Health: Marijuana Goes Mainstream

Posted on November 7, 2011

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

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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.”
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