Pubdate: Wed, 25 Feb 2004
Source: Anderson Valley Advertiser (CA)
Column: Cannabinotes
Copyright: 2004 Anderson Valley Advertiser
Contact:  http://www.mapinc.org/media/2667
Author: Fred Gardner
Bookmark: http://www.mapinc.org/find?115 (Cannabis - California)
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)

CANNABIS IN THE CURRICULUM

USC Med School Takes The Lead

"Any pain-management training that does not have information about cannabis 
is committing malpractice."  -Claudia Jensen, MD

On Feb. 13 students and faculty from the University of Southern California 
Keck School of Medicine put on a half-day program devoted to the clinical 
uses of cannabis and the relevant pharmacology. Some 30 first- and 
second-year med students attended the history-making event in McKibben 
Hall, which was organized by Rolando Tringale, a second-year med student, 
and Claudia Jensen, MD, a Ventura pediatrician who is an Instructor in the 
Department of Family Medicine.

Jensen teaches "Introduction to Clinical Medicine," in which first-year 
students learn how to take a patient's history and conduct a physical exam. 
Since the Fall semester of 2001 Jensen has spent a full day in the ICM 
class talking about cannabis and bringing in patients for students to 
interview. "They're open-minded and well educated," she says of her 
students. "And they actually go on to teach their colleagues the truth 
about cannabis. That's why Rolando wanted to do this 
presentation."  (Tringale had taken Jensen's ICM class last year.)

The Feb. 13 program started with first-person accounts from patients. 
Jensen had invited Ishmael Gayes, nicknamed Eddie Green, "a paraplegic -a 
very beautiful, intelligent, spiritual black man who was shot in the back 
over a woman when he was 17;" chronic pain patient Lisa Cordova Schwarz; 
and glaucoma patient Jim Carberry. Bill Britt, an activist from Long Beach 
who has post-polio syndrome and epilepsy, also described his use of cannabis.

Joseph Miller, PhD, associate professor of Cell and Neurobiology, discussed 
the pharmacology and biochemistry of the body's own cannabinoid receptor 
system, which is activated by THC and other compounds in the plant. 
Miller's research has been funded over the years by the National Institute 
on Drug Abuse. "He's not a medical marijuana protagonist," says Jensen, 
"he's not in the movement. He's just an honest man with a balanced, 
truthful perspective about drugs who was willing to be a speaker."

Psychology professor Mitch Earleywine, PhD, discussed the question of 
safety. Earleywine, the author of Understanding Marijuana (Oxford, 2002), 
said that medical users could minimize negative consequences by vaporizing 
instead of smoking. Earleywine also advocates "keeping dosage at a level 
that relieves symptoms but doesn't create any impairment" and "monitoring 
for any signs of craving that might indicate tolerance or withdrawal." 
Earleywine has found that "the people who run into dependence problems with 
cannabis are the ones who are drinking a lot of alcohol." He recommends 
that medical cannabis users avoid alcohol consumption.

Attorney William Logan gave a talk entitled "Medicine Dances With 
Lawyers,"explaining Prop 215 -California's Health & Safety Code Section 
11362.5- and recounting the court rulings that affect its implementation.

Jensen's presentation was a version of what she teaches the first-year 
students -"How do you tailor a history and physical to a medical marijuana 
patient?... What dose and route of administration to use?... What strain to 
use?" She also discussed "the advantages and disadvantages of having 
medical marijuana patients in your practice." C-Notes will devote a column 
in the near future to her observations.

Jensen had also invited -after getting administrative approval to do so- 
Richard David, proprietor of the USA Hemp Museum, who brought samples of 
hash, hash oil and other cannabis-based products, as well as some plant 
strains (in jars), providing, for some of the students, a first exposure to 
the once-prohibited herb

"How many of you use marijuana?" Jensen had asked. She says, "Probably 
seven students raised their hands. I told them 'I am very proud of you 
having the courage and the integrity to tell the truth, because that's what 
this conference is about.'" Jensen also asked how many had or knew somebody 
who had a condition treatable by cannabis. About 90% raised their hands.

Jensen says that the USC administration has been supportive of her efforts 
to introduce cannabis into the curriculum.  Althea Alexander, Clinical 
Instructor for Educational Affairs, attended the Feb. 13 conference and 
expressed gratitude to the patients who took part. Alexander regretted that 
the event had been scheduled for the getaway day of President's Day 
week-end; there would have been a much heavier turnout, she said, on an 
ordinary Friday.

Jensen hopes that next year the conference will be held in October, "when 
the students are freshest," and that it will be a requirement. (This year's 
was not offered for credit.)  Jensen had an insight about "elective" 
classes when she was in med school at the start of the 1980s. "I took an 
elective on 'Sexual Desensitization' and the only students who went to it 
were the students who were comfortable with sexuality. All of the really 
messed-up, up-tight people avoided it. So I don't think cannabis should be 
an elective. I think it should be required training."

Jensen has also given thought to developing a continuing medical education 
program for physicians, none of whom learned a thing about cannabis in 
medical school. (Doctors are obligated to earn a certain number of CME 
credits annually.) She has proposed to the administration that USC offer a 
CME course on cannabis.  Professor of Clinical Instruction Alan Abbott told 
her he was amenable and would look into possible funding. Wouldn't such a 
course pay for itself -or make money for the sponsor- Jensen was asked? 
"Doctors are just scared of marijuana," she says.  In 2000 she attended a 
conference at UC San Francisco organized by Geoffrey Guy, MD, of GW 
Pharmaceuticals. "It was poorly attended," she recalls.

Jensen thinks her colleagues in the medical profession will take steps to 
educate themselves on the subject of cannabis only when they are obligated 
to. And she has a strategy to obligate them. "The Medical Board of 
California has dictated that physicians have to take eight hours in pain 
management in order to maintain their licensure. My position is that any 
pain management presentation that any physician takes is inadequate if it 
does not include discussion about cannabis and cannabis compounds. The 
Medical Board should take the position that cannabis teaching needs to be 
integrated into those pain management sessions that physicians are already 
required by law to attend."

Jensen is a pediatrician who practices in Ventura. She has a special 
interest in cognitive function and development. She branched into treating 
adults as a result of her interest in cannabis. She says that with every 
patient she tries to figure out "the habits that are keeping them sick."

Jensen spends an hour seeing each new patient. She learned recently that 
she is under investigation by the Medical Board for allegedly providing 
substandard care to three ADHD patients (whose cannabis use she approved).
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MAP posted-by: Jay Bergstrom