Hobbes,
Is marijuana really a new experiment? Seems like usage is up a bit lately, but still below the highs (yes, pun) of the 70s. Usage among kids is down.
I feel like vaping is a much bigger public health risk than MJ. https://www.washingtonpost.com/health/2019/08/16/mystery-lung-illness-linked-vaping-health-officials-investigating-nearly-possible-cases/
Letâs just inhale a bunch of rando chemicals. What could go wrong?
I vape thc oil or vape in a volcano instead of smoking and the glycol in most carts concerns me. There is a company in CO now doing solventless hash oil carts that are absolutely the best.
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This part is tricky. For more common procedures, the ProPublica data is available. Not sure that itâs up to date or entirely accurate. It also doesnât really tell the whole story in terms of complication rates which would require a ton of econometric adjustment to really be comparable. Also, thereâs more to surgical outcomes than complication rates.
However, you can be fairly confident that the skull base lady at a major pituitary center in Toronto has done a couple (hundred) of these and knows whatâs up. Sheâs getting regular reps which matters. Maybe not so much with the person at a small regional university hospital that doesnât solicit pituitary cases. It probably seems clear to everyone here but Iâm not sure your average patient understands this.
Come on down to my ED pretty much any night and you can see someone with cyclic vomiting due to marijuana use. And the fact that youâve never seen anyone sick means fuck all.
It took decades to figure out heath problems from tobacco and that stuff could be easily studied because it wasnât illegal. THC/cannabis research is just now starting - no one knows what long term use will do.
To be clear, Iâm NOT against legalization - itâs probably 100% tobacco and alcohol are worse for you, and locking up people for marijuana use was and is racist, stupid and counterproductive. But I just laugh at the âitâs natural so itâs harmless, manâ crowd. Bunch of morons. We wonât know for at least a decade.
MM MD
Scientifically, yeah, itâs new, because there are (and couldnât be) any sort of controlled research done. When I was at NU one of the profs in pharmacology said heâd looked into starting a study similar to tobacco-in-rats in terms of lung injury and the DEA horseshit was so involved he just threw up his hands and walked away. Additionally, if any of the research material went missing he would have been criminally responsible - which kind of put a damper on things.
MM MD
Well, I wasnât insinuating that at all. My point was that with the huge number of users today with legality and medical legality means that the people getting sick are a tiny minority. Iâve been using for 25 years and have been around 1000s of users in my life.
âProbably alcohol and tobacco are worseâ lol. What happens to those people that vomit? They quit using and are fine.
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âWhat happens to tobacco users. They quit and theyâre fine.â Until that small cell cancer shows up at 58.
Stop confusing anecdote for science. Youâre parroting the âMy uncle smoked for 60 years and heâs healthy as a horseâ crowd. Youâre a sample size of one. As I noted, Iâm pro legalization, anti-criminalization and happy that things are going the way they are. But Iâm also VERY aware that weâre basically where we were with tobacco when doctors were endorsing Camels because they were good for lung health. We donât know, and wonât for years. Same for vaping, and I strongly agree with the sentiment that vaping is likely worse in terms of big numbers - just too many variables in the stuff.
MM MD
Ok, but it seems like thatâs not a case of us blindly proceeding with something unprecedented in making pot legal rather the change being that now we can study something that people have been doing heavily since about 1970.
I had trouble finding anything good on this earlier. Maybe this is the best chart:
Use has gone up a bit generally, but for 15 and older, itâs fairly steady for 45 years. Legalization just doesnât seem like some crazy experiment.
Do you have any links for any lung cancer caused from marijuana? This shit didnât just hit the market last year.
And no, tobacco smokers arenât fine when they quit. It takes months and months to restore your lungs. wtf.
Referrals, prior auth, formularies, provider networks for instance. I think the arguments on HMO rationing are about degree and tactics, not that rationing merely exists.
Iâm not talking about legalization as the experiment. Iâm talking about the medical outcomes. Only. I pretty donât much care what people do to their own selves, but I think itâs best to know what the LONG-TERM consequences are in terms of health.
MM MD
Hobbes was saying it wasnât studied because it was illegal.
I would ask wtf some doctors didnât just go do a study in Jamaica or something, but I imagine the freedom loving US government would look for ways to punish US doctors, companies, or Universities who tried anything like that. Still, should be some studies from some countries that arenât as totalitarian.
That isnât all true though. Colleges have been granted DEA licenses to grow and study even though it was illegal.
But it was already happening anyway. The only significant change health-wise is that now maybe you can study it. Though doesnât that really require federal reclassification?
The majority of the âResearchâ being done wasnât medical in terms of patient outcomes. It was funded by NIDA, and the âDAâ part of that stands for drug abuse.
The University of Mississippi from what I can tell, was (and probably still is) one of the leading research institutes for marijuana, and were growing acres of the stuff. But the research was along the lines of determining potency and county-of-origin. Stuff like that - not a lot of medical type stuff.
And I think Iâm done here. The topic isnât that interesting, itâs a massive derail, and for some people itâs a faith-based sort of thing. Although Iâm setting the over/under on Josh Gordon flunking a drug test at 9 1/2 weeks.
MM MD
All I stated was that the people vomiting are a tiny percentage of total users. Then it went into it possibly being as bad as tobacco or alcohol with the caveat that we canât know anything yet. Iâm open to new information pretty much always. We knew alcohol fucked people up centuries ago. Long before medical studies. Same with opium, etc.
Why the vomiting happens
âWe know that marijuana works in the brain to stop nausea and increase hunger,â Dr. Cline says. âBut it can also be toxic and cause cannabinoid hyperemesis syndrome. We believe, though we donât yet have research to support it, that marijuana actually slows gastric emptying, causing the GI problems.â
When your stomach canât empty normally, food simply sits there. When it sits there too long, Dr. Cline says, it tends to come back up through vomiting.
FWIW, not a matter of faith to me and Iâm not a user. Iâve used it like 8 times total in my life, the last time being like 10 years ago.
ROW been smoking it forever (more than a decade). Calling the Netherlands. Seems to be a thing with the US where the only reliable info can come from within the US (says âonly country where this puking could happenâ)
Long term admirer of your posts HH but take a look at the wider (world) evidence here
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