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“Medical” Marijuana

As I recall, coming of age in the 1960s meant, among other things, social roles being more clearly defined then than now. For example, if you wanted weed, you met someone at an L stop named Bobby. For the reasonable price of $5 you felt a grass-filled baggie slide into your pocket and by the time you’d muttered “Thanks, man…” Bobby had vanished.

On the other hand, were you a victim of one of the two epidemics of that hectic decade– crabs (pubic lice) or the clap (gonorrhea)–you didn’t return to the L stop for a follow-up with Bobby. You went to a doctor. This meant entering a fly-stained street level door, climbing a flight of sticky stairs, sitting in a miniscule waiting room strewn with decades-old issues of Time Magazine, and after being quickly checked by some old geezer (approximately my current age, I’d guess) you were jabbed with the business end of a railroad spike-sized hypodermic. This, too, cost about $5.

Imagine we’re back in 1968 or so and you could make a prediction about the future to a friend. “I’ll bet,” you might say, “that in the future, there’ll be no more Bobby and that someday we’ll all be going to a geezer doc for our penicillin shot and our nickel bags.” Picture your friend staring at you for a full minute, attempting to bring your face into focus. Then slowly, and with a vocal intonation unique to the times, whispering, “Wow! Grass from your doc. That is…so groovy.”

To put the very idea of “medical” marijuana into perspective, watch the latest Ken Burns series Prohibition on public television. When the federal government banned the sale of alcohol in 1920, Americans, especially those living in big cities, continued drinking alcohol, but the supply sources changed radically. Most alcohol came from bootleggers. Everyone remembers the Prohibition Era for its violent gang wars, thousands shot or jailed for the “manufacture and distribution of intoxicating beverages.”

Al Capone and his ilk aside, a completely legal source of alcohol was the medical profession. “Patients” filled doctors’ waiting rooms requesting prescriptions for “medicinal spirits.” My father, an apprentice pharmacist during Prohibition, remembered that at least half the prescriptions he filled were for pure grain alcohol, neatly labeled For Medicinal Use Only!

Now 90 years later we seemed to have learned nothing from all this. Marijuana is probably no more or less dangerous than alcohol, but just like the old Prohibition days we have drug dealers killing each other (and innocent bystanders) and thousands of young people wasting years of their lives in jail paying the price for their agricultural and/or distribution skills. Like Prohibition, enforcing restrictive laws costs us a fortune. Interestingly, we’re also facing the same federal-state conflict as we did during Prohibition. Marijuana growing and possession are federal crimes, but most state and local governments would rather not bother enforcing them.

Prescription for Pinot noir?
As a result of this, an increasing number of states are legalizing marijuana. This would be just fine with me except for one very important component. The new liberal state laws are classifying marijuana as a drug, requiring a doctor’s prescription.

Whoa! Wait! Exclude me, please. Classify marijuana where it belongs: along with alcohol, caffeine, nicotine, and aspirin. The medical profession does not need to be involved with marijuana. Yes, there are a few medical benefits from smoking a joint, but you don’t require a prescription from me for Pinot noir to gain its antioxidant effect or caffeine because it clears your thinking in the morning.

In states that have legalized or are likely to legalize marijuana (Illinois is one) things are moving quickly. For example, you can now buy a franchise in a marijuana chain called weGrow if you’re over 21 and have $25,000. Your franchised store will sell a variety of marijuana blends and a full array of equipment for your customers to grow it themselves.

But in order to buy your marijuana customers require a doctor’s prescription, a marijuana card. For that you’ll need to hire a doctor and pay him several hundred dollars a day to sit in a cubicle, listen to your customer report how his back, neck, or hair hurts and then rubber stamp prescriptions. Just like the old Prohibition days, your customers will line up, and as the doctor signs the prescriptions you’ll fill them in your new career as a marijuana pharmacist. Don’t know anything about marijuana? Take a few courses at Oaksterdam University (Oakland and Amsterdam being major HQs of legal grass) for “quality training in the cannabis industry.”

Being a marijuana doc does not strike me as one of your high-prestige physician jobs. You do have to wonder what sort of a doctor would work at one of these places, especially considering all those years spent in pre-med, medical school, and residency training. My guess is that these are mainly ex-solo practitioners who finally couldn’t handle the combination of 80-hour work weeks and declining incomes and simply closed up shop. They’re too old to start another practice, and the short hours and regular paycheck writing pot prescriptions looks solid, based on ads like this one.

Reefer madness
What finally ended Prohibition was money. Yes there was an inherent stupidity in the whole idea of Prohibition, but with the Depression of the 1930s both the state and federal governments were nearly broke. Legalizing alcohol would put hundreds of thousands of people back to work at legitimate jobs, and by taxing alcohol at astronomically high rates millions of dollars got funneled into half-starved treasuries.

Europeans have commented that we Americans suffer collective historical amnesia. They have a point. We’re not seeing the obvious comparison between Prohibition then and the squabbling over marijuana legalization now. With one fell swoop, legalizing marijuana on a national level would save approximately $20 billion every year. That’s what we spend on the marijuana component of our “war on drugs.”

Every year.

We’d also stop financially supporting a couple hundred thousand prisoners jailed on minor dug charges. With the judicious application of excise taxes (similar to alcohol and tobacco), legalizing grass would generate another $23 billion a year in state and federal revenue. We could put thousands of people back to work, all paying income tax, in a new industry that itself would pay corporate tax.

It makes utter financial sense to legalize marijuana on a national level. But please, please, please don’t apply the phony patina of “medical” to legal marijuana. Just let me and my profession stick with what it knows best: treating crabs and the clap.

Be well,

David Edelberg, MD

 

 

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21 Comments


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  1. Addie says:
    November 1, 2011 at 6:58 am

    I’m from the Bay Area and visit there regularly. At least in California medical marijuana has made no difference in the habits of marijuana users. They still buy and sell without prescriptions. Use of the drug is socially acceptable and widely used at parties, picnics and other gatherings without prescription. I see medical marijuana used there by people with shaky disability claims as proof they can’t work (mostly they can). If draconian drug laws can’t be enforced, certainly squeakings about prescriptions can’t either. No one pays any attention to these laws as they didn’t to Prohibition. I thought the most memorable quote from Burn’s documentary was from Will Rogers, “Oklahoma will remain dry as long as they can stagger to the polls.”

  2. Rob says:
    November 1, 2011 at 8:29 am

    My father used to say “I told you a million times not to exaggerate.” I completely agree with the article about legalization and ending the prohibition. I was not sure where the statistics about $20 billion in added revenues came from. I did find a site that calculates about 7 Billion in revenues if it is taxed as alcohol is: http://www.prohibitioncosts.org/

    Additionally – if marijuana is legalized, I am sure there will be some defecting from alcohol consumption in exchange for a little doobie. If we legalize and still realize the same amount of alcohol tax revenue and also gain that much marijuana revenue, then the economy will suffer since everyone would clearly be partying too much and not focusing on their work enough to keep us competitive with the rest of the world.

  3. Willy Gumperdink says:
    November 1, 2011 at 9:39 am

    <3<3<3<3
    A real doctor…conscientious, not an HMO automaton. A REAL human being. WoW!!!

  4. An Argument For Medical Marijuana - Do We Have Collective Historical Amnesia? says:
    November 1, 2011 at 10:02 am

    [...] Europeans have long argued that Americans suffer from ‘Collective Historical Amnesia’ when it comes to the legalization of marijuana. When viewed in the context of a comparative analysis to other formerly banned substances, one must question if they’re correct. This is a very interesting read from an ACTUAL doctor, Dr. David Edelberg, regarding the subject… thoughts?  http://www.wholehealthchicago.com/4355/%E2%80%9Cmedical%E2%80%9D-marijuana/ [...]

  5. Warren says:
    November 1, 2011 at 10:06 am

    I’ve been a proponent of legalizing marijuana for over a decade now. In all that time I was simply thrilled to see a few states to pass medical marijuana laws. Until your blog post I hadn’t considered that it really is pointless to manage marijuana via the medical establishment. You do have FAR more important things to focus your time on. So does law enforcement, the judicial system, the penal system, and just about every one else involved in this issue on just about any side of the various fences. It should be managed for sale via liquor stores along side booze and cigarettes.

    I think your numbers of savings to the states as well as additional tax revenues might be on the low side actually.

    California alone raises $1.4 billion in annual marijuana sales taxes. This doesn’t include revenues from the costs of obtaining and renewing your “card” annually. NY, Texas, and Florida wouldn’t be far behind that number. Honestly, you could tax this at just about any rate and I doubt most pot smokers would care. As long as they don’t have to worry about law enforcement “harshing their mellow” I think they’d just grin and bear it.

    I’d read somewhere a couple years ago (stats may not be accurate today) that roughly 85% of those imprisoned are there for non-violent drug offenses. Shouldn’t prison be for violent criminals? Do we need to build more prisions? No. We need to free the lowest level inmates, remand others to house arrest, and let the violent S.O.B.’s have the Big House to themselves. That would save countless billions but some argue that would cost thousands of jobs where corrections officers and support staff are concerned. But just as ending prohibition in the depression actually created jobs so could the end of prohibition of marijuana.

    As for the “card” doctors in California, well, I for one (Chicago resident) have a California Medical Marijuana card. From the time the doctor’s “assistant” asked me if I wanted my “card” as I walked past their “office” to the time I had marijuana in hand was under 20 minutes. The office consisted of two small rooms. A reception room and an “exam” room. The doctor, an odd 50-something guy in a (no kidding) hawaiian print shirt, listened to both my lungs and my heart. He took my blood pressure then asked me what’s been ailing me. I told him anxiety (who doesn’t have a little anxiety from time to time?) and he proceeded to write up the prescription. Card cost $150 to obtain and I believe half that goes to the state as a tax.

  6. Gina says:
    November 1, 2011 at 11:05 am

    Sweet ending! Made me LOL!

  7. Betsey Arias O'Brien says:
    November 1, 2011 at 11:51 am

    Help me understand! I’m a mother of young adults. Are the things I’ve read about pot’s harmful effects on memory, mood and cognition — especially among users under 25 — just hype? Like you, I am far less concerned with the law’s stance on this drug than with possible harm to a young smoker’s long-term health. Thanks in advance for your insights.

  8. Gina Pera says:
    November 1, 2011 at 12:02 pm

    Dr. Edelberg wrote: “Being a marijuana doc does not strike me as one of your high-prestige physician jobs. ”

    Exactly! I cannot tell you the number of people with ADHD I know who have been given “medical marijuana” to deal with the anxiety that often accompanies ADHD. These doctors are hacks who have no idea how to treat psychiatric patients and they are simply exploiting people’s misery. ADHD comes with cognitive deficits, including poor working memory and low initiation, and marijuana exacerbates those deficits. It is a horror for many individuals, couples, and families. As bad as online porn when it comes to addiction. Bad, bad idea.

  9. Gina Pera says:
    November 1, 2011 at 12:05 pm

    I’ve noticed that here in the Bay Area, the same people who scream “Big Pharma” and refuse to recognize the neurochemical basis of psychiatric disorders are the same ones who minimize the impact of marijuana on the brain and on their sperm. Same with alcohol.

  10. Mery Krause says:
    November 1, 2011 at 12:26 pm

    Three Cheers for you, Dr. E. I agree 100% with you, and not because I’m an addict, but because alcohol actually kills brain cells, while “Whacky Tobacky” only alters them temporarity, to aid in pain relief, suffering, and yes, enable us to think outside the box sometimes. Is that soooo bad?

  11. Paul Kuhn says:
    November 1, 2011 at 1:12 pm

    I agree with your conclusion that we should legalize cannabis but not with your statement that, “Marijuana is probably no more or less dangerous than alcohol.” Pot is much less dangerous than booze, the third leading cause of death in America. Marijuana can’t lead to fatal overdoses; it does not incite violent behavior or reckless driving, and even heavy use is not associated (like alcohol) with cirrhosis of the liver, brain damage, birth defects, heart disease and numerous types of cancer. In fact, even government has acknowledged on the website of the National Cancer Institute that cannabis inhibits cancer.
    The medical benefits of marijuana are not just “a few.” They are remarkable (thanks to our body’s endocannabinoid system). Cannabis slows the progress of ALS, Parkinson’s, MS, glaucoma and Crohn’s Disease. As demonstrated in recent “gold standard,” FDA-approved studies, it relieves pain as effectively as many addictive and deadly opiates without immobilizing patients. And I have seen first-hand that marijuana stops chemo-induced nausea in its tracks when the best legal medications fail.
    Of course, one benefit of full legalization (not just “medical marijuana”) would be to allow patients to determine for themselves how and when to use cannabis, involving their doctors only when they need additional advice. I’d label it the aspirin model. (Aspirin, like almost all medications—but not cannabis—can kill but we can buy it in drug stores without a doctor’s prescription.) Take two and call me in the morning.

  12. Lew Erenberg says:
    November 1, 2011 at 1:33 pm

    I agree wholeheartedly. The persecution of marijuana users is just like prohibition with the same results. In my opinion it has spawned widespread criminality and the subsequent criminalization of users, especially in the Black and Latino communities. Linking the mild narcotic to a doctor’s prescription also makes no sense to me.

  13. monica geady says:
    November 1, 2011 at 2:09 pm

    As always your writing is thought provoking. I look forward to your blog-I read it faithfully. Thanks for your honest take on things.

  14. H2 says:
    November 1, 2011 at 3:22 pm

    Frank Main in the Chicago Sun Times has the first of a four-part series on decriminalization here.

    http://www.suntimes.com/8397473-417/chicagos-pot-dilemma-should-marijuana-users-just-be-ticketed.html

  15. Dr E says:
    November 1, 2011 at 9:47 pm

    To Betsey
    I share your concerns about the effect of marijuana on the developing brains of teens and young adults. Personally, if grass were available legally, I would follow the Avis Car Rental rule. Avis will not rent a car to anyone under age 25 because they feel the brains have not adequately developed to assume the responsibility of a rented vehicle. I’d allow grass for anyone age 25 and up
    Dr E

  16. Dr E says:
    November 1, 2011 at 9:59 pm

    To Paul
    Okay, you’re right. Alcohol is a lot more dangerous than cannabis. I did much of my residency in a Veteran’s Administration Hospital and signed many a death certificate for alcohol poisoning, alcohol gastritis (bleeding), cirrhosis with liver failure, alcohol dementia, etc. etc. but never once saw a patient with permanent damage from cannabis. This doesn’t mean I’d be comfortable in a 747 with the pilot stoned on weed but alcohol does trump grass when it comes to screwing up your body. BTW, the “take two and call me in the morning” has its own dangers. Aspirin and Advil cause significant stomach bleeding; Tylenol can seriously mess up your liver.

  17. Beth says:
    November 2, 2011 at 6:14 am

    Once again, you hit the nail on the head!

  18. Louise says:
    November 2, 2011 at 5:14 pm

    To dredge up a phrase from our obviously shared youth, “Right on!”

  19. Susanne Sklar says:
    November 4, 2011 at 12:07 pm

    Was Cannabis ever used for ‘female’ troubles? Menopause wreaked havoc upon a dear friend; horrific weight gain, fatigue, depression, anxiety. She lives in California. And she told her doc, her REAL doctor, that when she was in college smoking weed helped her when she felt like garbage, especially when PMS was no fun at all. So. He SUGGESTED that she try medical marijauna — she thought that might be fun — she didn’t take it seriously – but oh my! was she happy when equilibrium began RETURNING. She’s lost 35 pounds in the last two years and doesn’t crash into frantic sorrow anymore. (In the course of this treatment she’s met two people with Lyme disease- my complaint – who claim they feel ENERGIZED by ‘medical’ marijuana. This sounds GOOD to me!)

  20. Judy Kayser says:
    November 4, 2011 at 8:13 pm

    I agree completely. Unfortunately, people seem to think it is fine to OFTEN drink themselves stupid while clinging to the belief that what they do is ok and marijuana is one step away from becoming addicted to coke or worse. I have seen more tragedy resulting from alcohol than I ever have from marijuana.

  21. Carlton Bailey says:
    November 4, 2011 at 10:48 pm

    Brilliant!