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Pot for PTSD? Oregon's medical marijuana law needs grounding in science, medicine

Posted: 08.29.2012 From Blog: 420 Blog

 

Pot for PTSD?

pot.JPGView full sizeBeth Nakamura/The OregonianOregon's medical marijuana program allows people to become cardholders if they have a qualifying medical condition such as severe pain. One politically loaded question facing the state is whether to include post-traumatic stress disorder on the list of qualifying conditions.

If Oregon held a public hearing on whether to define marijuana as an effective treatment for post-traumatic stress disorder, here's what would happen: 

First, several Oregon veterans would testify about their positive personal experiences with marijuana in treating their combat-related stress and anxiety. 

Second, marijuana advocates would speak in favor of adding PTSD to the list of qualifying conditions for Oregon's medical marijuana program. How could we do any less, they'd ask, for people who have served our country so honorably? How could we let even one veteran suffer? 

Finally, a couple of drug-treatment specialists would express concern about some common side effects of marijuana, including paranoia and addiction. 

At the end of the hearing, Oregon would wind up exactly where it started: short on clinical medical evidence, long on personal testimony and overflowing with politically loaded arguments. 

It's a fine way to debate marijuana, as other states have found, but it's not a great way to practice medicine. 

Medical marijuana advocates want Oregon to treat PTSD on par with severe pain, severe nausea, seizures, HIV/AIDS, muscle spasms and other health problems on the state's long list of qualifying conditions, as The Oregonian's Noelle Crombie reported this week

There's no evidence that Oregon veterans with PTSD have a hard time obtaining medical marijuana cards. (The inclusion of severe pain as a qualifying condition makes it possible for almost anyone to get a marijuana card, if a sympathetic doctor is handy.) There's also not a robust body of research showing marijuana as an effective medical treatment for PTSD. The state of Arizona, for example, recently decided not to add PTSD to their list of qualifying conditions for medical marijuana, based on the scarcity and quality of available studies. 

Yet PTSD comes up often in marijuana debates, because it's a hard-to-treat disorder -- and because it's easy to exploit for political purposes. It allows advocates to drape an American flag around the question of expanded legalization and let emotion ride herd over facts. 

The best available anecdotal evidence suggests that marijuana can provide relief for many patients with many types of medical problems, including PTSD. It would make sense, as the American Medical Association has recommended, to significantly expand the research and develop clinical trials to gather more information about side effects, optimal doses and best THC concentrations for different types of patients, including veterans with combat injuries. 

It also might make sense, ultimately, to further decriminalize marijuana as a recreational drug. 

Either change would require altering the short-sighted federal laws that wrongly classify marijuana like heroin and forbid all but the most limited medical research. 

The only untenable option is for Oregon to keep expanding its medical marijuana program without the science to back it up. It's the equivalent of practicing medicine without a license and dispensing medical advice based on personal anecdotes, political pressure and Google searches rather than sound evidence. People with serious health problems -- yes, especially veterans -- deserve better. Granting people permission to smoke pot is a government function, to be sure, but let's not pretend it's medicine. 
 

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