Source: Los Angeles Times (CA)
Contact:  213-237-4712
Website: http://www.latimes.com/
Pubdate: Sun, 27 Sep 1998
Author: Scott Gottlieb

TRYING THE DRUGS THEY PRESCRIBE

NEW YORK--Imagine walking into your doctor's office and finding a lit bong.
Would that scare you? As a fourth-year medical student, I have been taught
how to prescribe medications.  Appreciating a drug's pharmacological
benefits, however, is often a tempting inducement for some of my fellow
medical students to give it a try. Students cleverly argue that their
motives for self-prescribing medications are purely educational. After all,
they say, how can they prescribe a drug they have not taken themselves?  As
the medical establishment advocates a therapeutic role for marijuana, don't
be surprised if more U.S. medical students begin smoking pot. Once a drug
makes it onto the list of therapeutic medications it becomes fair game for
the surprising number of students willing to self-prescribe medication.

This was seen most recently in Britain, where efforts to legalize marijuana
be-came fashionable decades before Americans seized on the same idea.
British citizens were surprised to learn that the number of British medical
students who smoke dope regularly has doubled in the last decade.

The findings, first reported in the British Medical Journal, found that 46%
of medical students in England have tried marijuana at least once. while
10% claimed to smoke one joint or more per week.

The study found that despite greater knowledge of pharmacology, there was
no evidence that medical students were any more selective about the legal
or illegal drugs they consumed than students in general.

The study pointed out that students overwhelmingly disapproved of cigarette
smoking, indicating that health concerns were on their minds. The
implication of this finding was that smoking pit was not seen as similarly
dangerous.

These dismal findings stand out against Scott Gottlieb, a fourth-year
medical student at the Mount Sinai School of Medicine, has recently
returned front Britain, where he corn pleted a fellowship on the editorial
staff of the British Medical Journal.

Against a backdrop of increasing liberalization in Britain when It comes to
drug use. The British Medical Assn. recently urged the government to allow
marijuana to be prescribed in a range of medical conditions and asked
health officials to set up clinical trials to assess marijuana's
therapeutic benefits. These efforts have the full support of many doctors.
including the president of the Royal Pharmaceutical Society and the
previous president of the Royal College of Physicians.

Doctors in the United States are erroneously following the British lead.
Last year, the American Medical Assn. recommended a review of its policies
on marijuana as a 'medicinal remedy." A report issued in December by the
association's Council on Scientific Affairs recommended renewed research
efforts to see if the "potential benefits of smoking marijuana" outweigh
the known risks.

The image of smoking marijuana, even for supposed medicinal purposes, is
inextricably linked to images in our culture of illicit drug abuse. Whether
intended or not, permitting the "medicinal" use of maruuana sends a
powerful message that pot is OK. Those who cannot see a connection between
the efforts of British doctors to legalize marijuana and the surge in drug
use among their medical students mistakenly believe that the students don't
take their cues from doctors. Moreover. once a drug is deemed therapeutic
it becomes fashionable in some medical circles to give it a try. Indeed, a
1986 study published in the New England Jburnal of Medicine found that a
quarter of American doctors and medical students surveyed had
self-prescribed mood-altering drugs, most often tranquilizers and opiates.

Think for a moment about how many medicines doctors prescribe. None involve
smoking leaves or chewing plants. What doctors do instead is look for a
specific chemical and prescribe it in a known quantity.

The idea of medicinal marijuana merely substitutes the concept of medicinal
use for recreational drug use. That's the reason people don't like Marinol,
the widely available but rarely prescribed synthetic analogue to marijuana.
In short. people want to smoke dope.

If doctors are worried that HMOs have diminished the quality of medicine in
the United States, perhaps they're missing their own role in the decline.
With 10% of their medical students regularly abusing marijuana, British
doctors are realizing the trouble they are in. In the British press.
doctors are openly fretting that students on dope "might not be able to
remember the volumes of information being thrown at them," as one doctor
recently told a London newspaper.

That's where things are headed. That's what happens when doctors argue for
legal pot. In Britain, the results are now in, and doctors find themselves
hoisted by their own petards. Stay tuned for the U.S. version. A new age of
medicine is dawning--the stoned age.

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Checked-by: Joel W. Johnson