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SMOKING : SLOWLY TAKING YOUR BREATH AWAY
MEDICAL MARIJUANA - THE ELEPHANT IN THE ROOM AUTHOR James Patrick Murphy , MD , MMM
“ you ever thought about medical marijuana for your condition ?”
Asking this question might open the door to a subject that many patients have on their minds but are too self-conscious to bring up . Will my doctor think I ’ m a stoner ? Will I get discharged from the practice ? Will I ever be taken seriously again ? Medical marijuana is like the elephant in the room no one wants to acknowledge , even for physicians .
“ Thank you for asking . I ’ ve been reading about medical marijuana , but didn ’ t know if it would help me .”
Truth is , this elephant has been around for a long time , shows no signs of going away , and every year inches closer and closer to full scale legalization for both medical and recreational use . So , physicians need to learn about it . For this article , I will avoid sociopolitical arguments and focus on the clinical issues inherent to medicinal utilization of this very complex substance . “ How does it work ?”
Marijuana ( cannabis ) is a plant that contains a mixture of chemicals ( e . g ., THC and CBD ) called cannabinoids . More than 100 different cannabinoids have been identified in cannabis . The main intoxicating and addictive cannabinoid found in cannabis is delta-9-tetrahydrocannabinol ( THC ). Another very abundant cannabinoid found in cannabis is cannabidiol ( CBD ), which , in contrast to THC , is non-intoxicating and non-addictive . 1
Our bodies have an endocannabinoid system ( ECS ) with two primary receptors : CB1 and CB2 . 2 The major role of the ECS is to modulate our nervous system ’ s function , synaptic plasticity and response to disease states . The ECS seems to help other systems in the body work better . Although strong scientific evidence is lacking , many researchers and clinicians believe that by augmenting the power of the endocannabinoid system , we can beneficially treat a number of diseases ranging from psychiatric conditions to movement disorders , neuropathic processes ( e . g ., multiple sclerosis and spinal cord injury ), cancer , vascular disease , stroke , glaucoma , oste-
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