Health care professionals from all over the country are gathering in Denver through Thursday for the Marijuana for Medical Professionals Conference at the 1770 Sherman Street Event Complex. Yesterday's speakers covered a range of topics, including a care provider's duty to the patient, the difficulties in dosing and detailed discussions about how marijuana behaves in the brain and the body. Here are five major takeaways from day one.
Number 5: There are many inherent problems with prescribing plants to treat a condition.
Dr. Larry Wolk, director of the Colorado Department of Health, compared marijuana to foxglove in his opening remarks. As a physician, he noted, it isn't as easy to recommend that a patient with a heart condition grow foxglove at home and then prepare it for consumption in order to reap the effects of digitalis. Instead, physicians prescribe Digitalin, which contains a single chemical rather than the many that comprise a plant.
Number 4: However, many physicians believe that the marijuana plant has benefits that its extracted chemical components lack.
Physicians who are willing to work with medical marijuana and its chemical components are not blind to the fact that many of their patients prefer the plant to other laboratory-created options, such as Marinol -- and many of them believe there is a valid medical reason for this preference. The presence of so many more chemicals in marijuana than in Marinol mean that those additional components are interacting in the body alongside the "active" components such as THC and CBD that are typically isolated.
Number 3: Not all medical marijuana patients desire a psychoactive effect.
Caregiver Robin Hackett of BotanaCare stated that many of her medical patients are elderly -- and a lot of them initially hesitated to use medical marijuana because they didn't want to experience the psychoactive effects of the plant. Other physicians noted that patient populations living with chronic pain and illness aren't seeking a euphoric high; they're hoping for relief from their assorted conditions.
Number 2: The endocannabinoid system, which reaches throughout the entire body, is the key to why medical cannabis is effective -- but this important system has yet to make it into the curricula of many medical schools.
Laura Borgelt, PharmD, gave a detailed explanation of how marijuana reacts with endocannabinoid receptors, particularly the CB1 receptor, which is found in the brain, connective tissue, glands and organs, and the CB2 receptor, found throughout the immune system. How THC and CBD (and other chemicals found in marijuana) interact with these (and other) receptors is important to unlocking the secrets of how marijuana works in the body. However, Dr. David Bearman stated that many medical schools aren't teaching students about the endocannabinoid system, which will cause problems in care provision as these students are asked about medical marijuana by their patients.
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Number 1: Research is essential to moving forward with the medical uses of cannabis.
Over and over, speakers reiterated that objective clinical research is absolutely vital to their continued ability to effectively care for patients. Too little is known about the active chemicals in marijuana, the endocannabinoid system, tolerance and dosing, and variance between and among patients. As the legalization of medical marijuana continues to spread and patients approach health care providers with questions about how the plant might affect their conditions, those care providers will need evidence-based protocols that are simply unavailable given the current state of clinical research.