The process of enlightenment requires shining a bright light on a subject or topic in order to achieve a better understanding of a problem.
“The Enlightenment”, a philosophical movement of the 18th century, was characterized by the belief in the power of human reason. Progress in human societies historically is only obtained through this process of enlightenment. Progressive change is often prompted by a crisis which then initiates dedicated debate and research.
The practice of medicine is no different, as it has evolved throughout the ages in response to all of the myriad of challenges associated with maintaining physical wellness.
We have a fantastic example of this very truth with the use of cannabis for medicinal purposes.
Cannabis has been a constant presence throughout the recorded history of mankind, beginning in 10,000 B.C. and continuing to the present era. A natural substance with the ability to grow in nearly every climate, cannabis was used by humans both industrially and medicinally for millennia.
A Bureau of Prohibition chief (Henry Anslinger), a paper magnate (William Randolph Hurst), and the pharmaceutical industry (Bayer) conspired with the nationalist anti-Mexican movement at the beginning of the 20th century to form the most successful prohibition the world has ever seen.
While cannabis is still classed as a Schedule I substance under the Controlled Substances Act, the social and scientific pendulums have swung away from the side of ill-conceived illegality. Public support for cannabis and its many uses is at an all time high, the most recent example being the statement made by millions of voters nationwide by passing various pro-cannabis ballot initiatives on November 8, 2016.
This latest historical resurgence of cannabis as a medicine is really a reintroduction of a whole plant based medication used safely for years, albeit not within the current classical, traditional American pseudo-corporate model of medicine.
Presently, Big Pharma and insurance companies rule the roost in America and somehow doctors and the care they give to their patients have been forced to take a back seat to boardroom politics and profit margins.
Both cannabis and opioids have long been recognized as being highly medicinal in nature and were used routinely by ancient civilizations in the ages prior to chemistry and molecular isolation.
The introduction of the hypodermic needle in the early 1900’s began a massive shift in the shared prominence of both substances. Opioids are water based and can be easily distilled for injection, while cannabinoids are oil based and thus were not easily prepared for the needle.
Cannabis wasn’t derided as a medicine because of a lack of efficacy, safety, or cost to the patient. Rather prohibition of cannabinoids from the accepted practice of medicine was adopted because of the profit potential apparent to the heads of the early American pharmaceutical industry. Physicians fought the purposeful exclusion of cannabis from the Pharmacopoeia in 1942, however the battle was lost to the detriment of their patients.
Many have suffered and died since opioids and other manufactured medicines began their reign of terror. The leading cause of death in the United States for persons aged 50 and younger is overdose, a statistic that is criminal. States like Ohio are suing the opioid manufacturers over the misrepresentation of the dangers of narcotics. Governor Rick Scott has announced sweeping reforms in prescribing and dispensing laws within Florida to curb the scourge of the opiate plague.
Now is time more than ever before to fight the battle against prohibition of cannabis, using the shameful situation corporate profits and simple greed have created. We can use the national state of emergency caused by opiate medications to liberate the chains of oppression from cannabis.
As a practicing physician, the vast majority of my career has been spent within the world of traditional American medicine. A 1981 graduate of the Ohio State University College of Medicine, my residency spent at Mt. Sinai in Cleveland, and 32 years spent on the emergency room floor, I’ve had an an active education in conventional standards of practice.
Since my retirement from full time emergency medicine in May 2015, I have had the chance to view the system as a whole from a different perspective. In my years in medicine I have witnessed profound changes in science and technology. The advent of the computer age, multimedia advertisements for specific medications for certain conditions, the rise of the patient satisfaction survey are all aspects of healthcare that have evolved during my career.
Society and our need for instant gratification has prompted a movement within the medical sphere requiring quick answers. Billboard, magazine, and broadcast adverts for medication are prohibited in most countries, with the United States as an exception. While patient education is vital, combining the “solve it now” philosophy with ads for specific drugs and wrapping up the encounter with the dreaded patient satisfaction survey, physicians have been forced into a role never intended for clinicians.
The balance between compassionate healthcare is dependent upon all parties playing their appropriate roles and factors in today’s field of medicine have placed doctors in a risky position where they are forced to make decisions to appease the patient’s insurer and their practical administration.
Medicine is an art and requires decades of continued education. Healthcare cannot be “sold” as a consumer or retail product. Appropriate healthcare is much more than just pleasing patient’s, board members, insurance companies and drug reps. The corporate practice of medicine has dumped us as a society into the depths of opiate depravity.
Early research and increased survey evidence demonstrates that medical cannabis can be an important adjunct in pain management, psychological disorders, and many other conditions. With an infinite therapeutic ratio, very few significant drug/drug interactions and a well known and predictable side effect profile, we as physicians should be rushing to embrace it.
My practice prides itself on our three basic tenets of deliberate practice – patient care, education, and advocacy. We are proud to offer significant educational resources to both our patients and the community at large. While I possess an active, unrestricted DEA license, I don’t write conventional prescriptions for my patients. By properly educating our patients on how to properly use cannabis to treat their specific ailments, we’ve seen marked reductions in prescription medications and incredible increases in senses of their well being. Yesterday a woman came walking into my office that just three months prior was wheelchair bound.
While progress within the cannabis space extends beyond party lines, there is a minority of individuals holding on to tired remnants of the prohibitionist past.
This past September 20th was an example of this as we had our most recent Patient Support Group. At our public Cannabis Town Hall meeting we were honored to host Representative Carlos Guillermo Smith (D-Winter Park), leading political advocate Gary Stein, and patient activist (and named litigant in the first suit against the Department of Health over his right to use whole plant cannabis) Joe Redner.
It was well attended by both patients, other activists from across the state, and the public.
At the same time across town, the Venice council voted unanimously to ban dispensaries from operating within city limits. No city government official was concerned or interested enough in the fact finding to reach out for to us with questions. As one of the largest clinical practices of medical cannabis in Florida, we have over 500 Venetians within our practice.
The city council’s ignorance is willful, as a councilman attended another of our monthly meetings. I cordially greeted him in the event center’s lobby and we exchanged words and cards. I invited him to both our clinic and our next support group, to which he declined.
It is appalling how elected officials can be so callous and shallow in their uneducated beliefs. It is infuriating that men and women elected to serve can turn their backs on the will of the 71.3% of Floridians who voted to approve Amendment 2.
The flame of prohibition is slowly being extinguished, but it is still hot to the touch. We must educate ourselves and others on the true history of cannabis and the science behind it.
Much as the AIDS crisis of the mid-80s created a turning point in medicine of the time, the societal cancer of opiates requires another direction in medicine – toward a safe and effective plant that was commonly used before the insidiousness of money crept into the American healthcare system.
Those who still hang on to tired and false dogma must accept the erosion of their moral authority. Politicians who defy the will of the people and stand in the way of another option of patient treatment must be voted out of office.
Only when cannabis becomes a first choice medicine will the war have been won. Until then we must educate and advocate.