Gupta Gets Positive On Weed


Sanjay Gutpa MD, from CNN, has come out on the side of medical marijuana.   To him, that is a big deal.  Here is a snippet of what he said:

I apologize because I didn’t look hard enough, until now. I didn’t look far enough. I didn’t review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis.

Instead, I lumped them with the high-visibility malingerers, just looking to get high.

I am all for weed in those legitimate cases, as Sanjay would say.  In Maine, where medical marijuana is legal, I never started prescribing it because of who was coming out of the woodwork.  I did have a great example of a patient, however, with chronic pain and scarring from severe hidradenttis suppurativa who was seeing a pain doctor and was on narcs for years.   He negotiated a deal with me to see the “weed doctor” and he started a trial, knowing that I would now test him for narcs.  Long story short, he did great on weed and never took painkillers again.  Great story, right?  Well, I am here to tell you and Dr. Gupta that this is a rarity.  I cannot tell you how many suspect patients who started begging me to get a script.  The law allows them two ounces a week which, as Bill Murray from Caddyshack would say, will allow them enough to “smoke the bejesus out of it” and then share or sell a ton more.  In my opinion, over 90% of the people who asked me for it were people/patients whose intentions I did not trust.  Was I wrong?  That depends:

A recent study by Quest Diagnostics suggests that medical marijuana users are no more likely to misuse prescription drugs such as oxycodone than other patient populations. However, recreational marijuana users are more likely to misuse those drugs. The study, “Prescription Medication Misuse in America,” based on an analysis of 227,402 de-identified urine lab-test results of patients on commonly abused prescription medications, shows that 37 percent of medical marijuana users (those taking prescribed cannabinoids as pharmaceutical preparations) misused other non-prescribed drugs, while nearly half of patients who used marijuana recreationally misused prescription medications.

First of all, it is crazy to me that 37% of medical marijuana users are misusing other non-prescribed drugs and this is felt to be equal to the normal population.  But let’s take this study at face value.   My first patient who I described above truly needed weed and was someone I could trust and the study supports that.    The other patients, who I thought were just looking to get a legal excuse to smoke weed, I could not.   They were already recreational users and probably abusing other drugs as well.  I guess the study proves my point.   It is about trust just like when we prescribe narcotics.   So, to summarize, I support medical marijuana but unlike Sanjay, I am not Pollyanna about it.  Just because he had some epiphany about cannibis doesn’t mean there aren’t lowlifes out there ready to abuse the hell out of it.  I will stick to my 90% statement.

Now before people get on my case about being a hardass or why not just let them have it or weed never kills anyone and on and on, let me remind you of the next debacle that will occur once you open these flood gates.  Right now, Medicaid isn’t paying for it (and for some funny reason these patients now have cash for it.  Huh?) but there will be a movement to change this.  Lawyers will eventually get this overturned and that is when the fun begins. Then the 90% will turn to 99% because it will be a great new source of income for a ton of people as they sell what they supposedly medically need.  Not only will our taxes be paying for suspect people to use the drug but it will pay for their supply to sell it on the streets.  And this will not change it if is legalized for non-medical use either, by the way, because these same patients will want it for free via a prescription (think about the times they ask for tylenol scripts).  You may think, so what, we do this already for narcotics.  And I would say, exactly.

Nostradougus is back and he has spoken.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Gupta Gets Positive On Weed

  1. Dr.
    August 19, 2013 at 8:00 am

    Doug – ‘hidradenttis suppurativa’ – correct spelling matters. A waiting room populated with narcotic-seeking ‘low lifes’ seems to be your perennial fate and clearly, these vermin do not deserve access to your immense clinical fund.
    Gupta is respected and accomplished in all the ways that matter to the public. Perhaps that is why he has the many platforms which give his voice the gravitas which yours lacks. Moreover, the timing of his commentary and the recent changes to rules of incarceration rules for minor felons/weed eaters ultimately will benefit society as will the TAXES paid on WEED as they are diverted from the income stream from broken nosed ignoranti of Waste Management earmarked for more meaningful coffers. Is Topol next on your hit list? Since he’s a doc-rockstar, too – I figure it’s just a matter of time before your e-envy gets the best of you.

    • Doug Farrago
      August 19, 2013 at 8:09 am

      Appreciate the spelling correction.

      I wish I was as smart as you. Big words like perennial, vermin, gravitas, ignoranti are way over my head as well and how you used them in one blog response is impressive. Clearly, I am a stupid, petty, jealous little boy with a blog. Maybe I should take my ball and go home? Or, I could continue giving the real scoop from docs like me who are the grunts in the trenches and ignore douchers like you? Hmmmm. Let’s see. I pick the latter. Oh….is douchers misspelled? I can fix that later. I await your correction.

    • Pat
      August 20, 2013 at 12:05 am

      While I absolutely favor the abolition of laws that illegalize drugs, I’m immediately suspicious of anyone who wants more taxes diverted to more “meaningful” endeavors. How about just leaving people alone and leave it at that? You sound a lot like a purveyor of do-gooderism, and are more apt to demand that doctors too conform to popular pursuits in keeping with a presumed, prepackaged gravitas. Gupta, Drew, et al are media creations and as such will follow – not lead – their audience. An audience, like yourself apparently, that has scant experience in dealing with the legions of drug seekers, addicts, liars, and bums who swarm to every ER and urgent care whenever there is a new drug to take or new doc to prescribe it. Beyond that, It was hard to fathom what the hell you were talking about…

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