Really? I've always found the milder claims fairly believable (fighting nausea or chronic low level pain relief). As an anecdote, I can attest to dealing with kidney stone pain well (rather than stopping the pain it reduced how much I noticed it) and it ended up more effective and felt less dangerous than the opiods I had used in the past.
Some of the more "miracle" claims, however, seem pretty suspect to me and I'd want some reliable reseach.
What makes you skeptical of so many claims?
I do agree with the parent poster about the more miraculous claims though and I think, personally those more miraculous claims create skepticism for the actual benefits.
I kind of wish everyone took a more level headed approach to drugs in general. Every drug out there has some benefits and drawbacks. Without proper study, we're potentially missing many benefits and won't fully understand all the drawbacks.
This includes approved pharmaceutical drugs too. Too many drugs get rushed out without fully understanding the side effects until people start suffering or dying.
And yes, the pain relief is very real.
† For what it's being prescribed for, I mean—pain, nausea, anxiety, etc. THC, in its function as a psychedelic, may function as a treatment for certain psychiatric disorders (i.e. for much the same purpose LSD/MDMA/etc. are being investigated for.) But nobody's prescribing medical marijuana for this use-case right now; they're prescribing it for things where the presence of THC seems pretty irrelevant to the goal.
And there are a lot of people who are going to be more comfortable taking a plant in its natural state, than using an isolated compound that's been through a processing plant they have no control over, and which depends on a regulatory structure they have no faith in to tell them its safe (and what they are expecting).
Basically, there are a lot of people very skeptical of the corporate drug system (for good reasons, frankly), and the availability of natural herbal medicines does (for the most part [aside 1.]) no harm to them, and actually can do quite a bit of good.
If they don't trust aspirin, then let them use willow bark.
1. Obviously there are exceptions to this. There are some herbs that are considerably more dangerous and harmful than the useful compounds isolated from them. But there are also many herbs that are perfectly safe to use, and still effective to one degree or another. In some cases, they are every bit as effective, and even safer, than the isolated, concentrated alternatives (see St John's Wort).
Let me put it this way: the big-pharma drug manufacturing (and more generally, medical-equipment manufacturing) pipeline is set up such that the only thing about a drug that should be able to kill someone, is if the drug's active ingredient itself has a bad interaction with their body.
Something like medical marijuana, meanwhile, can kill you by heavy-metal soil toxicity; by pesticides; by coincidental allergens in non-active-ingredient plant matter; etc.
None of these things will be checked for when you get a dose of medical marijuana.
An analogy: would you trust IV saline solution that's just salt that someone poured into "carefully collected rainwater" and then put into a bag? Even for an immunocompromised patient (i.e. exactly the kind who consumes medical marijuana for e.g. supportive cancer treatment)?
No; you'd distill the water, wash and recrystallize the salt, and basically do everything else you can to ensure that "salt and water" is all that's in the "bag of salt and water" you're putting into the patient's bloodstream. Because that's how you ensure that some random variable doesn't creep in and mysteriously make them sick in a way that's impossible to diagnose.
"Should be" is a giant risk factor... "Don't worry Mrs. Jones, this drug shouldn't be able to kill you unless you have a terrible allergic reaction!"
Big-pharma has shown, repeatedly, that their sole motivation is not altruistic treatments of human aliments... it is that of any other corporate entity. Profit. I don't think that is inherently evil either.
Medical cannabis could kill you... you are right, but I would argue that you are much more likely to be killed from alcohol or tobacco related events.
For just one data point: I've worked in EMS for 14 years and I have never seen a cause of death that was directly the result of using cannabis. Unfortunately, I have lost track of how many people I have seen die that were the direct result of alcohol ingestion. Same for Oxycotin and other opioid based "medicine" prior to everyone and their brothers walking around with narcan.
Personally, I've never heard of a case where Big Pharma has ever created a delivery vehicle for a well-known, Generally-Recognized-As-Safe active ingredient (like e.g. aspirin) that then kills, or even harms, people.
Like, the Tylenol murders? Those were big news. It'd be even bigger news if the manufacturer themselves were responsible instead of some random MITM. But there has never been that kind of big news. They don't screw up when making pills. Pills are pills. Novel active ingredients can kill you. But—presuming the active ingredient is safe—the pills themselves killing you? When has that ever happened?
> Unfortunately, I have lost track of how many people I have seen die that were the direct result of alcohol ingestion.
Well, yeah; people are consuming arbitrary amounts of alcohol. That's what's bad about recreational alcohol use.
Same goes for opioids, in a different sense; addiction drives you to consume arbitrary amounts of opioids. That's what's bad about drugs of abuse.
And yet, as an EMT, you still stick car-crash victims with fentanyl, no? Even though it's an opioid, and potentially a vector for chemical dependence. But you're not likely to kill them with it. Why? Because it's a measured dose.
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Note that I'm not arguing that the active ingredients in medical cannabis could kill anyone. It's been pretty well shown that they don't really have an LD50.
It's not the active ingredients I'm worried about. It's the rest. It's the reason that hospitals don't get food for patients catered from arbitrary restaurants. You want to control all the variables you can. A CBD+THC tincture is going to have strictly fewer non-controlled variables than smoking the raw plant. A crystallized distillate suspended in a PEG gel pill is going to have fewer non-controlled variables still.
It's not about not-killing people. It's about treating people, successfully, with the highest ROI per treatment-hour possible and the least time spent flailing around trying to diagnose unknown brokenness while the patient continues to suffer.
FDA does a lot of good, but the trials that bring a drug to market are not foolproof, and many doctors prescribe off label.
I would estimate that legally regulated cannabis's other ingredients are an order of magnitude or two less risky than taking any pharmaceutical that has come to market in the past 20 years.
The exact same risks are in your grocery store produce aisle.
I'll grant that illegal marijuana has higher risk, but if it's regulated like any legal food crop I don't see the difference; in fact, I'd say there's less, since people consume it in relatively low quantities.
Doctors know there's a certain number of X-factors a patient can't avoid (like e.g. eating food from random sources if they're not under in-patient care) but they don't want to introduce new ones if they can help it.
Another analogy: a doctor will never prescribe you "a supplement." They might tell you getting more vitamin B in your diet would be good, but they'll never tell you to go out and buy a vitamin-B complex supplement. If they think you really need vitamin-B in a pill, they'll prescribe an actual big-pharma-pipeline-produced pill containing vitamin B.
Why? Because who-the-heck knows what's in the random supplement you bought off Amazon is why. If the pharmacy says they got a pill from big-pharma mfgr X, and mfgr X says they produced it (and the FDA endorses mfgr X), then that's a chain of custody and a chain of responsibility that holds them to account, and so ensures that there really is vitamin B (and nothing else) in the pill. That means you're not getting any extra risks just from taking the pills, beyond some weird interaction between you and vitamin B. Whereas, those supplement pills from Amazon? Nobody checked those. Your doctor does not want you to take random unchecked pills that may or may not contain vitamin B, and may-or-may-not contain lead/mercury/cyanide/whatever. They want you to take pills that certainly do contain vitamin B, and certainly don't contain those other things. Thus, prescriptions; thus, pharmacies; thus, the FDA itself.
You've seen very different doctors than I when it comes to calcium/D- and B- vitamins/multivitamins. They'll usually tell you "go get this over the counter." Sometimes with guidelines like "but not one of the ones with iron" or such.
Or even if they prescribe it, the pharmacy that gets the prescription (or maybe your insurance company - I forget which exactly had the problem with it when this happened to me) might say "just go grab one of the over the counter vitamins."
People have been using willow bark for pain relief for hundreds if not thousands of years. They have not been injecting saline solution.
There's reason to believe that, in some cases, it is better to get medicines in their tried and true forms (those used for hundreds or thousands of years) rather than their more recent isolated forms (which only have a few decades of use). There could be beneficial interactions between all those unknown substances. In some cases - again see St John's Wort - the natural herbs are more effective, safer, and with fewer side effects than the concentrated drugs. And they are infinitely more available, since they can be grown right in your back yard.
There are of course exceptions to this - there was the very popular Chinese herb that had been used for a thousand years that turned out to give you throat cancer.
Don't get me wrong, I use the medical system. I also sometimes use herbal medicine, but I'm much, much more likely to reach for Advil than I am for willow bark. But I understand those who reach for willow bark, and recognize the validity of their reasoning.
Personally, I want to see these herbs tested in proper trials so we can determine which are pure placebo, which are effective the way St John's Wort is, and which are dangerous the way that Chinese herb was. If we can identify the ones that are actually effective, then that opens up a ton of room for people to self medicate and frees up resources in the medical system for those who really need them.
It's the "whatever quality the market will bear" part that I worry about.
Consider: if you buy a bottle of ground willow-bark sitting on a store shelf in a random bodega... where did it come from? Who made it? Where did they grow it? What are the legal requirements re: pesticides, soil toxicity, etc. in the country they grew it [since it probably wasn't here]? And how certain are you of those answers?
And mind you, Chinese herbs are a bit better, even, since they're mostly just considered "food" by standards bodies, and so it's pretty hard to import them (or even derivatives of them) and local growers get regulated for "food purity" by entities like the FDA. (No standards body can protect you from things that inherently contain compounds nobody is aware they inherently contain, of course. Unless some other compound in the herb was considered the active ingredient, and isolated out...)
But, well, let me put it like this: my local pharmacy has some homeopathic tinctures (for some reason. At least they're on the bottom shelf out of most people's sight.) Who made those? And, given that they started as poisons before being diluted, how sure are you that they actually "did homeopathy correctly" and diluted them so that they're not actually going to poison you? DIY, then? How sure are you that you can "do homeopathy correctly", instead of accidentally poisoning yourself because you didn't stir your cyanide tincture well-enough? And then, how confident would you be that some big-pharma company could—if they wished—do homeopathy correctly? I'm guessing a lot more than your confidence in either BestElsewhere Imports Co or in your own two hands.
That's what I'm getting at. It's not about what happens when you grow it yourself. It's about the worst quality of product the market could potentially deliver to you when you go looking, and what that means for a doctor considering which delivery-vehicle to prescribe.
I think the point is that we need to work to improve the regulation of both concentrated drugs and of herbal supplements.
And in the mean time, if people want to use that plant because it makes the feel better - let them. And if their doctor thinks that plant will serve them better than the mass produced drug, let the doctor proscribe the plant. After all, their doctor is the real expert here.
> None of these things will be checked for when you get a dose of medical marijuana.
Medical marijuana is grown in controlled environments by licensed medical growers, the products are tested for heavy metals and contaminants like mold, and are tested for levels of active ingredients.
Strains are grown for their medical benefits and standardized yield of constituent active ingredients, and for patients that need an absolutely standardized product, extracts and formulations are produced that meet those requirements.
No one is selling some crop that was grown in Mexico, someone's basement or downstream from an oil refinery.
Why?
>2. that it makes any medical sense to prescribe a (non-dose-controllable) plant over a pill,
Some medication, in pill form, is highly toxic.. see opiates which is a common alternative to thc for pain relief.
How did your comment reach the top?
Because there are no studies proving it has any benefit? Because, from clinical anecdote (i.e. stories from my doctor friends) CBD alone seems to work perfectly as a treatment for every problem where "try medical marijuana" is the current line on the treatment flowchart?
I mean, admittedly, I'm not friends with every kind of doctor. I don't know whether THC has any added benefit in cancer treatment, for example. That's why I'm not denying the benefits of THC; I'm just skeptical of them. I'd like to see some supporting evidence!
> Some medication, in pill form, is highly toxic.. see opiates which is a common alternative to thc for pain relief.
Opiates in pills are no more or less toxic in pill form than in their "native" form (e.g. the opium poppy.) There are even animal nerve toxins that are classified as opiates. It is the molecule itself—and the dose—that makes something toxic, not the delivery mechanism.
The point of putting something in a pill—or even more simply, of extracting and distilling an active ingredient into an essence—is to make the dose measurable and to control for any unknown variables (the other stuff besides the active ingredient), so that dosing can be done precisely.
Without first isolating and measuring the active ingredient(s), there is no way to, for example, make "extended release" or "immediate relief" forms of medical marijuana, because you both don't know how much THC+CBD is entering your body, and (with edibles or anything besides smoking) don't even control how quickly your own metabolism takes up the active ingredient from the plant matter.
>It's like prescribing willow bark for a headache when aspirin exists.
Willow bark contains salicin, not aspirin, while marijuana contains both THC and CBD. Willow bark also doesn't have the same blood-thinning effects of aspirin, which makes both viable pain relief choices for different populations.
This really just sounds like "plants bad; pills good!"
The "key advancement of chemistry"—the thing that makes chemistry chemistry, rather than alchemy (and as it happens, the thing that differentiates baking from cooking) is being able to measure the reactants we put into a beaker, and clean the product of the reaction of any side-products, such that we can then crystallize/distill/etc. out the product alone, weigh it, and thereby determine the exact potency of product. Once we know that, we can then do all sorts of things: dilute it to a controlled strength; create delivery vehicles that deliver it at particular speeds; put it straight into the body in ways that would just kill you if you put into the body all the other stuff that you isolated the product out of; etc.
Anyone can do this. People make THC tinctures and essential-oils all the time, in their kitchens. It doesn't matter to me whether you do it or someone else does it for you; but it seems irresponsible to me to tell someone to go eat the non-processed version for medical effect.
> Hydroponic cannabis is grown in highly controlled environments and the dosage levels are tested to be within an acceptable range.
Sure, you can control everything about the production of the marijuana itself. But the key to medical treatment is the last mile, and specifically the ability to relate a patient's response over time to a dosing schedule/pharmacodynamic profile for the drug. If you prescribe someone "medical marijuana", without fixing down how they're going to take it, they could very well do anything from eating the whole batch at once, to vaping it every three minutes, to just doing hits off a bong whenever they feel pain. These are not the same thing, and medically they should be different prescriptions if the doctor has any hope of knowing whether the treatment is working.
Pills (or, really, anything more specific than "here's a plant, go to town") let a doctor say something more specific like "take one of these every two hours", and then from there know exactly how much of the active ingredient should be in the patient's bloodstream at any given time of the day, and so be able to measure effects (and side-effects!) against those that are normal, or abnormal, for that level of dose being in the patient's body for that period of time.
the cannabis testing industry is largely garbage.
the labs that are properly equipped to do the testing are either forbidden from doing it because they're DEA registered, or they make plenty of money without dealing with fly by night operations that can only pay in cash.
so the labs that can get reference standards aren't allowed to do the testing.
that doesn't mean there aren't labs that are doing taking samples and then sending reports back. it just means the reports are lies, and the information printed on the labels is meaningless.
your state can require things all day long, that doesn't mean anything productive is happening.
For point 2, I couldn't agree more. I think it's just an industry maturity thing. My wife is using it for appetite/anti-emetic effects and trying to 'dose' with dry herb or pen vaporizing is a joke, and most of the oils/edibles are administered in a way that has pretty gnarly taste/aftertaste that has been counter-productive for her. (I've started making my own tablets but it still feels like a crap shoot)
You shouldn't be, because empirical evidence shows that there are.
CBD's most overt therapeutic effect is mediated through action at 5HT1A autoreceptors and allosteric modulation of mu and delta-opioid receptors, whereas THC's MoA is mediated through CB1 agonism, to a lesser extent CB2 agonism, and to a lesser extent than CBD, allosteric modulation of mu and delta-opioid receptors.
THC has anxiogenic (and paradoxical anxiolytic) and psychotomimetic properties, and has the side-effect of inducing schizophrenia-related disorders in some people. CBD's action at 5HT1A receptors both induces an anxiolytic effect, and reduces the symptoms of psychotic disorders.
A combination of CBD+THC can reduce the negative side-effects of THC used alone, and CBD alone does not have the same effects as THC or CBD+THC. There are studies that document the synergic effects of combined cannabinoids versus isolated cannabinoids.
I'm not skeptical that THC does anything; it certainly does. What I'm skeptical of, is whether marijuana has the particular medical benefits it's prescribed for in part because of THC, rather than despite THC.
I did, though I wasn't explicit. CBD has no discernible effect on CB1 receptors, and produces no anti-emetic effect. THC's CB1 agonism is directly responsible for its strong anti-emetic effect. CB1 agonism also has effects on pain perception and processes in the gut.
CBD has no discernible effect on CB2 receptors, while THC does. CB2 agonism is responsible for effects on immune system, inflammation via autoimmune responses and inflammation in the GI tract associated with IBS, Crohn's and UC.
I can attest to the productivity and creativity benefits marijuana provides, and looking at well-known and successful creatives, many of them attribute some of that productivity and creativity to marijuana consumption.
Maybe it's useful if nothing else works but come on.
It only makes me wonder what other possibilities have been out there but banned and therefore unavailable for study and experimentation. Luckily the days of censoring and hoarding information seem to be coming to an end.
Of course as a society we love the pendulum effect. We'll swing it too far and then it will come back the opposite way too far (so much for my optimism :-P)
I'm in the camp that depression is rarely just some "chemical imbalance" in the brain that you were unlucky to be born with, and yet that is how we currently think of it and treat it.
It's most often the case there is something in one's past, very often from one's childhood, that has been avoided, and creates a chronic sense of worry/anxiety/depression that lingers.
Psilocybin has the effect of ego death - it feels as though the subconscious hold you have on your brain that pushes down uncomfortable feelings or memories just goes away. This paired with therapy can be very powerful because you naturally become much more open to talk through distressing things that you otherwise normally numb over and helps you process past traumas much more efficiently.
Which is somewhat similar to what i have read about the ketamine therapy, which essentially just makes certain areas of your brain more neuroplastic for a short duration, helping you get out of your routine thought patterns and help create new neural pathways and reshape the existing ones easier.
Note: I am not a brain researcher myself at all, so what I said could totally be just some pseudoscientific bs, but that's what I got after reading a bunch on both of the topic in a lot of places, including other HN threads. If you want to correct some misunderstandings in my post, please feel free to reply. I will be very happy to correct my misunderstandings.
I don't think you are accusing me of saying that, but just to be clear I completely agree with this. Michael Pollan's book also doesn't paint it as a "magic pill." No doubt some people assume that, but I don't believe it exists.
I do wonder about the accuracy of Freudian ideas, such as something in ones childhood being the cause or at least playing a role. It's certainly possible. Being raised by depressed people sucks, and there's a lot of scars that probably contribute to why depression seems to be inherited.
But I didn't get quite the one hit, life changing state of mind that is often attributed to psychedelics.
One thing that I have read is that the whole life-changing thing requires a transcendental experience - and that participants who failed to reach that echelon didn't experience long term improvement.
I can't really comment on that - because I simply never reached that breakthrough dose.
The biggest issue for me is that magic mushrooms taste kinda bad - it's rather hard to eat enough of them.
Truffles on the other hand, are completely inoffensive - tasting (in some way) like a slightly off nut.
I could quite happily snack on a big-ass bowl of those things, and watch enthralled as the world turned weird.
Did you take them under the supervision of a trained psychedelic therapist, with the appropriate dose, with the right intention, in a therapeutic context, over multiple sessions, using a protocol designed for maximum therapeutic effect (which usually includes talk therapy both before and after the sessions)?
Having the right set and setting are both absolutely critical to get the most out of psychedelics.
I must echo this entire post. I'm able to learn so much about myself when high. Far more personal than a therapist ever gets. I do introspection sessions after smoking. I smoke twice a week and do at most 5 hours of introspecting every week. This year I'm doing every other quarter.
After smoking I think about how to better myself and insights just flow in perhaps about 3 really good ones a session. And while yes about 10% of my insights are incorrect it's not a problem to write them all down in your phone and verify in a couple hours.
Doesn't seem like many people have similar experiences.
Really? A friend of mine had a similar experience to what @ergothus described in their comments. The friend had a biking accident and got stitches. To ease the pain the doctor prescribed Aadvil / Tylenol, but those drugs just caused diarrhea. So he tried edible marijuana[in a legal state] and it helped him a lot through a few weeks of painful recovery without any side effects.
I find miracle claims suspect as well, I don't think marijuana cures cancer.
It sort of makes sense intuitively. If you you can just make it through the agony of junk sickness. You are in the clear. A 36-hour dose seems preternaturally suited.
Edit to add link: https://atmanretreat.com/