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news about some herbs, and a peggy lee break
By | June 17, 2010
the Oregon Pharmacy Board reclassified marijuana as a “schedule II” drug under the state (not federal) Controlled Substances Act.
this puts it in the same category as morphine, oxycodone, amphetamine (Adderall), and methylphenidate (Ritalin), which would make it seem that we can now start writing prescriptions for it.
why do we write prescriptions, anyway? it’s to tell a patient what strength of medicine, taken how often, will be likeliest to help them. in schedule II, we provide just a 30-day supply with no refills, because the drugs are dangerous and must be closely monitored. if they aren’t helping you, they can only hurt you. you have to take them according to very specific directions.
now, your doctor doesn’t try each drug out, to see how it works in different strengths and frequencies, before prescribing it – that would be crazy. instead, we start from standardized prescribing instructions, based on scientific studies, in which the drug was first given, in certain doses at certain frequencies, to strong healthy people, so we know it doesn’t make you sick – then to sick people, so we know it makes you better. from this, we get a list of known effects – helpful/desired effects, known side effects, and possible adverse effects. these data tell us how we should write the prescription.
how are we going to do this with a plant? it’s like trying to write a prescription for tuna casserole!
there’s only one Ritalin, but there are many, many “marijuanas,” from the mississippi ditchweed that is (inappropriately) used in research studies, to the highly refined and concentrated strains currently cultivated for medical use by horticultural scientists in 14 states and the District of Columbia. if you used them identically, you’d get completely different results.
map by norml.com
if you’re reading this blog, you probably use echinacea at home, when you get a sore throat, right? well, what if echinacea were a controlled substance, that i was supposed to prescribe to you? i would have to name a very specific preparation (preferably one you could make at home*). the rx might say,
echinacea angustafolia, aerial parts
30% alcohol tincture
take 2mL PO scheduled four times a day for 5 days
please dispense 40mL
no refills
this will never happen, because this plant is regulated as a food, not a drug. so, instead, you have shelf after grocery shelf of teabags, tablets, capsules, and tinctures, of various species, from various locales, of all ages and degrees of freshness. i really have no way to tell you what these “echinaceas” are, which one you should take, how much to take, or how often to take it. i have no idea how to prescribe a plant – whether it’s “echinacea” or “marijuana.”
yet “schedule II” is a set of instructions for prescribing. so i’m confused.
no worries, though; nobody will be scribbling any rx’s anytime soon, ’cause the federal Controlled Substances Act bats last. my DEA license won’t cover marijuana, as long as it stays on schedule I for the feds – along with PCP, LSD, and other not-so-medicinal drugs.
(under the current Oregon Medical Marijuana Act, physicians never “prescribe” marijuana, they merely provisionally, and with many caveats, advise that marijuana might be one kind of treatment that could maybe possibly partly mitigate some of the effects of an individual patient’s particular illness – with only some illnesses being considered legit.)
i would like to remind everyone that the AMA (american medical association) did make the following statements recently:
“The AMA calls for further adequate and well-controlled studies of marijuana and related cannabinoids in patients who have serious conditions”
AND
“This effort should include… confirming that marijuana of various and consistent strengths and/or placebo will be supplied by the National Institute on Drug Abuse to investigators”
AND
“The AMA believes that the NIH should use its resources and influence to support the development of a smoke-free inhaled delivery system… to reduce the health hazards associated with the combustion and inhalation of marijuana”
AND
“Discussion of these alternatives between physicians and patients should not subject either party to criminal sanctions.”
the AAFP puts it in a little more backhanded frame:
“The American Academy of Family Physicians opposes the use of marijuana except under medical supervision and control for specific medical indications. (1989) (2007)”
here’s what i’d like to see: medicinal marijuana legalized universally (nonscheduled, and added to the United States Pharmacopeia) – with strong enforcement of antiprofiteering laws (much stronger than those currently benefiting pharmaceutical corporations and natural-remedy hucksters) – and immediate engagement of serious clinical research amongst the huge patient panels already in place.
you could start, in oregon alone, with the 1,294 cancer patients, 509 glaucoma patients, 791 epilepsy and seizure disorder patients, and 7,843 patients with intractable spasms caused by multiple sclerosis and other neurological diseases, who are current cardholders.
many of california’s 37,624 cardholders being treated for PTSD, mood disorders, and substance abuse (you heard right), could undoubtedly provide statistically significant samples.
and the (anecdotally) strong and effective medicines these patients use – “silver haze” for epilepsy, “granddaddy purple” for adverse effects of chemotherapy, “sour diesel” for multiple sclerosis, “new york diesel” for migraine headache, etc. – are a very far cry from the mississippi ditchweed employed in otherwise rigorously-constructed scientific studies.
it’s like studying carrot juice as a treatment for acne, when your patients are actually using accutane (both substances bearing a resemblance to vitamin A, but in completely different strengths, get it?).
“sour diesel?!”meanwhile, as reported by my crusading-journalist spouse, there’s a fake-pot panic brewing in the deep south. “herbal incense” that is supposed to “simulate marijuana” (yeah, right) has been outlawed in louisiana.
but that’s not all. from the same article, “HB173 would prohibit a number of plants from being blended and smoked or inhaled. The plants in question include mugwort, honeyweed, sacred lotus and dwarf skullcap.” ditto arkansas, georgia, kansas, and others.
see why they call it ’skull-cap’?and why? “It’s in our high schools and it’s spreading rapidly“! jeez, in my day it was banana peels, “lettuce opium,” morning-glory seeds and nutmeg. perhaps these states will someday have to institute a “Medical Skullcap Program”, where diagnosed insomniacs may register to use herbal sleep aids without fear of going to jail. have they already developed the random drug testing programs that will detect mugwort in the urine? if so, i’m quite impressed – creating many jobs, no doubt, in a nation of unemployed.adults and at-risk youth. (whoops, they’re already on it.)
mugwort, coming soon to a DARE program near you!my young and glamorous spouse comments that next on the lawmakers’ target lists might be “spinning around really fast, masturbating, or any other activity that might alter a young person’s consciousness,” and wonders “where the natural health community is on this issue, or if they are laying low because it’s targeting head shops instead of Whole Foods.”
meanwhile,
and it’s a good day for curin’ your ills,
so take a deep breath, and throw away the pills,
’cause it’s a good day from mornin’ till night.
*how to make the aforementioned echinacea tincture:
Blend equal weight to volume (1:1) of flower heads and leaves (fresh) to alcohol [100 proof]… This provides approximately 30% alcohol tincture which is ideal for extracting polysaccharides (water soluble), cichoric acid (alcohol soluble) and akylamides (alcohol soluble).
…100 proof is 50% alcohol. When you add an equal weight of Echinacea flowers and leaves, you in effect reduce the alcohol percentage to about 30%, because the Echinacea flowers and leaves contain about 85% water. Thirty percent alcohol is adequate to preserve the tincture.
observe me NOT prescribing it. because it’s a PLANT!
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