Tuesday, February 18, 2014

A Reefer Miracle Cure ... But That's a Problem

The medical literature is expanding as more of the health-giving aspects of marijuana are discovered. There's no point in, erm, rehashing that as much is common knowledge and you can read the latest news.  What is most interesting just now is a specific piece of that news regarding the extraordinary benefit that came to one child.

Charlotte Figi was having up to three hundred grand mal seizures per week and nothing worked to give her any relief ... until someone gave her a specific variety of medicinal reefer.  Since then there has been a radical improvement in her physical condition and in what she is capable of doing.  (AP News:  Colo. pot aids kids with seizures, worries doctors)

While this is grand news for Charlotte, it's really not so good for medicine as what is Dr Welby to say when a patient comes into his or her office to ask for the same treatment for another kid.  There's nothing much that can be said as there is no verified optimal dose, length of treatment, etc.  In this regard, the science lags far behind what is being learned in the field.  Given the evidence, any researcher capable of doing more than paraphrasing other people's work will dig into it to determine if it's real and repeatable.  Being repeatable is hugely important.  If the reefer cures Charlotte then you've got a good story for Reader's Digest.  If it cures all those kids then you have a good story for a Nobel Prize committee.

It's dangerous business.  Reefer is fundamentally harmless ... unless you are vulnerable to it.  For children such as Charlotte who are prone to seizures, giving them a strain of reefer with any measure of excitability to it is likely to cause far more problems than it solves.  There's no way any doctor would risk that so the value of the plant in formal medicine is not, at present, too high.  Nevertheless, other benefits (e.g. pain relief) are known and documented but they're obvious whereas improvement of circumstance for someone afflicted by seizures is dramatic and previously unknown.

Reefer will be legal soon enough.  States are falling all over each other getting it on the books.  Governors are sniffing out easy tax dollars as there's nothing that excites the libido of a politician so much as another sin tax.  Some states will hold out as Kansas and Iowa have pretty stupid ideas about a lot of things but even they will yield eventually.  At the rate it's going, it would probably be a surprise if it takes more than five years for medical marijuana to become legal across the country.  That deal is really already done, it's just a matter of letting the clerks (i.e. politicians) fill out the paperwork.

The biggest interest is in how quickly the medical community can respond.  Whatever the phenomenon with Charlotte Figi, science needs to understand it and very quickly.  Much of the study is being handed to them but it remains to be seen how long it will take for an effective evaluation to the point at which doctors can prescribe this treatment for others.

Don't expect the Food and Drug Administration to move quickly on this.  While criticized constantly regarding time-to-market concerns, the FDA has remained the most steadfast and effective defense against bad medicine the world has ever seen.  Please don't waste my time with hysterical examples of failures as I haven't forgotten when the Thalidomide babies were on the cover of LIFE magazine.  The examples of those failures exist but they do not refute the validity of my initial contention that no-one has ever been better protected against bad drugs.

As a parent of a kid with the same affliction as Charlotte, your first thought on being rejected by an actual doctor is to get in touch with Charlotte's parents to find out what they did.  For this reason, it's crucial that the research be conducted quickly.  Charlotte's people will mean well but they may provide information they thought was helpful in her treatment but really was not.  That information will then become part of a folklore that will be almost impossible to replace once the actual science is known.

It's a complex problem.  Anyone would want the same relief for other kids that Charlotte seems to be getting but no-one would want to make their problems worse.  Science will have to do some serious skating to keep up with what's happening.

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