by Croakker » Sat Mar 19, 2011 10:35 pm
OK, here's my input from having watched this thing. Warning: it's a long critique. And to disclose, I'm on the fence about legalization. I don't use it, don't intend to use it, and if I ever catch my boys using it, I'll make them regret it.
First of all, not all peer reviewed literature is the same. JAMA, New England Journal of Medicine - these fall into the category of medical literature titans. If it's published in a journal like this, it's gold. There's an entire spectrum between that, and the slum journals that basically exist to pad the CVs of researchers. Knowing which are which takes some experience with reading these journals. Some of the ones he quotes from are more obscure. Addiction, the British Journal of Clinical Pharmacology, BMJ (British Medical Journal) - these are heavyweights. Some of the studies he quotes are from articles published in very minor journals. If they were well-designed studies, they'd have been published in the big boys. Also, the narrator doesn't fully explain some of the findings. It makes me wonder if he's being intentionally sensational, or just doesn't know how to critically read an article.
Marijuana-year: With smoking, it's referred to as 'pack/year'. If you smoked a pack a day for two years, you have a pack/year history of 2. If you smoked two packs a day for one year, you also have a pack/year history of 2. It is very evident, through a number of studies, that marijuana smoke is far worse for you than a regular cigarette, mostly due to the lack of a filter such as are on commercial cigarettes. However, few people sit and smoke 20-40 joints a day. I don't use marijuana, so I'm not sure how many the typical user smokes in a day, but I'm betting it's less than 10. So, in comparing marijuana/year and pack/year, it's a little bit of an artificial comparison. That's not to say unfiltered marijuana smoke is safe; it definitely causes injury to cells and can promote any number of oral cancers just as, say, cigar smoking would.
Driving under marijuana. When I was in college, my psych prof actually hired some students and performed an experiment where they drove on a track with obstacles representing humans. They did it three times: sober, drunk on alcohol, and after a few joints. When drunk, the subjects reaction time was slowed, and they failed to avoid the obstacles. When high, they drove slower, but didn't even swerve when presented with an obstacle.
Marijuana and pregnancy. Yes, the odds ratio quoted in that paper is 1.36. The incidence of malformation of a child is 1.36 times as likely among marijuana smokers in that study. BUT, next to it is the confidence interval, which extends from 0.97 to 1.91. Think of it as the margin of error of their results. Dipping below 1.0, I would discount this statistic. The more pressing statistic to me is in the adjacent table, where it shows that someone who smokes 3+ tobacco cigarettes a day has an odds ratio of 1.56 of having a low birthweight baby, with a confidence interval well above 1.0. Don't smoke while pregnant!
Yes, he doesn't really go into medical marijuana. The purpose of his talk was to discuss recreational marijuana.
Medical marijuana works. Numerous studies show lighting a joint or ingesting it helps with nausea related to cancer treatments, and improves appetite in terminal AIDS. There are also numerous studies that demonstrate significant benefits in chronic pain, journal articles that I myself have read in depth. Here's the kicker though: the medical marijuana used in all the studies published in the anesthesiology literature - the experts in pain management - were done using Marinol or it's Canadian equivalent who's name escapes me. That's the pill form, using the active ingredients of marijuana. NOT smoking it.
Medical marijuana as practiced by some other states is mostly a fabrication to cover distributing marijuana. Don't believe it? Colorado... 100k prescriptions for medical MJ in 2009. How many were written for people suffering from cancer, glaucoma, HIV? Combined, it was less than 3% of the total. Over 90% were written for chronic pain. And of those, 75% of the prescriptions went to people less than 40 years of age. That's a lot of young people with chronic pain symptoms. Oh, and the vast majority of those prescriptions were written by just 15 physicians. (My source for this paragraph was Time magazine, if you were curious.)
I think there was a bit of bias in the direction of warning against the use of marijuana in this video. While I don't want my kids smoking joints, I think alcohol is a much bigger short term danger, and tobacco a much bigger long term danger. I work in a hospital, and I see a lot of people with traumatic injuries due to drunk driving (them, or the idiot that hit them), and an even greater number of people with issues from tobacco abuse. I also think the US wastes a lot of time and money in the prosecution and internment of marijuana users and distributors, money that could be used much better in a lot of other arenas. Now, heroin, cocaine, PCP... those should never be legalized; they'll kill you.
Of course, while I see very few people with marijuana related trauma / medical issues - and I've never even heard of an overdose - I'd never want to have my physician treat me after smoking a joint. Or let someone drive who had been.
Edit: I will say the most common issue I've seen in the OR from marijuana would be the young guys who smoke a huge amount daily who then come in to have their gynecomastia taken care of. In other words, Kilt - the joints led to them growing breasts, which they then had to have reduced. Built in Saturday fun for you, perhaps?
OK, here's my input from having watched this thing. Warning: it's a long critique. And to disclose, I'm on the fence about legalization. I don't use it, don't intend to use it, and if I ever catch my boys using it, I'll make them regret it.
First of all, not all peer reviewed literature is the same. JAMA, New England Journal of Medicine - these fall into the category of medical literature titans. If it's published in a journal like this, it's gold. There's an entire spectrum between that, and the slum journals that basically exist to pad the CVs of researchers. Knowing which are which takes some experience with reading these journals. Some of the ones he quotes from are more obscure. Addiction, the British Journal of Clinical Pharmacology, BMJ (British Medical Journal) - these are heavyweights. Some of the studies he quotes are from articles published in very minor journals. If they were well-designed studies, they'd have been published in the big boys. Also, the narrator doesn't fully explain some of the findings. It makes me wonder if he's being intentionally sensational, or just doesn't know how to critically read an article.
Marijuana-year: With smoking, it's referred to as 'pack/year'. If you smoked a pack a day for two years, you have a pack/year history of 2. If you smoked two packs a day for one year, you also have a pack/year history of 2. It is very evident, through a number of studies, that marijuana smoke is far worse for you than a regular cigarette, mostly due to the lack of a filter such as are on commercial cigarettes. However, few people sit and smoke 20-40 joints a day. I don't use marijuana, so I'm not sure how many the typical user smokes in a day, but I'm betting it's less than 10. So, in comparing marijuana/year and pack/year, it's a little bit of an artificial comparison. That's not to say unfiltered marijuana smoke is safe; it definitely causes injury to cells and can promote any number of oral cancers just as, say, cigar smoking would.
Driving under marijuana. When I was in college, my psych prof actually hired some students and performed an experiment where they drove on a track with obstacles representing humans. They did it three times: sober, drunk on alcohol, and after a few joints. When drunk, the subjects reaction time was slowed, and they failed to avoid the obstacles. When high, they drove slower, but didn't even swerve when presented with an obstacle.
Marijuana and pregnancy. Yes, the odds ratio quoted in that paper is 1.36. The incidence of malformation of a child is 1.36 times as likely among marijuana smokers in that study. BUT, next to it is the confidence interval, which extends from 0.97 to 1.91. Think of it as the margin of error of their results. Dipping below 1.0, I would discount this statistic. The more pressing statistic to me is in the adjacent table, where it shows that someone who smokes 3+ tobacco cigarettes a day has an odds ratio of 1.56 of having a low birthweight baby, with a confidence interval well above 1.0. Don't smoke while pregnant!
Yes, he doesn't really go into medical marijuana. The purpose of his talk was to discuss recreational marijuana.
Medical marijuana works. Numerous studies show lighting a joint or ingesting it helps with nausea related to cancer treatments, and improves appetite in terminal AIDS. There are also numerous studies that demonstrate significant benefits in chronic pain, journal articles that I myself have read in depth. Here's the kicker though: the medical marijuana used in all the studies published in the anesthesiology literature - the experts in pain management - were done using Marinol or it's Canadian equivalent who's name escapes me. That's the pill form, using the active ingredients of marijuana. NOT smoking it.
Medical marijuana as practiced by some other states is mostly a fabrication to cover distributing marijuana. Don't believe it? Colorado... 100k prescriptions for medical MJ in 2009. How many were written for people suffering from cancer, glaucoma, HIV? Combined, it was less than 3% of the total. Over 90% were written for chronic pain. And of those, 75% of the prescriptions went to people less than 40 years of age. That's a lot of young people with chronic pain symptoms. Oh, and the vast majority of those prescriptions were written by just 15 physicians. (My source for this paragraph was Time magazine, if you were curious.)
I think there was a bit of bias in the direction of warning against the use of marijuana in this video. While I don't want my kids smoking joints, I think alcohol is a much bigger short term danger, and tobacco a much bigger long term danger. I work in a hospital, and I see a lot of people with traumatic injuries due to drunk driving (them, or the idiot that hit them), and an even greater number of people with issues from tobacco abuse. I also think the US wastes a lot of time and money in the prosecution and internment of marijuana users and distributors, money that could be used much better in a lot of other arenas. Now, heroin, cocaine, PCP... those should never be legalized; they'll kill you.
Of course, while I see very few people with marijuana related trauma / medical issues - and I've never even heard of an overdose - I'd never want to have my physician treat me after smoking a joint. Or let someone drive who had been.
Edit: I will say the most common issue I've seen in the OR from marijuana would be the young guys who smoke a huge amount daily who then come in to have their gynecomastia taken care of. In other words, Kilt - the joints led to them growing breasts, which they then had to have reduced. Built in Saturday fun for you, perhaps?
