Well, guess what non-toxic and inexpensive medicine patients use as a substitute for those expensive, dangerous pharmaceutical drugs? If you said marijuana, you are correct!

A recent survey conducted by the Berkeley Patients Group and reported in the American Psychiatric Association’s Institute on Psychiatric Services found that 66% of their medical marijuana patient clients reported using marijuana as a prescription drug substitute. Most patients said they used marijuana because it was more effective than their prescribed drugs and was accompanied with fewer, and less severe, side effects.

Unfortunately, the federal government insists that marijuana is a dangerous drug with no accepted medical use. Perhaps if it came in a pill, cost a fortune, and had debilitating side effects, it would sail right through the FDA approval process.

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This experience apparently taught Shurtleff why people would want to use this medicine. He even said that with the proper controls he would support a medical marijuana program in Utah, so that others in his situation wouldn’t have to choose between obeying the law and relieving their suffering. Hopefully, this will be a small step toward enacting such a bill.

Under current state law, Utah residents can be jailed for six months and fined $1,000 for possession of less than an ounce of marijuana. Sale of any amount nets a sentence of up to five years and a $5,000 fine.

While Shurtleff is to be commended for his change of heart, it is unfortunate that he had to go through such a horrible experience to finally see the necessity for medical marijuana access and patient protections. Our leaders shouldn’t have to feel the pain that patients feel to treat them with compassion.

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Canadian researcher Mark Ware presented results of a yearlong safety study known as the COMPASS study, which compared 215 patients who used marijuana to manage chronic pain with comparable control patients who did not use marijuana. Ware and colleagues report “no difference in serious adverse events” between the two groups, concluding, “Cannabis use for chronic pain over one year is not associated with major changes in lung, endocrine, cognitive function or serious adverse events.”

A much-awaited study came from the University of California, San Francisco, where Donald Abrams and colleagues tested the effects of adding marijuana to the therapeutic regimen of chronic pain patients on long-term morphine or oxycodone therapy. Unfortunately, because the researchers were crunching numbers right up until the conference, the abstract doesn’t include a lot of details. But the study shows that marijuana did indeed add significant pain relief on top of that already provided by the narcotic painkillers. The scientists conclude, “Cannabinoids may augment the analgesic effects of opioids, allowing longer treatment at lower doses with fewer side effects.”

Meanwhile, British researchers added to the body of evidence indicating that marijuana can aid the treatment of multiple sclerosis. Two-hundred and seventy-nine patients received either a standardized cannabis extract, given orally, or a placebo. Patients receiving the extract were twice as likely to experience relief of muscle stiffness, and also reported relief of body pain, spasms, and sleep problems.

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“I look at the risk-benefit ratio, and I worry,” Carroll concludes, and understandably so.

Rheumatoid arthritis is an autoimmune disease, characterized by inflammation of the lining of the joints. It can be painful and even disabling.

Of course, there’s a drug that’s a well-documented pain reliever and anti-inflammatory, and there is already some evidence that it may work for rheumatoid arthritis. It doesn’t cause fatal infections, cancer, or heart failure. But you won’t see major drug companies advertising it. Can you name this drug?

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Scott, who suffered a long, painful battle with degenerative joint disease and a degenerative disc disease, was a great friend to MPP and a tireless advocate for the rights of patients to use medical marijuana without fear of arrest.

Most recently, he was involved in the fight to pass a medical marijuana bill in New Hampshire, which was vetoed by the governor after legislators scrambled to pass a bill they had reworked to his specifications.

We here at MPP will miss Scott dearly, and we offer our sincerest condolences to his wife and family. We’ll continue your work, Scott, and make sure the New Hampshire legislature overrides Gov. Lynch’s veto and ensures no seriously ill Granite Stater ever has to endure what you endured just to treat your pain.

Here’s Scott back in August 2007, securing Obama’s support for the rights of medical marijuana patients, which led the Obama administration to announce its historic policy change earlier this year:

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Last November, the British government ignored the advice of its Scientific Advisory Board and moved marijuana into a more dangerous class of drugs, a move described by top scientists at the time as “a sad departure from the welcome trend … of public policy following expert scientific advice.”

Of course, here in the United States, government has been ignoring its scientific advisors on marijuana policy for decades, at least since Nixon first lined his bird cage with the two-year study he commissioned recommending marijuana’s decriminalization.

And that unwelcome trend continues to this very day here, as evidenced by drug czar Gil Kerlikowske’s recent lie that marijuana “has no medicinal benefit.” Not sure who Kerlikowske’s scientific advisors are, but the one we taxpayers use, the National Academy of Sciences’ Institute of Medicine, says: “Nausea, appetite loss, pain, and anxiety … all can be mitigated by marijuana.”

Then again, it doesn’t take a scientist to know that it’s wrong to deny sick people medicine that eases their pain, or to arrest responsible adults because they prefer a drug that’s safer than alcohol or tobacco.

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Okay, let me say right up front that a) I know that headline is provocative, and b) neither I nor anyone can answer the question with any certainty given what we know and don’t know so far about Michael Jackson’s death. But the question needs to be asked.

It needs to be asked because suspicions that prescription painkillers may have been involved in Jackson’s death are strong enough that the federal Drug Enforcement Administration has been brought into the investigation. And we know that he had a documented history of battling pain and at least some acknowledged problems with prescription painkillers.

We don’t know yet what pain drugs Jackson was on or what they were prescribed for. But if he was addicted to prescription painkillers, that addiction almost certainly started with legitimate and needed treatment for real pain. And that’s where medical marijuana might have helped.

We know — repeat, we know — that marijuana can be effective against certain types of pain. As The Lancet Neurology put it a few years ago, “cannabinoids inhibit pain in virtually every experimental pain paradigm.” We know that human clinical trials such as this one have found marijuana to be effective, particularly for neuropathic pain.

And there is considerable evidence that marijuana and cannabinoids can act synergistically with opioid painkillers, providing better pain relief at lower doses than either class of drugs by itself. For example animal studies such as this one have reported that such combination therapy avoids the development of tolerance and allows effective relief with lowered opioid doses — avoiding the pattern of escalating doses that can lead to addiction and overdose risk.

And there is evidence that this same effect occurs in people. For example, in a series of cases reported in the Journal of Pain and Symptom Management (which, alas, you can only access by paying for it — sorry!), patients on morphine and other narcotics were able to cut their doses roughly in half when smoked marijuana was added to their regimen.

At MPP, we hear similar stories from patients all the time: Again and again, patients tell us that use of medical marijuana allows them to cut back or eliminate the heavy doses of narcotic painkillers they’d been taking, while obtaining equal or better relief. There is enough science corroborating these accounts that they deserve to be taken seriously.

We can’t yet say that medical marijuana could have saved Michael Jackson, and we may never know that for sure. But there is simply no reasonable doubt that marijuana can help some chronic pain patients reduce both their suffering and their consumption of addictive and potentially deadly narcotics. If the U.S. government acknowledged that reality instead of denying it, lives could be saved — maybe lots of them.

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For the first time in my life, I’ve just been prescribed an opioid painkiller: hydrocodone/acetaminophen, commonly known by the brand name Vicodin. The occasion was a medical procedure known as brachytherapy. I’ll explain more about that below, but it’s pretty low on the fun meter. There can be lingering pain for a few days, hence my introduction into the fabulous world of narcotic pain drugs.

I can’t help but notice some odd contrasts with medical marijuana.

My prescription bottle came with a warning label affixed by the pharmacy, cautioning me about acetaminophen (best known as the active ingredient in Tylenol): “Taking more acetaminophen than recommended may cause serious liver problems.” It’s rather disconcerting that the most prominent warning in one’s first narcotic prescription concerns a pain drug that’s handed out almost like candy, one of the most common ingredients in combination cough-and-cold remedies sold over the counter. But the warning is a good idea: Overdoses of acetaminophen, mostly accidental (due to people combining cold medications and not knowing they’re getting multiple doses of the stuff), are estimated to cause 458 U.S. deaths each year due to acute liver failure.

Hydrocodone, a Schedule III narcotic, can cause physical dependence. Overdose can cause respiratory failure, cardiac arrest, and death.

Yet this useful but potentially deadly combination was handed to me in an ordinary prescription bottle, without even a childproof cap.

Now consider medical marijuana. It’s far less addictive than hydrocodone or other opioids. No fatal overdose has ever been documented. And yet it’s in Schedule I, so doctors are legally barred from prescribing it. In many of the states where patients are permitted under state law to grow marijuana for medical use, they are required to do so in an indoor, securely locked facility — while my narcotic cocktail doesn’t even rate a childproof cap. This is crazy.

This might be a good time to mention that if you want to help change some of this insanity, please sign up now for MPP’s free email alerts.

Finally, as promised, a word about brachytherapy. It’s a treatment for prostate cancer, involving the implantation of dozens (in my case precisely 85) tiny, radioactive seeds in the prostate gland. Over about six months or so, the radiation zaps the cancer and you live happily ever after. Please do not be alarmed. My little malignancy is early, localized, and non-aggressive. I’ll be fine.

And at this point I don’t actually have a need for medical marijuana. But dumb laws shouldn’t tie my doctor’s hands for no good reason.

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There is evidence that marijuana may work synergistically with opioid pain drugs, allowing equal or better relief with reduced doses of narcotics and reduced development of tolerance to the drugs. But most of this evidence comes from animal studies, so data from human clinical trials is urgently needed.

Dr. Donald Abrams of the University of California, San Francisco, is doing just such a study right now and needs volunteers who are suffering from chronic pain and currently taking OxyContin or MS Contin. Compensation and assistance with transportation to San Francisco are available. If you or anyone you know might be eligible to participate, please check out the details here and consider joining this important effort.

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