The Cannabis Question: A Doctor's Perspective - Valley News Live - KVLY/KXJB - Fargo/Grand Forks

The Cannabis Question: A Doctor's Perspective

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  • The Cannabis Question: A Patient's Perspective

    The Cannabis Question: A Patient's Perspective

    The bill has taken yet another step in the Senate and seems to be gaining momentum. Public Policy Polling says 65% of Minnesotans approve of legalizing medical marijuana, but the governor has said he won't sign it.
    The bill has taken yet another step in the Senate and seems to be gaining momentum. Public Policy Polling says 65% of Minnesotans approve of legalizing medical marijuana, but the governor has said he won't sign it.
  • The Cannabis Question: How it Works

    The Cannabis Question: How it Works

    Showing signs of compromise, the future of medical marijuana in Minnesota looks to be closer than ever before. 
    Showing signs of compromise, the future of medical marijuana in Minnesota looks to be closer than ever before. 
Could getting high soon become the doctor's orders? The future of alternative medicine in Minnesota is up for debate.

A bill to legalize medical marijuana just cleared another hurdle in the state Senate. Another committee hearing is scheduled Wednesday. As lawmakers weigh whether to approve marijuana as medicine this legislative session, Valley News Team's Hope Hanselman has been digging for months to track down the answers to your questions.

For the rest of the week, The Cannabis Question will investigate the issue facing Minnesotans and ask the tough questions to those who hold stakes in the matter.

Currently, two bills are stuck in the legislature that would legalize medical marijuana, they differ on how patients can consume the drug.
The Senate bill has received more action in the last week. That's the one that would allow patients with a doctor's note to smoke marijuana bought at tightly-regulated dispensaries in the state. However, the doctors who would write those prescriptions are at odds over the approval of cannabis as medicine.

"For doctors to prescribe a medicine, you have to be able to show doctors how the science works," Dr. David Thorson, of White Bear Lake, said.

Let's start with something on which we can all agree: medicine, in this country, is based on science. Science is based on evidence.

"I need to know what I'm prescribing, how it's going to affect, what the side-effects are, because I need to have that conversation with the patient," Thorson said.

Marijuana as medicine certainly isn't a new concept. Some anthropologists say cannabis shows up in the bible, ancient Greece and the Middle Ages. But, the drug is illegal under US federal law, meaning modern clinical trials are few and far between.

"You'll get no funding for study and it's basically illegal to use unless you have very restricted circumstances," Dr. Bob Koshnick, of Detroit Lakes, said.

Now, Minnesota doctors are facing the possibility of prescribing their patients 2.5 ounces of cannabis- the equivalent of about 50 joints.

"Physicians feel like they're being put in the middle of something on which we don't have the basis to make the right decision and how to treat it," Thorson said.

According to Koshnick, a number of doctors in the state are fearful a new US Attorney General will be less tolerant of states with medicinal cannabis laws. Currently, he says, the feds keep a close eye but largely allow doctors to abide by their states' rules. Some doctors believe a new Attorney General will start prosecuting those issuing prescriptions.

Twenty-one states, including the District of Columbia, now have approved medicinal cannabis. Those states have provided the backbone pushing some doctors, including Koshnick for access.

"I think what needs to be done is we need to have more states enacting laws that puts the pressure on the feds," he said.

On the other hand, the trend across the country is setting a precedent that makes other doctors, including Thorson, wary.

Dr. Thorson is the head of the Minnesota Medical Association, a group of professionals who have formally opposed the legalization of medical marijuana.

"The big problem I have, or the Medical Association has, is that it is not science or evidence-based. It's based on anecdote," he said. "It's hard when you see a young child with a seizure disorder and the mother is there saying this made my child much better."

The emotional stories of suffering that are swarming the House and Senate floors this year haven't swayed these doctors. They want research, not access.
"We have the FDA, who is supposed to look into the safety of the efficacy of medicine, and they have not looked into this," Thorson said.

However, the federal government does have a patent on cannabis, saying compounds in the plant called cannabinoids are proven to be useful in treating such diseased as AIDS.

Dr. Bob Koshnick says his Detroit Lakes clinic often sees patients using the drug illegally. He'd write a prescription... if he could.

"marijuana is a safer alternative to pain control than the opioids that we now use. I think it has many other medical uses," he said.
Both doctors agree, as with any drug, risks are involved with marijuana.

"The data would show that if you're exposed to marijuana earlier, the addiction potential is higher. But, there is a subset of patients that will be addicted to marijuana," Thorson said.

The National Institute of Drug Abuse says one in 11 people who try marijuana become addicted. For comparison, three in four people who try caffeine become addicted.

"Prescription opioids are killing about 17,000 people a year. That's not the case for marijuana," Koshnick said.

This science you want want to ignore: a person cannot overdose on weed and getting high, alone, has never killed anyone. Thus is the argument that has many doctors at odds over how much evidence is enough.

"There's a lot of data to suggest, for some patients, it is a big deal. So, I think making it over the counter, if you will, will allow people to say, hey, this must be safe," Thorson said.

Today's marijuana has become five times stronger since the 1960s. For many, that's a top1960's concern and may be a contributing factor the rising rates of marijuana-related emergency room admissions.

Lawmakers trying to address that issue have included a stipulation in their legislation, saying cannabis plants would have to be professionally grown to help monitor the potency of the medication.
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