Pubdate: Wed, 05 Jun 2013
Source: New York Daily News (NY)
Copyright: 2013 Daily News, L.P.
Authors: Craig Blinderman and Sunil Kumaraggarwal
Note: Blinderman, M.D., is the director of adult palliative medicine 
services at Columbia University Medical Center/new York-presbyterian 
Hospital. Aggarwal, M.D., PH.D., is vice chairman of New York Physicians


On Friday, Mayor Bloomberg called medical marijuana "one of the 
greatest hoaxes of all time." From a mayor who has generally promoted 
public health policies based on sound medical and epidemiological 
evidence, such a comment is puzzling. It flies in the face of science.

Bloomberg's remarks came one day after the New England Journal of 
Medicine revealed the results of a doctors' poll asking whether 
marijuana should be used to help alleviate symptoms in a woman with 
metastatic breast cancer: 76% said yes.

The Journal's findings are consistent with public polling in New 
York: 82% of all New Yorkers believe it's a good idea to allow 
seriously or terminally ill people to use marijuana if recommended by 
a physician.

Marijuana has been shown to relieve pain, muscle spasms and 
spasticity, as well as stimulate appetite and weight gain in patients 
with wasting syndromes. The evidence comes from medium and large, 
double-blind, randomized, placebo-controlled trials - the gold 
standard for medical research.

The body of medical evidence has grown to suggest that marijuana can 
help relieve symptoms related to cancer and its treatment, irritable 
bowel syndrome, Crohn's disease and symptoms related to HIV/AIDS. 
There is also emerging data suggesting that cannabinoids (the active 
biochemical components of cannabis) may slow the debilitating 
progression of multiple sclerosis.

Compared with other medications, marijuana has low toxicity and is 
extremely safe. There is no known case of an overdose death from 
marijuana. In contrast, a review of deaths from the FDA Adverse 
Reporting System between 1997 and 2005 showed 196 deaths from 
medications to prevent nausea and vomiting and 118 deaths from 
medications that suppress muscle spasms.

Opioid pain medications, which are widely prescribed, are now 
responsible for more accidental deaths than traffic accidents; almost 
15,000 people died from prescription pain medications in 2008 alone, 
the last year for which data are available.

In addition, the evidence regarding the safety and addiction 
potential of marijuana from states that have allowed marijuana to be 
prescribed medicinally have, to date, generally shown no increase in 
overall marijuana use.

For example, a 2012 epidemiological study concluded that medical 
marijuana laws have had no discernible effects on adolescent 
marijuana use. Indeed, the study suggests that adolescent use may 
actually decrease with the passage of laws legalizing marijuana for 
medicinal purposes, perhaps because it is perceived as less glamorous.

While marijuana use can become a problem for some, few users become 
dependent on it. According to the National Institute on Drug Abuse, 
only about 9% of those who try marijuana ever become addicted (a 
number likely inflated due to the illegal context of use), compared 
with 32% of tobacco and 15% of alcohol users.

Many physicians in the New York medical community have been pushing 
for the passage of a bill pending before the Legislature that would 
allow health care practitioners to certify patients with serious, 
debilitating illnesses so that they may have access to a small amount 
of medical marijuana to relieve their symptoms. This is no hoax; it 
is compassionate care for real people.

The FDA's medication approval system is hopelessly politicized and 
broken. That's precisely why 18 other states and the District of 
Columbia have chosen to pass medical marijuana legislation, 
prioritizing the well-being of their sickest residents over politics. 
New Yorkers suffering from serious or debilitating illnesses should 
not have to wait any longer for relief.
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MAP posted-by: Jay Bergstrom