Dr Young:

Do you think the Supeme Court has refusal to disturb a lower court's decision to allow doctor's to discuss medical use of marihuana will have much effect in those nine states? Do you think other states will adopt it? Why can't the drug companies try to get the fda to use the same substance and market it? When is is usually needed, for salvage, late state cases? (By the way, I smoked it a lot years ago but grew to hate it as it made me so self conscious, tired and introverted, plus it is bas for lungs and I quit smoking tabacco for that reason). Kevin

Thanks for your question.

Since I'm neither an attorney or legal scholar, and have not read the Court's decision, you'll have to take what I say with an appropriate large grain of salt.

As I hear, the decision has less to do with the merits of medical marijuana than first amendment- freedom of speech issues. Either way, as a doc in one of the nine states, I've not taken much notice to the Court's then-impending review about MM, nor view that this will change my prescribing or counseling habits.

We have forms from the state of Colorado that we can fill out that provides documentation of the medical need for marijuana. The forms do not stipulate how patients might obtain the plant (this is the sticky part, since selling and growing, to my knowledge are still illegal). I usually don't go out of my way to encourage the use of MM, in part because of some of the issues that you've raised, but MM can be a good adjunct for some.

That said, part of my lack of overwhelming excitement over the ruling stems from the fact that we do have a FDA-approved, synthetic cannabinoid, dronabinol (Marinol) that has been used with great success in my practice in the treatment of anorexia, and to lesser extent, for nausea and other symptoms-- the very things that many would claim to require MM. In appropriate doses, there is little or no buzz (maybe this is why some are reluctant to use it). Not to sound like the pharmaceutical company has paid for this, but rather that the issues of legality and access are minimized with a pure chemical compound that is tested for safety and efficacy, and avoids the need to inhale tars. It's used in my practice for early- and late-cases, whenever the symptoms indicate their use.

Hope this helps, thanks for reading. BY