WESTFORD PHYSICIAN WOULD NOT PRESCRIBE MARIJUANA TO PATIENTS

Responding to a spate of articles and editorials prompted by the
recent Supreme Court decision regarding medical marijuana, I
offer my take on the subject from the perspective of a practicing
physician. The key points for me are that, if such products could be
developed by the pharmaceutical industry, they would be regulated for
safety and efficacy by the Food and Drug Administration (FDA) and I
could be more certain as to the dose I would be prescribing. In
addition, I believe this would already fall under the purview of the
FDA, so that we do not need the courts to intervene. I would like to
make an illustrative comparison. Let's say I had a patient with
intractable pain for whom opiate therapy would be appropriate. I would
never tell him to go out and buy a few bags of heroin. Heroin can be
quite effective in easing extreme pain, but I could never be certain
of the dose he would be getting. Heroin is a street drug, cut
with any number of substances in illegal laboratories. What
adverse effects might these uncontrolled additives have? The
pharmaceutical industry provides us with a number of similar opiates
(such as Morphine), regulated by the FDA for safety in prescribed
uses, with standardized dosing. Several routes are available,
including oral, injectable and transdermal. I would like similar
availability and regulation of various drug delivery systems for the
active ingredient(s) of marijuana, so that I can be as sure of dosing
as I am for medically available opiates. Do I think marijuana should
be legalized? That is, or should be, a separate issue entirely.
We are addressing medical uses of marijuana. Simply put, I'm not
looking to prescribe smoked marijuana, but rather a regulated
medication.

Katherine L. Phaneuf, MD

Westford