Medical Marijuana: Health Risks and Benefits in California San Francisco NORML Conference April 19, 2002

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Medical Marijuana Health Risks and Benefits in
California San Francisco NORML Conference
April 19, 2002

• Tod H. Mikuriya, M.D., President

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Marijuana and Health Risks and Benefitsfor
California Physicians

• Intellectual challenge, clinical experience with
  patients, expanding upon medical intelligence
  prior to removal from clinical availability.
• Continuing experiences of confidence and trust of
  patients.
• Freedom from managed care
• Opportunities to optimize management of chronic
  conditions and advocate for the patient.

• Federal Threats Actions
• State Harassment
• Medical Board
• County DAs
• Sheriffs Police
• Organized, corporate, and individual medicine
• Marginalization and stigmatization
• Exclusion from conferences
• Advocacy undesired bias
• Abortion doctor
• Mill doctor
• Censorship from publications

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1996 Federal Threats Actions Against
California Physicians

• Removal of DEA Controlled Substances
• Moving to take Mollie Fry, M.D.s DEA
• Drop from Medicare None Yet
• Federal law suits- Injunctions prevent
• IRS audits- None yet
• Termination of grants- None yet
• Actions without threat Evolving Covert

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Benefits of medical marijuana for California
Physicians

• Continuing experiences of confidence and trust of
  patients.
• Opportunities to optimize management of chronic
  conditions and advocate for the patient.
• Intellectual challenge, clinical experience with
  patients, expanding medical intelligence prior to
  removal from clinical availability.
• Freedom from managed care

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Patients Medical Marijuana Benefits

• Safe and effective medicine to manage chronic
  serious medical conditions.
• Immunomodulator Analgesic
• Mood and affect modulator easement
• Anti-Spasmodic anticonvulsant
• Harm Reduction Substitute
• Multiple and concurrent therapeutic effects

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Cannabis Pharmacological Safety

• Free from unwanted side effects compared with
  mainstream polypharmacy and non-medical drugs-
  alcohol and nicotine..
• Compared with opioids, steroids, NSAIDS,
  sedatives, tricyclics, and benzodiazepines
• Improved quality of life
• Mobility, emotional well being and control of
  pain
• Less money spent on drugs to control side effects

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Medical Marijuana BenefitsPsychosocial

• Relief from criminal status
• Improved self esteem
• De alienation
• Increased participation in community
• Decreased fear and paranoia
• Improved critical thinking
• Optimal coping with chronic illness

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Medical Marijuana Medical Risks

• No pharmaceutical potency standards
• No guarantees of purity or freedom from
  contamination
• Pesticide residues, biologic agents, or heavy
  metals
• No dose consistency of oral products

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Medical Marijuana Risks

• Endemic Negligent Governance
• Criminal Justice System
• Attorney Generals Office consensus without
  tutelary mandate policy Counties do their own
  thing
• County and local absence of Training and
  Information Bulletins or General Orders.
• Problematic prosecutorial, court, and probation
• Excessive discretionary powers
• Subpoena abuse

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Medical Marijuana RisksPhysicians and Health Care

• Gross and pervasive non-compliance because of
  federal threats.
• He who pays the piper calls the tune
• Medicare, MediCal federally funded
• Federal academic medicine funded grants
• Federal Veterans Administration Hospitals
• General fear and ignorance of physicians

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A Statewide Audit is Critical

• I propose a statewide effort to Implement the
  Compassionate Use Act of 1996.  
• Beyond the current federal assaults on California
  patients, physicians, taxpayers, and voters,
  unless a systematic effort is organized and
  motivated with adequate funding, efforts
  conceiving and passing propositon 215 will have
  gone for naught.
• Only a comprehensive audit with remedial civil
  remedy will ensure the will of the voters five
  years ago.