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Title: A Doctor's Take on Pot
Source:
Scientific American
URL Source: http://blogs.scientificamerican.com ... t-blog/a-doctor-s-take-on-pot/
Published: Aug 23, 2016
Author: Nathaniel P. Morris
Post Date: 2016-08-24 11:14:24 by Deckard
Keywords: None
Views: 9724
Comments: 42
On August 11th, the Drug Enforcement Administration announced its decision to keep marijuana classified as a Schedule I drug. The federal government has historically referred to this category as the “most dangerous” group of substances, including drugs like heroin and bath salts. As a resident physician specializing in mental health, I can't make much sense of this. Every day, I talk to patients about substance abuse. Whether evaluating patients in clinic, in the emergency department, or on inpatient units, my colleagues and I screen patients for substance use. It's a vital component of any clinical interview, particularly in mental health care, and helps us understand patients' habits and their risks for medical complications. During my medical training, I've learned which substances to worry about, and which ones matter less. Alcohol is usually the first substance I ask about. Many people have seen drinking go wrong, be it a friend making a bad decision or a family member struggling with alcoholism. But clinicians see the worst of this on the front lines. Intoxicated patients stream into emergency departments after crashing their cars, inhaling their own vomit, or falling into a coma. According to the National Institutes of Health, alcohol-related conditions contributed to more than 1.2 million emergency department visits in 2010. The Centers for Disease Control reports excess alcohol consumption causes roughly 88,000 deaths in the US each year. And alcohol can be just as frightening when patients stop drinking. Heavy drinkers who don't consume as much as they usually do can go into alcohol withdrawal, ranging from mild tremors to terrifying seizures and death. I've spent much of my residency training so far learning how to treat and recognize complications from alcohol withdrawal. It's not only alcohol that clinicians worry about. Cocaine can cause heart attacks, kidney failure, and complications during pregnancy like placental abruption. Methamphetamine can trigger an assortment of responses, from hyperthermia to violent agitation to cardiogenic shock. Opioids like morphine can plunge patients into respiratory failure and kill them. Intravenous drug use puts patients at risk for hepatitis, endocarditis, or even brain abscesses. But, for most health care providers, marijuana is an afterthought. We don't see cannabis overdoses. We don't order scans for cannabis-related brain abscesses. We don't treat cannabis-induced heart attacks. In medicine, marijuana use is often seen on par with tobacco or caffeine consumption—something we counsel patients about stopping or limiting, but nothing urgent to treat or immediately life-threatening. The federal government's scheduling of marijuana bears little relationship to actual patient care. The notion that marijuana is more dangerous or prone to abuse than alcohol (not scheduled), cocaine (Schedule II), methamphetamine (Schedule II), or prescription opioids (Schedules II, III, and IV) doesn't reflect what we see in clinical medicine. This isn't to say marijuana is harmless. Indeed research suggests it may have deleterious effects on the developing brains of adolescents. Marijuana use has been linked to psychotic symptoms in some individuals. Synthetic marijuana has emerged as a new public health challenge and, in 2012, Congress added many of these toxic compounds as separate entities under the Schedule I category. According to NPR, Chuck Rosenberg, acting head of the DEA, explained the decision to keep marijuana as a Schedule I drug was based more “on whether marijuana, as determined by the FDA, is a safe and effective medicine." Regulations have prevented US researchers from answering this question over the last several decades. As written in a recent New York Times editorial, "the government itself has made it impossible to do the kinds of trials and studies that could produce the evidence that would justify changing the drug's classification." Yet, according to a 2015 systematic review, studies from around the world suggest cannabis and cannabinoid therapies may help patients in a number of ways. These include treating chronic pain, muscle spasms, debilitating side effects of chemotherapy like nausea, and weight loss from HIV infection. Dozens of US states have listened to such findings in recent years and passed legislation approving the use of medical marijuana. Despite keeping marijuana as a Schedule I substance, the Obama administration has promised to expand national research into the drug. This is a welcome change, and we'll hopefully develop deeper insights into the risks and the benefits of cannabis use. In the meantime, our nation’s substance policies should be grounded in the realities of clinical practice. In hospitals across the country, patients writhe in agony from alcohol withdrawal, turn violent from crystal meth, and struggle to breathe after overdosing on prescription opioids. These are the cases that keep health care providers on edge. These are the patients we follow closely. When our pagers go off, we hurry to the bedside, give medications, alert security or even begin resuscitation. With marijuana? Not so much. We rarely worry about marijuana. So why is it still a Schedule I drug?
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Begin Trace Mode for Comment # 33.
#1. To: Deckard (#0)
Here we f**king go again. Set up that "dangerous" -- no, "most dangerous" -- strawman and knock him down!
Back to that lie? "Schedule I drugs are considered the most dangerous class of drugs" - https://www.dea.gov/druginfo/ds.shtml
Hmmmm. Nothing on your link about "most dangerous".
Not any more - they pulled that text a few days ago: web.archive.org/web/20160...dea.gov/druginfo/ds.shtml
Probably because it was an outdated position they no longer have. NOW what are you going to do?
If by that you mean they realized that continuing to claim that marijuana was one of the "most dangerous" drugs had become so laughable as to do them more harm than good.
It appears they became sensitive to the fact that their phrasing did not comport with the Schedule I definition at 84 Stat. 1247 (1970). 84 Stat. 1236, 1247 (1970). It is codified at 21 U.S.C. § 812 without textual change. SEC. 202. (a) There are established five schedules of controlled substances, to be known as schedules I, II, III, IV, and V. Such schedules shall initially consist of the substances listed in this section. The schedules established by this section shall be updated and republished on a semiannual basis during the two-year period beginning one year after the date of enactment of this title and shall be updated and republished on an annual basis thereafter. (b) Except where control is required by United States obligations under an international treaty, convention, or protocol, in effect on the effective date of this part, and except in the case of an immediate precursor, a drug or other substance may not be placed in any schedule unless the findings required for such schedule are made with respect to such drug or other substance. The findings required for each of the schedules are as follows: (1) SCHEDULE I.— (A) The drug or other substance has a high potential for abuse. (B) The drug or other substance has no currently accepted medical use in treatment in the United States. (C) There is a lack of accepted safety for use of the drug or other substance under medical supervision.
Yes, "became sensitive" after at least 45 months of having that text on that page, just at the time when their decision to not reschedule was drawing attention to that page.
Like the commies of the past you want America drugged and stupid.
Was it commies who ended the Prohibition of the stupid-making drug alcohol?
Your changing subject. The commies like you want America drugged and stupid so that we fall as a nation. Your position is immoral.
Your changing subject. Nope - the subject was drugs and their unbanning.
Marijuana has not passed the tests that every drug must pass. Anecdotal evidence from the illegal use of marijuana does not suffice. For medical use, Medical marijuana requires that the product be of a known strength and purity. Even grandpappy making perfectly good shine, if he wants to go legal and get licensed, probably would have to do some things that he does not do when making his shine. And to get a schedule change, there nothing like reading who does it according to federal law. The Attorney General requests from the Secretary (not DEA but DHHS) a scientific and medical evaluation, and recommendations. The Attorney General considers and acts upon schedule changes. DEA is an enforcement agency, not a medical or scientific department. It is part of the Department of Justice. In the case of an applicable treaty, and there is one, removing a drug from the schedule would require a change in the treaty or federal law. http://law.justia.com/codes/us/2014/title-21/chapter-13/subchapter-i/part-b/sec.-811/ The Attorney General shall, before initiating proceedings under subsection (a) of this section to control a drug or other substance or to remove a drug or other substance entirely from the schedules, and after gathering the necessary data, request from the Secretary a scientific and medical evaluation, and his recommendations, as to whether such drug or other substance should be so controlled or removed as a controlled substance. In making such evaluation and recommendations, the Secretary shall consider the factors listed in paragraphs (2), (3), (6), (7), and (8) of subsection (c) of this section and any scientific or medical considerations involved in paragraphs (1), (4), and (5) of such subsection. The recommendations of the Secretary shall include recommendations with respect to the appropriate schedule, if any, under which such drug or other substance should be listed. The evaluation and the recommendations of the Secretary shall be made in writing and submitted to the Attorney General within a reasonable time. The recommendations of the Secretary to the Attorney General shall be binding on the Attorney General as to such scientific and medical matters, and if the Secretary recommends that a drug or other substance not be controlled, the Attorney General shall not control the drug or other substance. If the Attorney General determines that these facts and all other relevant data constitute substantial evidence of potential for abuse such as to warrant control or substantial evidence that the drug or other substance should be removed entirely from the schedules, he shall initiate proceedings for control or removal, as the case may be, under subsection (a) of this section. (c) Factors determinative of control or removal from schedules In making any finding under subsection (a) of this section or under subsection (b) of section 812 of this title, the Attorney General shall consider the following factors with respect to each drug or other substance proposed to be controlled or removed from the schedules: (1) Its actual or relative potential for abuse. (2) Scientific evidence of its pharmacological effect, if known. (3) The state of current scientific knowledge regarding the drug or other substance. (4) Its history and current pattern of abuse. (5) The scope, duration, and significance of abuse. (6) What, if any, risk there is to the public health. (7) Its psychic or physiological dependence liability. (8) Whether the substance is an immediate precursor of a substance already controlled under this subchapter. (d) International treaties, conventions, and protocols requiring control; procedures respecting changes in drug schedules of Convention on Psychotropic Substances (1) If control is required by United States obligations under international treaties, conventions, or protocols in effect on October 27, 1970, the Attorney General shall issue an order controlling such drug under the schedule he deems most appropriate to carry out such obligations, without regard to the findings required by subsection (a) of this section or section 812(b) of this title and without regard to the procedures prescribed by subsections (a) and (b) of this section. [snip]
Despite all the legalese you applaud, did you ever realize marijuana is a backyard weed? Or are you really understanding and knowing the goddamned concept that: GOVERNMENT CAN NOT ENFORCE MARIJUANA LAWS?
Correction. Marijuana is an illegal backyard weed.
#38. To: misterwhite (#33)
Top • Page Up • Full Thread • Page Down • Bottom/Latest"The federal government has historically referred to this category as the “most dangerous” group of substances, including drugs like heroin and bath salts."
#6. To: misterwhite (#1)
Here we f**king go again. Set up that "dangerous" -- no, "most dangerous" -- strawman and knock him down!
#14. To: ConservingFreedom (#6)
"https://www.dea.gov/druginfo/ds.shtml"
#17. To: misterwhite (#14)
Nothing on your link about "most dangerous".
#18. To: ConservingFreedom (#17)
"Not any more - they pulled that text a few days ago"
#21. To: misterwhite (#18)
Probably because it was an outdated position they no longer have.
#22. To: ConservingFreedom, misterwhite (#21)
If by that you mean they realized that continuing to claim that marijuana was one of the "most dangerous" drugs had become so laughable as to do them more harm than good.
SCHEDULES OF CONTROLLED SUBSTANCES
#23. To: nolu chan (#22)
It appears they became sensitive to the fact that their phrasing did not comport with the Schedule I definition at 84 Stat. 1247 (1970).
#24. To: ConservingFreedom (#23)
#25. To: A K A Stone (#24)
Like the commies of the past you want America drugged and stupid.
#26. To: ConservingFreedom (#25)
#27. To: A K A Stone (#26)
"Was it commies who ended the Prohibition of the stupid-making drug alcohol?"
#30. To: ConservingFreedom, A K A Stone (#27)
Nope - the subject was drugs and their unbanning.
(b) Evaluation of drugs and other substances
#31. To: nolu chan (#30)
#33. To: buckeroo (#31)
"Despite all the legalese you applaud, did you ever realize marijuana is a backyard weed?"
Replies to Comment # 33. backyard weed
End Trace Mode for Comment # 33.
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