Patients who smoke Marijuana (MJ) are a curious lot. They come in with symptoms of depression, poor concentration, apathy, mood swings, and poor concentration, but they do not correlate these complaints to smoking. In contrast, patients who eat too much, drink excessive amounts of alcohol or caffeine will admit their habits are problematic – but never MJ users. They adamantly defend it. So many times I hear MJ smoking relaxes them and ‘takes the edge’ off. Sometimes they say they are self-medicating. What they will never admit to is they are self-medicating their MJ dependency. No MJ smoker has ever admitted MJ has any problems to it whatsoever.

By the way, another attribute of MJ smoking patients is they are very picky what they will ingest. They are dubious or antipathy about prescription medications, but they are OK to buy something off the street laced with goodness knows what.

I try not to get into argument with my patients whether MJ is safe or bad etc. What I point out is THEY shouldn’t smoke, given their manifest request “I want to get better”.

Alas, they seldom give up smoking. Most MJ smokers drop out of care as they don’t want to give up smoking and they know they will be continually asked to do so.

People do what they want, regardless or advice (or laws); they believe what they want to believe.

Is there actual medicinal benefits to MJ smoking? Should it be legal for medicinal purposes or even just for recreational use? I don’t know. I find it hypocritical two of the most addicting and damaging substances known to mankind – nicotine and alcohol – are legal. My topic today is the medicinal debate of MJ.

Is MJ smoking useful? I wish I knew. I want to support legitimate treatments for people and not go on hearsay, bad data, and hopeful wishes. Getting objective data on the medicinal use of MJ is hard to come by, as it is so politicalized.

In my studies on the topic, I read MJ has been used and prescribed for various treatments for several millennia, but that in itself is not a good argument to prescribe it. The discontinuation of bleedings and mercury baths were savagely opposed on this same argument.

MJ remains illegal for a very bad reason – the ravings of Richard Nixon. Nixon commissioned a study group on drugs. Based on the data they had, they recommended decriminalizing MJ. Nixon was livid.  He demanded that, despite the report, his administration issue a ‘goddam strong statement on marijuana”. Tapes released years later, reveal him adding anti-Semitic attacks against the advocates of decriminalization

“You know it’s a funny thing. Every one of the bastards that are for legalizing marijuana is Jewish. I suppose it’s because most of them are psychiatrists.”

Nixon won, and Marijuana remains to this day an illegal substance, no different than heroin and cocaine.

The kooky mixture of federal laws (where MJ remains illegal) but some state laws where MJ smoking is permissible makes everybody both confused and unhappy. Supporters of MJ smoking shouldn’t be happy that MJ remains illegal;  opponents shouldn’t be pleased with federally licensed illegal behaviors.

It is all a mess.

Whether MJ is useful, ‘safe’ and/or should be legal will remain a muddle for some time. I can’t imagine any politician with enough courage to make it legal.

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