By Robert C. Goethe, MD
Medical marijuana (cannabis) is a relatively new phenomenon in the United States, being first legalized in California in 1996 and now available in 29 states. It’s becoming ever clearer to many physicians that it is a very effective medicine that can be used for chronic pain, control of seizures, anorexia, PTSD, and many other maladies. Pharmaceutical companies have jumped on the bandwagon too, and are acting to patent the active ingredients and profit off of it.
One issue that is frequently encountered is how safe is it to use with people with alcoholism.
About one in nine Americans is addicted to some mind-altering substance, most commonly alcohol because it is legal and available. Alcoholism kills about 88,000 people a year in the United States. Active alcoholics have a life expectancy 30 years less than an average person, and their lives are typically unstable. Many find a solution by way of Alcoholics Anonymous (AA). AA is based on abstinence, not moderation, and urges avoiding all psychoactive drugs. AA stresses a clean and sober existence based on a spiritual (not religious) program.
Cannabis is quite a bit different than alcohol in several ways. It is not physically addictive, nor does it harm your liver or kidney or cause “wet brain”. Behavior on alcohol is described as “rowdy and aggressive” while cannabis usually has a calming effect. Many lives are ruined by alcohol but one is hard-pressed to find a comparison to cannabis, except that it is illegal and can arouse the ire of the legal system.
There has been some experience in California where doctors have used cannabis as a substitute for alcohol, calling it “the lesser of two evils”. There is anecdotal evidence that this has been successful, but certainly not ideal.
Then there are those who have quit alcohol on their own and began self-medicating with cannabis. In AA this is called “the marijuana maintenance program” and is not encouraged.
Alcoholics who successfully quit drinking call themselves “recovering alcoholics” and generally live normal, happy lives once they remove the obsession to drink. However, they are prone to illnesses just like the rest of us and it’s not uncommon to find them having to take pain pills, anti-anxiety mediations and anti-depressants. Percocet, OxyContin, Xanax, Klonopin, Lyrica, Gabapentin, and many others are potentially addictive and dangerous with serious side effects. Cannabis can be a safer substitute and by many reports, is more effective.
I use the word cannabis because “marijuana” carries with it so much of the bad connotation implied by the DEA over the last 45 years who labeled it as dangerous, addictive and of no medical use. Oddly enough, the government has recognized that this is untrue and recognizes that this label has enabled pharmaceutical companies to synthesize some of its compounds and sell it at great profit. In fact, the federal government secured the patent, (National institute of Health Patent No. 6,630,507) for cannabidiol (CBD), the non-psychogenic component in cannabis that is recognized as an anti-inflammatory, anti-seizure and potentially anti-cancer molecule.
Medical cannabis is an extract from the marijuana plant and contains varying amounts of CBD, THC, and other compounds that make it unique and better than any one compound a pharmaceutical company can isolate and sell back to us. In fact, many strains of cannabis now have these compounds in specific ratios that give the patient the sought after effect without the psychogenic “high” effect, if desired.
When talking to other doctors experienced in this topic, it has been noted that medical cannabis prescribed for medical conditions has not been a problem for recovering alcoholics. It is my recommendation to alcoholics who are in recovery to avoid recreational cannabis and keep a clear head. But if there is a medical condition that can be treated with cannabis, it is most likely to be a very safe and effective medicine compared to what is available from pharmaceutical companies.
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Dr. Bob Goethe is a board certified anesthesiologist, with over 40 years of medical experience who is now semi-retired in Citrus County and chooses to support the medical marijuana initiative because he has seen it’s benefits in patients and strongly believes in the cause.