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March 07, 2007
What is a Potdoc?
When I posted Doctor Minot’s fascinating clinical evaluation of President Bush and promised to offer an alternative evaluation at some later date, I had only a vague idea of how I’d do that or what I’d say. However I was too intrigued by the opportunity it offered for dealing with several related issues to pass it up. For one thing, it would be another opportunity to call attention to the shortcomings of DSM nosology, which I have come to regard as having a pernicious influence on both Psychiatry and Public Policy.
I was even less certain of how to deal with another requirement that was clearly implicit in the exercise: that of providing a basis for presuming to critique the articulately stated opinion of a practicing psychiatrist with extensive clinical experience. Although cannabis consultation, the field in which I’ve been working since late 2001, is still very new, formally unrecognized within Medicine, and has been subject to unusually rapid change since passage of Proposition 215 brought it into existence in November 1996, it does exist.
By calling for the signed opinion of a licensed physician that use of cannabis was of at least potential benefit to an individual, Proposition 215 demanded an entirely new kind of doctor-patient relationship, one predicated on an expertise no physician could possibly have then possessed for the simple reason that in 1996, all use of cannabis had been illegal for sixty years. While that illegality hadn’t prevented Psychiatry and the Behavioral Sciences from producing a flood of studies of drug users, nearly all had been orchestrated by NIDA, were unanimous in assuming a deleterious effect from any ‘drug of abuse,’ and tended to categorize chronic users as either addicts or criminals.
In brief, there had simply been no unbiased studies of either ‘therapeutic’ or ‘recreational’ use of cannabis by admitted chronic users during the entire historic interval between 1937 and 1996, despite occurrence of an officially admitted ‘marijuana epidemic’ beginning in the mid Sixties. It is my contention that what I’ve been engaged in for the past five years is a systematic study of the existing user population, a study that was impossible before it was enabled by Proposition 215. With the exception of a substantial contribution from a single generous donor for database development, this work has been financed by applicants.
That the study has been misunderstood, misjudged, and/or ignored by most political supporters of the notion of ‘medical marijuana’ is simply another facet of human behavior to be noted, understood, and dealt with along the way to publication in the peer-reviewed literature, a goal of the study ever since my initial patient experiences suggested it could be done.
That initial impression has been amply confirmed by data which could not have been anticipated and which, when promulgated to a competent audience, should have the power to compel further objective analysis in a contentious area that has been completely dominated by religious thinking for a dangerously long interval.
Doctor Tom
Posted by tjeffo at March 7, 2007 04:22 PM