medical marijuana

[True Anomaly]

I don't think a meta-analysis refers to a body of evidence, particularly given the conclusions of both publications which suggest thc or derivatives may be helpful in certain instances. Neither paper, however, seems to constitute a ringing endorsement. Additionally, I am relatively sure you must be aware that meta data analysis is subject to errors due to adverse data selection and omissions. The authors do appear to have made efforts to avoid that and their conclusions don't appear to be politically motivated. But even if you take the conclusions at face value, they don't offer tremendous support for the use of cannabis. The risk of adverse events, in my mind, is of greater significance when the potential benefits are marginal or questionable, as seems to be the case here. Meta analysis has been popularized in medicine, in part, because patient data is difficult and expensive to gather. Generally, though, it constitutes doing retrospective research on someone else's research data. The conclusions, though interesting, hardly constitute a body of evidence in favor of the use of cannibis and I don't know that the authors intended their conclusions to be definitive. Are you sure you aren't reading what you want into the conclusions?

 

I assure you I have no bias for or against marijuana in the medical setting- although I'm happy to see marijuana actually be studied to look at effectiveness rather than just banished to the netherworld of Schedule I and pretend like it doesn't exist.  The only bias I have is against the over-prescribing of opioids, which I'm also happy to see that efforts are being made to turn around our practice patterns for the past 15-20 years.

[DogLovingPA]

I don't have a strong opinion one way or the other for the use of marijuana for medical purposes or for it's legalization.

 

On an ancillary note for those of you who are in states where it can be used legally (illegal in my state) -  in pulmonary we have had a handful of patients who inhale marijuana oils via vaporizer with some pretty impressive CT scans of their lungs.  Obviously, a few observations can't be extended to a blanket statement about the safety of vaporized marijuana oil but these were folks in their young 20's so how they inhale/consume/use the drug may have implications.  The one patient I am thinking of that comes to mind has stopped using the oils, I'm interested to see what his repeat scan looks like in 6 months to see if the effects have reversed.  

[Reality Check 2]

Dr. Dustin Sulak is not a board certified physician.

He did a one year internship and then turned to medical marijuana and complementary medicine.

No offense, he looks to be about 12 years old and probably rides a skateboard to work.

 

He gets into all kinds of neat things like hypnotherapy and such but, in my opinion, is in no way an expert on marijuana despite being a member of the Academy of Marijuana Doctors or whatever it is called.

 

God Bless the Internet - you can make a video about just about anything and call yourself an expert.

 

A video featuring a cover shot of Cheech and Chong is funny but questionable in integrity.

 

Go check his credentials for yourself....................

 

http://www.maine-health.com/providers/dustin-sulak/

 

My opinion doesn't change about MJ - still not federally legal. Still not fully researched in all its flavors and potentates and interactions with other meds. It can get me and my patient in more trouble than it is worth................

[Reality Check 2]

ktkalt - take a deep breath

 

I have been a PA for over 25 years and I taught at an Osteopathic Medical School.

 

He IS NOT BOARD CERTIFIED. He did an internship. Says so right on the site I cited. Board Certification is Family Medicine, Internal Medicine, Neurology, Psychiatry etc.

 

He did the minimum of one year of internship to become a licensed DO. He cannot practice as anything specialized without a residency and training.

 

Your info is all wrong. I know what I am talking about and you are reacting and lashing out.

 

I KNOW WHAT A DO IS - I WORK WITH THEM ALL DAY EVERYDAY. I KNOW THE DIFFERENCE BETWEEN DO AND MD AND I KNOW WHAT A RESIDENCY IS AND WHAT BOARD CERTIFICATION IS.  YOU need to read about it and figure it out.

 

Do not lash out at me - I AM A PA and I have every right on this site. You are wrong, wrong wrong and not presenting facts or appropriate information.

 

STOP - I am not going to go over this with you.

[Reality Check 2]

"In my academic journey, I earned two bachelor degrees in Biology and Nutrition Science from Indiana University in Bloomington. In 2008 I graduated from the Arizona College of Osteopathic Medicine at Midwestern University – Glendale. Although my medical school curriculum emphasized allopathy, my osteopathic degree has given me the opportunity to learn from some of the best D.O.’s in the country. I have spent much time and study developing my skills in osteopathic manipulation, including cranial and biodynamic osteopathy.

After medical school I completed a one-year internship at the Maine Dartmouth Family Medicine Residency, which included rotations in emergency medicine, surgery, obstetrics, geriatrics, pediatrics, and inpatient internal medicine.

Additionally, I have studied with a Lakota Medicine Chief, a Lubavitcher Rabbi, several excellent allopathic and osteopathic physicians, and many teachers of yoga, qi gong, tai chi, meditation, Reiki, and other forms of hands-on energy healing.  I regularly attend cannabis research conferences and am a diplomat of the American Academy of Cannabinoid Medicine.  I always continue to learn, practice, integrate, and teach the cutting edge techniques of the healthcare evolution."

 

Direct quote from the website I cited. It is the clinic where this guy works.

READ AND EDUCATE BEFORE YOU SPOUT.

 

[rev ronin]

Ktkaltmed has been disinvited from the forum for blatantly unprofessional and antagonistic discourse. (in case any of you were wondering where the posts that generated the hoopla went)

[PACdan]

I don't have a strong opinion one way or the other for the use of marijuana for medical purposes or for it's legalization.

 

On an ancillary note for those of you who are in states where it can be used legally (illegal in my state) -  in pulmonary we have had a handful of patients who inhale marijuana oils via vaporizer with some pretty impressive CT scans of their lungs.  Obviously, a few observations can't be extended to a blanket statement about the safety of vaporized marijuana oil but these were folks in their young 20's so how they inhale/consume/use the drug may have implications.  The one patient I am thinking of that comes to mind has stopped using the oils, I'm interested to see what his repeat scan looks like in 6 months to see if the effects have reversed.  

 

The same issue is evolving with the popularity of vaping. These solutions ("e-juice") of nicotine, vegetable glycerin, propylene glycol, flavorants and other additives are not regulated. I am aware of the use of diacetyl for flavoring in some of these vaping suspensions and its link to bronchiolitis obliterates (popcorn lung). I wonder if these cannabis oil preparations are also being flavored or include other adulterants?

[kittryn]

Ktkaltmed has been disinvited from the forum for blatantly unprofessional and antagonistic discourse. (in case any of you were wondering where the posts that generated the hoopla went)

 

what? why are you penalizing ktkaltmed for confronting this clown reality check 2, and contributing to the topic? I can't believe that! and you're leaving his smears all over this thread, what could have been interesting if a dialogue had been allowed to proceed without abuse and condescension?

 

wow

[Reality Check 2]

Kittryn

 

I am not a clown and you have stooped to a childish level by using the reference.

I am a professional PA of over 25 years who works clinically and at the Masters educational level. I have called no one names nor used profanity or stated falsehoods.

 

My notations to the dismissed poster involved factual information easily obtained about a person who is not a board certified physician.

The Ktkaltmed person had no idea what it takes to become a board certified physician and began name calling and using abusive, unintelligent and childish interactions that are inappropriate to this forum and our profession.

It was not a dialogue and had nothing to add to the discussion. 

 

Your deeply held beliefs about marijuana are duly noted but obviously not shared by many on this forum. If that is upsetting to you - then perhaps you should seek another forum dedicated to the medical use of marijuana or just accept that others have strong feelings as you do and respect that. 

 

Also, I am a woman, not a he.

 

I respect and value this forum as an avenue to speak with my colleagues all over the country and discuss matters of importance. This forum is not for fighting or bashing or pushing an agenda.

 

Please respect that. 

 

My opinions and discussions are as valuable as yours. 

 

There is, however, no place for name calling, smearing, slandering, childishness or abusive behavior. 

When posting about a topic, one should do research and know the proper and actual processes for things such as board certification. 

 

I will not risk my access to this forum by engaging in conversations that have no purpose or use the above behavior.

 

That said, I have no further comments about medical marijuana.

[kittryn]

I can't even read this thread anymore. totally disappointing.

 

rev ronin, I am really sorry you have allowed this "reality" check person to dominate and destroy any reasonable discourse on this topic. I really think it is a mistake to let a bully take over any thread. I was enjoying the comments and information so far about medical marijuana, and I think that "reality" check's comments were far more inflammatory than anything anyone else has said here.

 

and oops - I was confusing "reality" check with the other relentless poster on this thread, "johnnyM2", who is not a PA. they sound very much the same.

 

maybe you should just take the whole thread down, as it seems to be a topic that arouses intensely critical behavior from some, and the actual comments that are attempting to explore the topic are being drowned out. doesn't seem to be much point in keeping it up.

[kittryn]

I don't have a strong opinion one way or the other for the use of marijuana for medical purposes or for it's legalization.

 

On an ancillary note for those of you who are in states where it can be used legally (illegal in my state) -  in pulmonary we have had a handful of patients who inhale marijuana oils via vaporizer with some pretty impressive CT scans of their lungs.  Obviously, a few observations can't be extended to a blanket statement about the safety of vaporized marijuana oil but these were folks in their young 20's so how they inhale/consume/use the drug may have implications.  The one patient I am thinking of that comes to mind has stopped using the oils, I'm interested to see what his repeat scan looks like in 6 months to see if the effects have reversed.  

 

I'm not sure vaping oils is safe. I think it is generally recommended that vap(es?) be used with the dried, ground up plant material itself.

[JohnnyM2]

I can't even read this thread anymore. totally disappointing.

 

rev ronin, I am really sorry you have allowed this "reality" check person to dominate and destroy any reasonable discourse on this topic. I really think it is a mistake to let a bully take over any thread. I was enjoying the comments and information so far about medical marijuana, and I think that "reality" check's comments were far more inflammatory than anything anyone else has said here.

 

and oops - I was confusing "reality" check with the other relentless poster on this thread, "johnnyM2", who is not a PA. they sound very much the same.

I did, however, stay at a Holiday Inn. Does that count? Reality Check, I'm not sure which of us is being insulted here, but I'm ok being insulted along with you. IMO, disagreeing is not the same as being inflammatory, nor is vigorous defence of a position.

I do find it interesting that the medical marijuana topic is so emotionally charged that a professional discussion can't be sustained, which is why I stopped my "relentless" posting.