able to summon up an interviewee. CHW/Mercy and Sutter couldn’t help. Kaiser rep Katie Minke responded via e-mail, stating that while Kaiser physicians may recommend medical marijuana to patients “if felt to be clinically appropriate and beneficial,” the few she spoke with suggested the topic did not come up often enough in their practices for them to feel “expert” discussing it with a reporter.
 
Doctor-Researchers Speak Out
Thankfully, one local doctor, UCD’s Barth Wilsey, M.D., was more than willing to talk. Trained in both anesthesiology and neurology pain management, Wilsey has been at the forefront of researching cannabis’s use for patients with neuropathic pain (nerve damage), just one of a long list of conditions (AIDS, cancer and glaucoma, to name a few) whose symptoms may be relieved by marijuana. “Neuropathic pain is somewhat harder to treat than surgical pain, and many patients don’t receive adequate treatment,” says Wilsey. Those patients, he suggests, may be candidates for cannabis, and he’s got the science to prove it. In a double-blind, placebo-controlled trial of the effect of medicinal marijuana on patients with nerve injury pain of diverse causes, Wilsey and his research team found that cannabis provided a painkilling effect.
 
That was the predictable part. What took the researchers by surprise was this finding: Low-dose marijuana (3.5 percent delta-9-THC) was as effective as a higher dose (7 percent delta-9-THC) in alleviating nerve injury pain. (THC is the cannabinoid thought to be most potent in marijuana.)
 
This was an unexpected boon, says Wilsey, who advocates for the responsible use of the herb, and only for medical purposes. “Our goal is to find the lowest strength possible that’s effective,” he says. “We don’t want individuals to divert this for recreational use. We want this to be used as a medicine.” Lower doses are preferable: The study found that while lower-dose cannabis did not impair patients’ ability to think, other than some minor problems with memory, higher doses resulted in problems with memory, ability to pay attention and motor control. (Additional studies are under way at UCD Research Center to confirm these findings.)
 
But such side effects are nothing, argue advocates, compared to the damage that can be done by some of the potentially addictive medications commonly prescribed for patients who might otherwise be helped by marijuana.
 
“I’m aware of deaths from opioids (prescription painkillers), but I’m not aware of deaths from marijuana,” says Wilsey. “When kept out of the hands of young people and those with certain psychotropic disorders, this herbal medicine is rather safe.”
 
 
 
Cancer: Cause for Concern?
But there is one safety issue that keeps rearing its head: the smoking thing. The logic is simple: If cigarette smoking causes cancer, wouldn’t smoking marijuana carry the same risk? Makes sense, but it hasn’t yet been proved. While it is widely agreed that marijuana contains cancer-causing carcinogens, research findings have been inconsistent, and recent studies have not shown a substantial risk of cancer, according to the American Cancer Society website, cancer.org. 
 
“We’re not sure that cannabis necessarily causes lung cancer in and of itself,” says Wilsey.  “But I’m not advocating that anybody smoke anything. If there are other ways of delivering cannabis, that should be sought.” Wilsey’s studies have taken this variable into account, using marijuana cigarettes in one study and vaporized cannabis in another.
 
Is vaporization an effective delivery system? Recent research suggests it is. When noted cannabis researcher Donald Abrams, M.D., and his team at UC San Francisco studied vaporization as a “smokeless” delivery system, they found it as effective in delivering THC to the bloodstream as cannabis cigarettes. Participants reported they preferred vaporization to smoking by a long shot—a 14 to 2 margin.
 
For Abrams, who has long worked with cancer and HIV/AIDS patients and is the chief of hematology and oncology at San Francisco General Hospital, marijuana’s medicinal use just makes sense.
 
“Every day I’m recommending cannabis to patients with cancer,” he says. “I see patients all the time who have nausea, pain, loss of appetite, depression and insomnia. I have one medicine I can recommend.”
 
Which conditions qualify?
Wondering whether your medical condition qualifies you for a card? It’s not just for patients with AIDS, cancer or glaucoma: People with migraines, arthritis, anorexia and any other severely limiting condition (as per the Americans With Disabilities Act of 1990) may qualify you. For more information about the Medical Marijuana Identification Card Program, visit the Sacramento County Department of Health and Human Services website at sacdhhs.com. You can apply online or request an application packet by calling (916) 875-2066.

 

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