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Worth Repeating: Update - Medical Marijuana As Schedule +1

Posted on October 22, 2012 by News Admin

 

Worth Repeating

By Ron Marczyk, RN
Toke of the Town Columnist 


"The DEA had ignored accumulating evidence of marijuana's benefits, and so acted "arbitrarily and capriciously" in rejecting the rescheduling petition last year. Federal law requires the agency to take such evidence into account, accusing the Department of Health and Human Services of creating a Catch-22 for medical marijuana advocates by strictly limiting researchers' access to marijuana, then arguing there is insufficient scientific evidence to merit rescheduling it."

The present day drug scheduling is an incomplete scale in that it only lists negatives!

Medical marijuana does not fit into the present drug schedule; this unique medicine is so special that its multitude of many actions creates its own stand-alone category, a "positive side," mirror-image type of drug scheduling.

Due to the wealth of new medical information that has been discovered about the endocannabinoid system, this update is overdue.

The current scheduling of drugs, which classifies cannabis (marijuana) as a Schedule I drug, is an incomplete rating system. It is missing a corresponding equal positive or upside rating of the health benefits that a drug or medicine may bestow to treat an illness or disease. 

The present "half of a rating system" that inaccurately classifies marijuana as a Schedule I drug.
 
This chart is a negative scale. Starting backwards from 0 -5, -4, -3, -2, -1 the harm increases as the negative number gets smaller.

Nowhere on this list do you see the word "health" or "wellness." What's missing is its polar opposite, a "schedule of positive health benefits."

The present marijuana drug scheduling scheme is a faulty concept, because it is missing half of a complete scale!  It only includes a negative harm scale but doesn't include an opposite beneficial scale or "schedule of positive health benefits." 

A schedule of positive health benefits would look something like this:
 

0 to +5 = the increasing benefits of a medicine to produce healing and overall health (the green shade is the missing half!)
 
Remember! Real scientific conclusions should be stripped of political and profits motives. 

Marijuana as a Schedule I drug really is a negative scale because it classifies drugs in descending order of supposed harm in three categories: High potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use of the drug or other substance under medical supervision.

My question is: Under the present system, what metric was measured that places a drug in a category? How did marijuana get to be placed in Schedule I? What exactly was measured?

We are talking science here: science demands a precise measuring system in its methology, and without one, marijuana as Schedule I is unscientific, completely arbitrary, and just somebody's opinion. 

The big problem with the present scheduling model is that it lacks a rubric, which would provide clear criteria for measuring or evaluating a drug objectively. Such a measure would add or subtract points from a drug; this new methology would be clear and could be used by physicians and patient on an individual patient-by-patient basis, which is the very definition of individualized medicine.
 
Drug scheduling is based on an outdated disease model of health. It's focused on harm, it's focused on negatives, and it's focused on what may go wrong. Yes, these are important, but only half of the picture.

Nowhere in the above drug schedule list does it instruct you on how to find your health.
Taking a page from positive psychology, which looks at what can go right with health and medicine, the new schedule of positive health benefits scale would measure what goes right and would be measured together by both physician and patient in a team approach to better health. 

Because of marijuana's unparalleled record of safety, as in there has never been a recorded death due to its direct use, it would be the gold standard that all other drugs would be measured against.
 
A prototype of this "positive scale of health benefits" would include five parameters, each equal to one point, which would be added together for an overall holistic score.

Parameter 1 would just be a statistical overall rating of a drug's safety   Parameters 2 and 3 would be physician-rated; Parameters 4 and 5 would be patient-rated.

The definition of a drug is any substance that changes you physically, cognitively, emotionally or how you behave socially. We all consume many "drugs" in a normal day and what is a negative side effect to you may be a positive side effect to me.

To truly judge a medication, a complete drug profile of both harmful and beneficial effects must both be presented: how else one can accurately make a good decision?
  
Schedule of positive health benefits rubric

1. Kill ratio: This would be based on the LD 50 kill ratio. The dose required to kill half the members of a tested population after specified test duration. LD50 figures are frequently used as a general indicator of a substance's acute toxicity.

If the drug has never caused a death, it would get a full point.  How many people die per year as a direct result of taking this drug? The lower the number the higher the score.

There has never been a recorded death due to the direct effects of marijuana intake. In this regard, marijuana has a perfect score of 1.00 in this category. 

"According to the Merck Index, 12th edition (the number one reference book for medical doctors), the LD 50 value for rats by inhalation of THC is 42 mg/kg of body weight. Comparing this to an average human being, one estimate of THC's LD 50 for humans indicates that about 1,500 pounds (680 kg) if cannabis would have to be smoked within 14 minutes." 

Marijuana may not be for everybody, but it will not kill you, either.

2. Multi physical therapeutic effects: How many medicinal conditions can be treated by the medicine at the same time? Give .20 points for each condition treated, 5 conditions = 1.00
Example: Penicillin only treats infection -  Total score = .20

A short list for marijuana would be - anti tumor = .20, analgesic = .20, anti-inflammatory =.20,   20, appetite stimulant = .20, anti spasmodic = .20   Total score =1.00 

http://medicalmarijuana.procon.org/view.answers.php?questionID=000087

The US Government Accountability Office (GAO) noted the following symptoms or conditions under Appendix IV of their Nov. 2002 report titled "Descriptions of Allowable Conditions under State Medical Marijuana Laws":

1. Alzheimer's Disease 
2. Anorexia 
3. AIDS 
4. Arthritis 
5. Cachexia 
6. Cancer 
7. Crohn's Disease 
8. Epilepsy 
9. Glaucoma 
10. HIV 
11. Migraine 
12. Multiple Sclerosis 
13. Nausea 
14. Pain 
15. Spasticity 
16. Wasting Syndrome
 
3. Multiple psychiatric therapeutic effects:  How many psychology conditions could be treated with this one medicine?

PTSD = .20, depression =.20, ADHD = .20, OCD = .20 sleep aid =.20 
Total sore =1 .00
 
4. Spiritual therapeutic effects: Historically cannabis/marijuana was infused into all of the early Asian and Middle Eastern proto-religious cultures. Marijuana smoke helped shape the thinking of early developing belief systems. Marijuana smoke primed the human mind to develop abstract cognition. 


"The cannabis was presumably (cultivated and) employed by this culture as a medicinal or psychoactive agent, or an aid to divination. To our knowledge, these investigations provide the oldest documentation of cannabis as a pharmacologically active agent, and contribute to the medical and archeological record of this pre-Silk Road culture."

How does one measure this interpersonal spiritual healing effect? 

• Increased ability to practice some type of mindfulness meditation = .20 pts.

• Increased frequency of creative flow states = .20 pts

• Increased desire to exercise = .20 pts

• Increased level of spontaneous joy or peacefulness with family, friends and yourself =.20 pts

• Decreased states of anger, and being in conflict with others = .20 pts

5. Major unwanted side effects as reported by patient:  .20 points for each side effect that interferes with lifestyle as reported by the patient. 

This scale is individual to the person taking the drug. A drug that may bring no relief to you may be very beneficial to me. In this age of personalized medicine, this is based on the individual genome of the human taking the drug. That is why marijuana is not for everybody, but it should not be against the law for everybody.

But ultimately it comes down to the rights of the patient to choose which medicine they want to take based on knowing how their bodies react to difference medicines. I have a right to know what makes me feel better and to have my own definition of health and lifestyle. 


Footnotes

Schedule I Controlled Substances

Substances in this schedule have a high potential for abuse, have no currently accepted medical use in treatment in the United States, and there is a lack of accepted safety for use of the drug or other substance under medical supervision. 

Some examples of substances listed in schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, "ecstasy".

Schedule II Controlled Substances

Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.

Examples of single entity schedule II narcotics include morphine and opium. Other schedule II narcotic substances and their common name brand products include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®), and fentanyl (Sublimaze® or Duragesic®).

Examples of schedule II stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other schedule II substances include: cocaine, amobarbital, glutethimide, and pentobarbital.

Schedule III Controlled Substances

Substances in this schedule have a potential for abuse less than substances in schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence. 
Examples of schedule III narcotics include combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®) and products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with codeine®). Also included are buprenorphine products (Suboxone® and Subutex®) used to treat opioid addiction.

Examples of schedule III non-narcotics include benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as oxandrolone (Oxandrin®).

Schedule IV Controlled Substances

Substances in this schedule have a low potential for abuse relative to substances in schedule III.

An example of a schedule IV narcotic is propoxyphene (Darvon® and Darvocet-N 100®). 
Other schedule IV substances include: alprazolam (Xanax®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®).

Schedule V Controlled Substances

Substances in this schedule have a low potential for abuse relative to substances listed in schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. These are generally used for antitussive, antidiarrheal, and analgesic purposes. 
Examples include cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC® and Phenergan with Codeine®). 



Editor's note: Ron Marczyk is a retired high school health education teacher who taught Wellness and Disease Prevention, Drug and Sex Ed, and AIDS education to teens aged 13-17. He also taught a high school International Baccalaureate psychology course. He taught in a New York City public school as a Drug Prevention Specialist. He is a Registered Nurse with six years of ER/Critical Care experience in NYC hospitals, earned an M.S. in cardiac rehabilitation and exercise physiology, and worked as a New York City police officer for two years. Currently he is focused on how evolutionary psychology explains human behavior.


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