Medical Marijuana: Health Risks and Benefits in California San

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Medical Marijuana: Health Risks and Benefits in California San

  1. 1. Medical Marijuana: Health Risks and Benefits in California San Francisco NORML Conference April 19, 2002 Tod H. Mikuriya, M.D., President
  2. 2. Marijuana and Health Risks and Benefits for California Physicians <ul><li>Federal Threats & Actions </li></ul><ul><li>State Harassment </li></ul><ul><ul><li>Medical Board </li></ul></ul><ul><li>County DA’s </li></ul><ul><li>Sheriffs & Police </li></ul><ul><li>Organized, corporate, and individual medicine </li></ul><ul><li>Marginalization and stigmatization </li></ul><ul><ul><li>Exclusion from conferences </li></ul></ul><ul><ul><ul><li>“ Advocacy = undesired bias </li></ul></ul></ul><ul><ul><li>“ Abortion doctor” </li></ul></ul><ul><ul><ul><li>“ Mill doctor” </li></ul></ul></ul><ul><ul><li>Censorship from publications </li></ul></ul><ul><li>Intellectual challenge, clinical experience with patients, expanding upon medical intelligence prior to removal from clinical availability. </li></ul><ul><li>Continuing experiences of confidence and trust of patients. </li></ul><ul><li>Freedom from managed care </li></ul><ul><li>Opportunities to optimize management of chronic conditions and advocate for the patient. </li></ul>
  3. 4. 1996 Federal Threats & Actions Against California Physicians <ul><li>Removal of DEA Controlled Substances </li></ul><ul><ul><li>Moving to take Mollie Fry, M.D.s DEA # </li></ul></ul><ul><li>Drop from Medicare – None Yet </li></ul><ul><li>Federal law suits- Injunctions prevent </li></ul><ul><li>IRS audits- None yet </li></ul><ul><li>Termination of grants- None yet </li></ul><ul><li>Actions without threat: Evolving & Covert </li></ul>
  4. 6. Benefits of medical marijuana for California Physicians <ul><li>Continuing experiences of confidence and trust of patients. </li></ul><ul><li>Opportunities to optimize management of chronic conditions and advocate for the patient. </li></ul><ul><li>Intellectual challenge, clinical experience with patients, expanding medical intelligence prior to removal from clinical availability. </li></ul><ul><li>Freedom from managed care </li></ul>
  5. 7. Patients’ Medical Marijuana Benefits <ul><li>Safe and effective medicine to manage chronic serious medical conditions. </li></ul><ul><ul><li>Immunomodulator Analgesic </li></ul></ul><ul><ul><li>Mood and affect modulator; easement </li></ul></ul><ul><ul><li>Anti-Spasmodic anticonvulsant </li></ul></ul><ul><ul><li>Harm Reduction Substitute </li></ul></ul><ul><li>Multiple and concurrent therapeutic effects </li></ul>
  6. 10. Cannabis Pharmacological Safety <ul><li>Free from unwanted side effects compared with “mainstream” polypharmacy and non-medical drugs- alcohol and nicotine.. </li></ul><ul><ul><li>Compared with opioids, steroids, NSAIDS, sedatives, tricyclics, and benzodiazepines </li></ul></ul><ul><ul><li>Improved quality of life </li></ul></ul><ul><ul><ul><li>Mobility, emotional well being and control of pain </li></ul></ul></ul><ul><ul><ul><li>Less money spent on drugs to control side effects </li></ul></ul></ul>
  7. 11. Medical Marijuana Benefits Psychosocial <ul><li>Relief from criminal status </li></ul><ul><ul><li>Improved self esteem </li></ul></ul><ul><ul><li>De alienation </li></ul></ul><ul><ul><ul><li>Increased participation in community </li></ul></ul></ul><ul><ul><li>Decreased fear and paranoia </li></ul></ul><ul><li>Improved critical thinking </li></ul><ul><li>Optimal coping with chronic illness </li></ul>
  8. 12. Medical Marijuana Medical Risks <ul><li>No pharmaceutical potency standards </li></ul><ul><li>No guarantees of purity or freedom from contamination </li></ul><ul><ul><li>Pesticide residues, biologic agents, or heavy metals </li></ul></ul><ul><li>No dose consistency of oral products </li></ul>
  9. 13. Medical Marijuana Risks <ul><li>Endemic Negligent Governance </li></ul><ul><ul><li>Criminal Justice System </li></ul></ul><ul><ul><ul><li>Attorney General’s Office consensus without tutelary mandate policy: Counties do their own thing </li></ul></ul></ul><ul><ul><ul><li>County and local absence of Training and Information Bulletins or General Orders. </li></ul></ul></ul><ul><ul><ul><li>Problematic prosecutorial, court, and probation </li></ul></ul></ul><ul><ul><ul><ul><li>Excessive discretionary powers </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Subpoena abuse </li></ul></ul></ul></ul>
  10. 14. Medical Marijuana Risks Physicians and Health Care <ul><li>Gross and pervasive non-compliance because of federal threats. </li></ul><ul><li>He who pays the piper calls the tune </li></ul><ul><ul><li>Medicare, MediCal federally funded </li></ul></ul><ul><ul><li>Federal academic medicine funded grants </li></ul></ul><ul><ul><li>Federal Veterans Administration Hospitals </li></ul></ul><ul><li>General fear and ignorance of physicians </li></ul>
  11. 15. A Statewide Audit is Critical <ul><li>I propose a statewide effort to Implement the Compassionate Use Act of 1996.   </li></ul><ul><li>Beyond the current federal assaults on California patients, physicians, taxpayers, and voters, unless a systematic effort is organized and motivated with adequate funding, efforts conceiving and passing propositon 215 will have gone for naught. </li></ul><ul><li>Only a comprehensive audit with remedial civil remedy will ensure the will of the voters five years ago. </li></ul>

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