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Legalizing Recreational and Medical Use of Marijuana: Here We Go!

Health Editor’s note: At least 12 states are ready to consider legalizing marijuana in 2018.  More will join the list so this will make a banner year for marijuana legalization.  Whether for medical or recreational use, states will be making the use of marijuana legal and more importantly more accessible. The statistics show that over 60 percent of Americans now support full legalization of use for adults. 

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The state of Michigan will probably create a system that will allow for licensed businesses to grow and sell marijuana products to adults while collecting a sales tax.  If the statewide vote is approved, Michigan will join the eight other states plus D.C. in allowing recreational use at 21. 

States that will move toward recreational use of marijuana will be: Ohio, Connecticut, Rhode Island, Delaware, Michigan, New Jersey, Vermont and those who are moving toward legalization for medical use are Oklahoma, Kentucky, South Dakota, Utah, and Missouri. 

What I see happening, are less arrests, convictions, jail and prison time for those who use marijuana. Jails and prisons will develop a decreased census, people who use marijuana will not be deemed felons and I think that is a good thing.  I also see the use of marijuana for medical purposes as a boon to medical care. What do you think?…..Carol

Talking About Pot with Cancer Patients

Discrepancy between oncologists’ actions, knowledge

by Charles Bankhead, Senior Associate Editor, MedPage Today

Cancer specialists frequently discussed medical marijuana with patients and almost half recommended cannabis for treatment, even though fewer than a third of the clinicians felt sufficiently informed, a national survey showed.

Overall, 80% the 237 oncologists surveyed said they had discussed medical marijuana with patients, and 46% reported they had recommended medical marijuana for management of cancer-related issues. Almost 80% of the conversations were initiated by patients, as reported online in the Journal of Clinical Oncology (JCO).

“Our findings identify a concerning discrepancy between oncologists’ self-reported knowledge base and their beliefs and practices regarding medical marijuana,” Ilana M. Braun, MD, of Dana-Farber Cancer Institute in Boston, and co-authors concluded. “These findings are clinically important and suggest critical gaps in research, medical education, and policy regarding medical marijuana.”

Having expertise in medicine means “knowing what you know, as well as what you don’t know,” said Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center in New York City, who was not involved with the study. “In the case of an emerging potential treatment option like medical marijuana, it’s understandable there might be some discrepancy in how much an oncologist knows about that option and how much they think that option might be beneficial or at least useful for consideration for a patient.”

The study raises questions about the current evidence base for medical marijuana and points out a need for more research to evaluate the benefit-burden ratio for medical marijuana as compared with other treatments for cancer and cancer-related side effects, added Epstein, who is a clinical expert for the American Society of Clinical Oncology. A better understanding of the logistics surrounding medical marijuana also is needed.

“A state might have made it legal for medical marijuana to be dispensed, but an individual might not have the process in place to dispense it.” Oncologists in states that have not legalized medical marijuana need education about the therapeutic alternatives that might be available, he added.

As of the JCO article’s publication date, 30 states and the District of Columbia had legalized use of marijuana for medical purposes, and all but one of the laws included cancer as a qualifying condition. The authors noted that the state laws encompass a complex topic, including terminology, biology, and formulations.

The term “medical marijuana” refers to nonpharmaceutical cannabis products that healthcare providers may recommend for therapeutic purposes that comply with state law. On the other hand, “therapeutic marijuana” refers to nonpharmaceutical cannabis products used with “medicinal intent,” regardless of compliance with the law.

Medical marijuana comes in a variety of strains and potencies, the authors continued. The products might be “smoked, vaporized, ingested, taken sublingually, or applied topically.”

No randomized trials have evaluated medical marijuana for oncology indications. As a result, oncologists must extrapolate from research on pharmaceutical cannabinoids or from evidence involving patients with other diseases and conditions.

Oral synthetic tetrahydrocannabinol received FDA approval for treating chemotherapy-induced nausea and vomiting. However, cannabis has hundreds of active ingredients that have both synergistic and inhibitory “entourage effects,” the authors noted, making comparisons between whole-plant medical marijuana and pharmaceutical cannabinoids that contain one or two ingredients. Observational studies showed that medical marijuana legalization is associated with reductions in opioid-related hospitalizations, but no randomized trials have compared the two strategies for pain relief.

Previous surveys of oncologist attitudes about medical marijuana addressed only use as an antiemetic and were conducted prior to passage of current laws. Braun and colleagues sought to obtain contemporary information about oncologists’ views and knowledge about clinical use of medical marijuana.

The investigators mailed surveys to 400 randomly selected medical oncologists. The survey included questions about clinical discussions of marijuana, views on comparative efficacy versus other therapies, risks of medical marijuana versus other therapies, and items to allow comparisons of respondent characteristics and their answers.

Subsequently, 237 oncologists responded to the survey, forming the basis for data analysis. The results showed that:

79.8% of the oncologists discussed medical marijuana with patients or families

78% of the conversations were initiated by patients or families

45.9% of the oncologists recommended marijuana clinically

56.2% of those who recommended marijuana did not consider themselves sufficiently knowledgeable to make recommendations

29.4% of all respondents felt sufficiently knowledgeable to make recommendations about medical marijuana

The authors reported geographic variation in the responses: Oncologists in the South were least likely (69%) to report discussing medical marijuana with patients or families or recommending it (34.7%), and those practicing in the West were most likely (95%, 84%; P=0.02, P<0.001). Oncologists who had a high practice volume (>60 patients weekly) and who practiced outside a hospital were also more likely to report discussions about medical marijuana, and practicing outside a hospital increased the likelihood of recommending medical marijuana.

With regard to oncologists’ perceptions about the effectiveness of medical marijuana, a third said they considered medical marijuana to be at least as effective or more effective than standard pain treatments, another third said it was less effective, and another third said they did not know. Two thirds of the respondents said medical marijuana is equivalent to or better than standard medications for cachexia. A minority said medical marijuana was at least equivalent to standard therapy for nausea and vomiting (48.4%), anxiety (45.8%), coping (40.3%), and poor sleep (34.9%).

The proportion of oncologists who responded “I don’t know” regarding medical marijuana’s effectiveness varied by indication, from 27.6% for poor appetite/cachexia to 45.1% for poor sleep.

“[The findings] highlight a crucial need for expedited clinical trials exploring marijuana’s potential medicinal effects in oncology … and the need for education programs about medical marijuana to inform oncologists who frequently confront questions regarding medical marijuana in practice,” the authors concluded.

Braun reported having no relevant relationships with industry. One or more co-authors disclosed relationships with UpToDate and Wolters Kluwer, and compensation for expert testimony.

Primary Source

Journal of Clinical Oncology

Source Reference: Braun IM et al “Medical oncologists’ beliefs, practices, and knowledge regarding marijuana used therapeutically: A nationally representative survey study” J Clin Oncol 2018; DOI: 10.1200/JCO.2017.76.1221.

Author Details
Carol graduated from Riverside White Cross School of Nursing in Columbus, Ohio and received her diploma as a registered nurse. She attended Bowling Green State University where she received a Bachelor of Arts Degree in History and Literature. She attended the University of Toledo, College of Nursing, and received a Master's of Nursing Science Degree as an Educator.

She has traveled extensively, is a photographer, and writes on medical issues. Carol has three children RJ, Katherine, and Stephen - two daughters-in-law; Suzy and Katie - two granddaughters; Isabella Marianna and Zoe Olivia - and one grandson, Alexander Paul. She also shares her life with husband Gordon Duff, many cats, two rescue pups, and two guinea pigs.

Carol's Archives 2009-2013

26 Replies to “Legalizing Recreational and Medical Use of Marijuana: Here We Go!

  1. Is Veterans Today now working for zionists to legalize drugs?

    Look the history… UK engaged China in two wars, the Opium War 1 and 2, to enforce chineses to buy the drug. If the british army was used who was profiting with the drugs? Yes, the british royal family is London bankers. And they rule the drugs market at centuries. In 2000 Taliban eradicated the opium production in Afghanistan; one year later the country was invaded by USA, UK, NATO armies for the sole purpose of restore the opium production. And they are there since then, and will stay until needed to ensure the opium production.

    1. Sukhoi Berkut, If you has paid attention to what the article said, there was no mention of legalizing opioid use, although that is already done with people getting prescriptions for opioids. This is about marijuana…..not an opioid. Opioids and marijuana…..not the same. Carol

    2. Great comments Johnny America. It’s true, Indica might as well be called In-da-couch, because if you smoke too much you’ll be stuck in the couch. However, throughout my 20 year experience with marijuana I’ve found certain Indica strains that I absolutely love. Like the Hindu Kush, for example. The taste is unmatched by anything else, IMO. However, if you over do it, it will put you In-da-couch and you WILL cancel whatever plans you have for the rest of the day. Personally, when I smoke potent Indica strains like Kush, I NEVER smoke a whole joint at once. I will roll one up and smoke it at different times throughout the night. That way I can make 1/4 ounce last a week.

      I never found that it made me stupid. A couple years back, I actually took an IQ test after smoking some O.G. Kush (a potent Indica) and got a score of 134..Lol..I NEVER smoke bongs, because I find bong hits will ruin your plans, whether your smoking Indica, or Sativa. I believe it’s because it’s nothing to cut up .5g (your average joint) and burn it all in one bong hit. I smoked bongs in high school, but not anymore.

    3. Many strains are hybridized these days. A lot of dispensaries will label their products either Indica dominant, or Sativa dominant. I think one of the main reasons there’s so much Indica floating around is because it’s more suitable to grow indoors. The Indica plants are often less than 6ft tall and super bushy. Whereas, I’ve had Sativa (like sour diesel and Great White shark) grow beyond 10ft tall! That makes Sativa harder to grow indoors for most people. Don’t get me wrong, I love my Sativa too! But, since much of what we buy on the streets was grown indoors, a lot of it will be Indica dominant.

    4. Carol Duff, you could not understand what I said, even if it is simple.
      Drugs are there for the profit of zionists and to create an army of brainless-dumb people, the walking (brain) dead. Marijuana do a “great” job by killing neurons, the only body cells that cannot replicate. Once the neuron is killed, that is forever. The reason drug users loose memory, have a slow brain, and related problems, is for that, they are killing the neurons.

      Dumb people are easy to control and dominate. That is the reason the zionists are pushing to legalize drugs. They want people like you, addicted, and not like me.

      And be honest with yourself… you are doing all of this only to justify your own addiction!

    5. “The finest herb you will ever smoke will be uplifting feather lite, see-through “foxtail” sativa buds…”

      Absolutely correct. That’s exactly how my sour diesel turned out one year and it was FANTASTIC. A great buzz without cancelling all plans and no burnout aftereffect.

      2g/day minimum in bong loads? Wow! It is probably the cleanest way to smoke it, but I just couldn’t do it.

      Thanks for the suggested reading. I’ll be checking that out, for sure.

    6. Sukhoi- Marijuana is NOT addictive. I smoked it everyday for 20 years and then in Dec 2017, I decided to go on hiatus and haven’t smoked it since. I have it around, but haven’t touched it. I’ve experienced no withdrawals or anything else that comes from quitting addictive substances.

  2. It is problematical when People know so little about the benefits of Herbs and Plants in the world around them and cannabis is definitely a major player for many uses while being a part of natural healing methods for thousands of years and found in ancient burial sites world wide . With a modicum of effort one can research Ethnobotanicals , and other plant categories that have historical use or avowed beneficial properties , one ‘ grass ‘ in particular you could grow in your landscaping and no one would have a clue . Ah , the old days in 1970 Viet Nam when one could buy a pack of ‘ OJ’s ‘ , pre rolled oversized joints with your choice of fill and extra oils ,all neatly packaged in a 10 pack ,sold right outside the base gates by men with suitcases holding everything from LSD to Opium . i saw this with my own eyes including many Military ‘ folks ‘ shipping material home in volumes . Hypocrisy defined by .gov . The Hemp family is an incredibly useful plant for Humans , part of natural living .

  3. Carol, I hope the ongoing research takes into account the many different strains bred in recent years that have very distinct effects. 30% THC strains are extremely potent, and can lack the therapeutic effects of the more traditional strains, which offer a more balanced ratio of the two main cannabinoids THC and CBD, which act synergistically. (Better highs also.) The upside is that tons more is now known about breeding and cannabinoids than even a few years ago, and there are some tremendous medicines being created. I suspect differing cannabinoid ratios can be tailored to address different conditions. The neurological benefits alone, to those with MS, Parkinson’s, Alzheimers, are tremendous. Also, method of ingestion matters a lot, with topical and edible/internal use showing particular promise in oncology. Thanks for this post.

    1. My sleep hasn’t been affected by the layoff. However, I find I’ve been having vivid dreams that I can clearly remember throughout the whole day.

      “After 3 months, you should flat out hallucinate when you resume…hehe…”

      Ya, when I resume I’m going to have to ease my way back into the shallow end. Lol…

      Enjoy that Power Plant x Frosty Freeze! Sounds awesome!

    2. WOW, This is amazing stuff! The same thing happened to you when you went on hiatus. Man, these dreams are so vivid that they seem absolutely real. Some are very intense, indeed. Some are hilarious, too. A couple weeks back I had a dream where I was given a sweet Harley in exchange for some construction work I did. I had so much fun riding it. It was awesome, until I was out partying and forgot where I parked it! I looked everywhere for it, but couldn’t find it anywhere. I was sooo pissed 😤. I even woke up pissed and it took me a couple minutes to realize it was just a dream.

      Wtf are dreams? If the things we see when we’re awake rely on light, than what about the things we see in dreams? We are in dark rooms with our eyes closed, yet things we see in dreams often seem as real as reality itself. Some suggest the pineal gland produces it’s own light and that’s what causes it.

      That’s crazy you mention the music produced in the mind. I’ve played guitar in a few different bands and that’s how I wrote riffs. I didn’t actually “write” them down. I’d hear them in my mind and produce them on the guitar.

  4. I would rather see it decriminalized rather than legalized. Two different things. Now of course, there would still be penalties if you are driving or using heavy machinery under the influence…just like any other medication or alcohol. In California, medical use has been legal for quite some time but, just legalized for recreation this year. Citizens of the state can grow up to 6 plants and there are caveats with max grams per household and can only be used in the confines of one’s private property. Of course the Feds can still come in with a SWAT team and arrest, destroy property, use deadly force and all the wonderful other violent things the stasi state does to people in the name of ” compliance” . California needs to use the 10th Amendment to nullify any Fed actions within the state on all levels to protect it’s states citizens rights. I believe the 10th Amendment Center is working on that now.

    1. And there you have said it: the feds can use any amount of force and violence to obtain compliance.
      Just remember, only the state can use violence as a means of forcing compliance. Even if they have to shoot you and kill you. Only the state can legally rob you(civil asset forfeiture) and steal your children (CPS).
      You will comply or else.

  5. Don;t forget, in states where the prisons have been privatized and the contracts signed between those state and the corporations that are to run them, the state has to promise to keep the prisons filled to 100%. Is marijuana is decriminalized, those who use it will no longer be criminalized and sent off to a prison for profit thereby reducing the numbers inside these corporate run prisons, thereby, it stands to reason that since these prisons must be maintained at full capacity, a new list of felonies must be created in order to do so. Misdemeanors must be converted to felonies and new laws written intended to criminalize what was once legal behavior must now become felonies with the resulting convictions and the prerequisite full capacity prison population for the profit of the stockholders.

    1. In Canada, the laws set to be passed in July permit the growth of 4 plants for personal use and personal possession of up to an ounce. Large government licensed producers (LP’s) are growing to sell to the public. The product of these LP’s is subject to the same scrutiny as organic food grown for public consumption. Health Canada representatives conduct inspections of these facilities to ensure standards are met. Every batch must pass analytical lab testing and products must be packaged and shipped in tamper-evident, childproof containers. Like anything new, there will be kinks to be worked out, but we’re going to have to wait and see what happens.

  6. I think legalization is a good idea. You make a great point regarding arrests, convictions, jail and prison sentences, Carol. I have seen CBD oil help my immediate family members in treating fibromyalgia, epilepsy and anxiety. It’s really made a difference in their lives and has allowed them leave behind the dangerous prescriptions and terrible side effects that go with them. It probably doesn’t work for everyone the same way, but neither does anything else. At least with marijuana, or biproducts like CBD oil, people don’t run the risk of becoming addicted to heroin, or having a long list of terrible side effects. So if it works for them, great. If not, you’re no worse off than you were when you started it. I’ve used it recreationally for about 20 years, but I’ve been on hiatus for the last five months. It hasn’t even been difficult. No withdrawals, no side effects from coming off it. Nothing. So ya, I say legalize it.

    1. Correction: “…has allowed them ‘to’ leave behind the dangerous prescriptions…”

  7. I feel pot is like marriage. You do not need the permission of anyone to live together and bear children, and you do not need a piece of paper to do it either. It ‘s all about possessions. If the husband dies he wants the wife to have his possessions, so the marriage certificate kinda does that. I’ve never sought permission to grow or smoke weed, and what the paper says just applies to possession or distribution. I’ve met too many dealers who have judges and lawyers as customers to care what people say. As for the medical benefits, it should be a crime, if it helps and somebody prevents somebody from getting it that needs or wants it.

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