Controlled Prescription Drugs VS Medical Marijuana

May 10, 2010 – The National debate concerning the legalization of marijuana and, especially, of medical marijuana, continues to rage not just within the general public, but also including special groups of people like mothers and Baby Boomers. Within the Facebook community the groups such as “Moms for Marijuana” and “Baby Boomers for Medical Marijuana” have as their primary goal educating people, challenging the preconceived ideas and battling ignorance with the only effective weapon against it – Knowledge.

I worked in addictions for almost 10 years, and my addiction medicine experience encompasses general drug-addiction clinics, methadone maintenance programs and “detox” and “rehab” departments of a general hospital. I am also certified by the American Society of Addiction Medicine since 2004. My addiction medicine education and experience unequivocally indicate that it is a gross scientific fallacy to classify marijuana in the same group with heroin and cocaine. It is also my opinion that marijuana is much safer than alcohol and most controlled prescription drugs. However, when such an “unorthodox” opinion is expressed, people have the right to know what exactly it is based on.

Let’s begin with the known fact that there has never been one single case of a fatality associated with marijuana use, and it has been used by humans for over 10,000 years for both medicinal and recreational purposes. How many substances do we know that fit this characterization? Not many, I assure you, especially when we look among substances used as medicine or even for recreational purposes. Even such over-the-counter remedies as Aspirin and Tylenol can produce severe organ damage and fatal outcomes when the “toxic” dose of these substances is ingested. But there are no known cases of fatal marijuana intoxication because amazingly, the cannabinoid receptors, as opposed to opiate receptors, for example, are quite scarce in close proximity to the vital centers in the brain stem, the centers responsible for breathing and circulation. With marijuana use sleep will supervene long before any dangerously “toxic” effects can take place.

Now let’s look at such dangerous consequences of alcohol, heroin and controlled prescription drugs as physical dependence and associated physical withdrawal syndrome. No one will venture to deny that alcohol, opiates, barbiturates and benzodiazepines produce severe physical dependence with (frequently life-long) methadone maintenance therapy that becomes necessary for opiate addicts and the well-known cycles of the “revolving doors” of “detoxes” and “rehabs” for benzodiazepine addicts. In fact, the benzodiazepine/methadone combination is so dangerous that some physicians (who are, thankfully, in the minority) seriously believe that such a combination is more dangerous than heroin itself, and will deny methadone maintenance to patients using those substances. As we know, benzodiazepine withdrawal is very similar to alcohol withdrawal, and it is characterized by hallucinations, severe anxiety, seizures and even death. Opiate withdrawal is generally not life-threatening, but it sure is brutal. It is easy to see why I so strenuously object to current DEA classification system, and urge my colleagues do the same. It makes no scientific sense at all to classify the substance like marijuana which has neither a documented physical withdrawal, nor any fatalities associated with its use as Schedule I (which totally ignores the remarkable medicinal properties of Cannabis Sativa, but this is another matter), while classifying Codeine as Schedule III and benzodiazepines as Schedule IV. What better ally could I wish for than the American Medical Association itself which now not only recognizes the medicinal properties of the Cannabis plant, but also urges the Government to change its classification from Schedule I drug, while the Canadian veterans already won the right to have this natural remedy paid for by their government!

Let’s look more closely at the main argument that the marijuana “opponents” offered (at least until very recently) as their “trump card” objection to the legalization of that substance. This objection is based upon the so-called “gateway drug” theory that basically states that, even if marijuana is not dangerous in itself, it serves as a “gateway drug” to the use of other, much more dangerous substances. This “theory” is by now discredited by the science of addiction medicine as invalid. Here are the reasons why. There is no “cause and effect” relationship between a substance use and a subsequent addiction to another substance. Most of us have tasted alcohol, consumed caffeinated beverages, eaten sweet foods or even smoked cigarettes, but we have not “progressed” to being cocaine or heroin addicts as a result. As Substance Abuse: A Comprehensive Textbook explains, most people who are addicted to anything became addicted not because they had used some “gateway” drug, but because they are somehow genetically prone to this or that particular addiction, such as alcoholism, for example. People don’t become alcoholics because they may have smoked a joint that “led” them to alcohol abuse, they are alcoholics because they have a genetic predisposition to become dependent on that particular substance. The opiate addicts whom I treated for many years began their addiction careers not because they were exposed to marijuana, but either as a result of a primary exposure to heroin, or as a result of opiates having been prescribed to them by medical professionals. Here we deal with yet another aspect of this story – the substance’s addiction liability, or the percentage of people who develop an addiction-spectrum disorder after an exposure to a particular substance. Marijuana has an addiction liability of 3%, compared with 10% for alcohol, 18% for cocaine, up to 21% for opiates, and between 50 and 75% for nicotine. This is why even our President has such trouble quitting cigarettes out of all the substances that he had “tried” while a young man. This constitutes yet another big reason why the classification of marijuana as the Schedule I substance is nothing short of ridiculous. It was recently discovered that the same brain centers become activated when a person is craving sugar and cocaine. Are we now to consider sugar as a “gateway drug” to cocaine? Well, this would follow if the so-called “gateway drug” theory were valid. But it is not valid. A colleague whom I befriended on Facebook brought up an interesting question; he pointed out that most patients in “detoxes” and “rehabs” smoke cigarettes, and this is very true. This alone would invalidate the “gateway drug” theory in my opinion.

I believe that we, as medical professionals, should not be puppets to the DEA and its outdated and scientifically faulty scheduling classifications. Without brave doctors, and nurses, and researchers who are not afraid to stand up and proclaim the scientific truths we would never have legalized medical marijuana in one single State. Let me point out something more: if marijuana had even a fraction of the dangers caused by alcohol, we would not be having this conversation at all. But we ARE having this conversation, and it is a necessary conversation, just as it was a necessary conversation during the days long passed, when the courageous thinkers of those days asserted, often sacrificing their own safety, that the EARTH IS NOT FLAT. Source.

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