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The purpose of this blog is to stimulate thought and discussion about important issues in healthcare. Opinions expressed are those of the author and do not necessarily express the views of CMDA. We encourage you to join the conversation on our website and share your experience, insight and expertise. CMDA has a rigorous and representative process in formulating official positions, which are largely limited to bioethical areas.

Marijuana: Profits, Politics and Popularity Over People

August 1, 2018

by James Avery, MD

In his book Ends and Means, Aldus Huxley describes himself and, in the process, the current movement of marijuana into the mainstream: “I had motives for not wanting the world to have a meaning; consequently assumed that it had none, and was able without any difficulty to find gratifying reasons for this assumption.”

Huxley is describing the strong tendency for humans to rationalize and justify their beliefs and actions. Later, he says the following, “Most ignorance is vincible (conquerable). We don’t know because we don’t want to know. It is our will that decides how and upon what subjects we shall use our intelligence.”

In these statements, Huxley accurately described why corporations, business schools, entrepreneurs, politicians and even physicians are flocking to legalize marijuana. They don’t want to know that today’s marijuana is 10 to 30 times more potent than the marijuana of the 1970s and has the potential to create havoc on our society. They don’t want to know that is addictive. (One out of every nine adults and one of every six juveniles who use marijuana will, at some point, meet the Diagnostic and Statistical Manual of Mental Disorders criteria for a substance use disorder.) They don’t want to know that marijuana will cause deaths from traffic accidents, fires, psychotic killings and suicides. (From 2010 to 2014, marijuana-related traffic deaths increased 92 percent in Colorado while all traffic fatalities in the same period rose only 8 percent.) They don’t want to know that it can cause serious damage to young brains and that the overall availability will lead to an increase in child and teen usage. (In the journal Pediatrics, researchers disturbingly found that Cannabis use is on the rise among adults with children in the home.)

Instead of hearing the truth, many people prefer profits, politics and popularity over people. And, as you will read below, physicians are not exempt.

Profits Over People
Business schools such as Yale, Wharton and University of Southern California are devoting faculty and student resources to the emerging marijuana industry. At UCLA, students have even launched the Cannabis Business Association, an official campus club. Entrepreneurs looking for greater profits are looking for ways to increase profits and lure more customers. THC (the hallucinogenic ingredient in marijuana) is now being put into breath sprays, sodas, hot cocoa, hard candies, cake, candy bars, coffee, ice cream, cotton candy, and the list goes on and on. According to Forbes, edibles marijuana sales are expected to grow 25 percent annually. In Nevada, edibles accounted for 45 percent of all weed sales. Incredibly, over 60 of 379 companies listed on the Canadian Security Exchange are in pot-related businesses. (Companies are barred from U.S. Stock Exchange because marijuana is illegal on the federal level.)

Politics Over People
Politicians seem to be jumping over each other to get votes, tax revenue and tourist dollars by legalizing marijuana in their states. Recreational marijuana is legal in nine states, while medical marijuana is legal in 30 states. Senate Minority Leader Charles Schumer announced in April that he has decided to support decriminalizing marijuana at the federal level and will advocate bills to help marijuana businesses prosper. Schumer, echoing John Boehner, the Republican former Speaker of the House, cited an “evolved thinking — both personally and by the nation” for his switch. It was the first time that a leader of either party in Congress endorsed a rollback of one of the country’s oldest drug laws. On June 20, 2018, Canada became the second country in the world to legalize marijuana. (The first was Uruguay.)

Popularity Over People
Sadly, some physicians seem to prefer popularity over science. In the May 2018 edition of the Journal of Clinical Oncologya study found that 46 percent of cancer doctors said they have recently recommended medical marijuana to patients, although most admitted they did not have sufficient knowledge to do so. This is irresponsible behavior by physicians who are kowtowing to their even less knowledgeable patients.

Medical Marijuana
U.S. Department of Health and Human Services Secretary Alex Azar recently said there was “no such thing as medical marijuana.” His point was this: there is not enough research or evidence to support the use of marijuana as a beneficial drug. The National Academies of Sciences, Engineering and Medicine recently called on the federal government to support better research, decrying the “lack of definitive evidence on using medical marijuana.”

Simply put, marijuana has not gone through the clinical trials that all medications go through, and there has been virtually no research exploring potential adverse interactions with prescription and non-prescription medications. In other words, at this time, physicians are hard pressed to recommend marijuana as a medicine or supplement.

Until proper studies are done, it would be beneficial for physicians to warn their patients about the marijuana hype. For instance, a study came out a few years ago that showed that CBD (in doses 10,000 times of that found in the plant) reduced the size and growth of some brain tumors. You can guess the headlines: “Weed Cures Brain Cancer.”

Physicians need to actively confront the view held by so many that marijuana is a safe, natural and weak hallucinogenic. Some people even see it as a natural substance that can promote good health. One hospital in Pueblo, Colorado, reported in July 2016 that nearly half the babies tested over a one-month period had marijuana in their system. Vicky Houston, of Woodland Park, saw nothing wrong with using marijuana while pregnant. “I believe it’s beneficial, I don’t think it’s toxic in any shape or form,” she told a local television newsperson. These claims can be easily refuted scientifically but this false message is dominating the airways.

Today’s culture has made it almost impossible to talk about limiting the availability of marijuana to adults. However, it is the responsibility of physicians—and especially Christian physicians—to present the truth with love and grace. After all, we are our brother’s keeper.

James Avery, MD

James Avery, MD

Jim Avery is the National Medical Director for Diversicare Healthcare and Visiting Assistant Professor of Medicine at the University of Virginia’s School of Medicine.

Dr. Avery was in a solo one-physician practice for fourteen years doing internal medicine and pulmonary medicine. He was eventually persuaded to join Suncoast Hospice, the largest hospice in the country at that time, as their Senior Medical Director. Other stints included being Senior Medical Director at VNSNY Hospice in New York City, Chief Medical Officer at Golden Living in Washington DC and the Chief Executive Officer at Hospice of the Piedmont in Charlottesville.

He is board-certified in internal medicine, pulmonary, hospice and palliative medicine and is a certified nursing home medical director (CMD).

Dr. Avery was awarded the Lillian B. Wald Award for his hospice and palliative care work in New York City and the Roger C. Bone Award for National Leadership in End-of-Life Care. Dr. Avery was named “One of the 50 Most Influential Physician Executives” by Modern Physician magazine and was also nominated as “One of the 100 Most Influential People in Healthcare” by Modern Healthcare magazine.