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Evidence Necessary Before Prescribing Marijuana

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Jan. 5, 00
By Richard Roberts, MD.
Special to JSOnline
The medical marijuana debate was rejuvenated last month when Vice President Al Gore suggested that the government give doctors greater flexibility to prescribe the drug to relieve pain and suffering. Despite the new attention to the issue, an old problem remains: good, quality evidence that marijuana is superior to existing treatments does not exist. Nobody is more aware of patient suffering than those of us who dedicate our lives to alleviating it. If marijuana were really the wonder drug that some groups purport it to be, physicians would be in favor of prescribing it. But the fact is that the majority of patients respond very well to current, proven treatments. In my own experience, over the past 16 years of practicing medicine, I have never been tempted to recommend that a patient smoke marijuana. This is because established treatments have proven to work well for them. But do understand, however, that not every patient is so fortunate. What would we have to lose by trying marijuana in those difficult to treat cases? What we lose, more specifically, what the patient may lose, is the chance to treat the problem with one of the medications that have survived rigorous, well-controlled studies. To do otherwise, is to risk making the problem worse by pursuing an unknown course that may cause severe side effects and even death. I can't help but think the interest in medical marijuana is derived partly from myths about health care in America, that somehow magic cures, potions and "natural" remedies are available, but being denied to the public. As successful and sometimes amazing as modern medicine has become, Physicians can not work miracles. The human body remains in many ways a mystery. We are learning more, and need to learn much more, to help those patients who do not respond fully to traditional medicine. But subjecting patients to drugs that have not or can not pass scientific muster would be a violation of the physician's oath to do no harm. Science ultimately reveals secrets to conquering disease, even though the process may take longer than we would sometimes like. Dr. Roberts, of the State Medical Society of Wisconsin, practices family medicine in Belleville, Wisconsin. He is president-elect of the American Academy of Family Physicians. Published: January 5, 2000 © Copyright 2000, Milwaukee Journal Sentinel