Daily Dose

Is Sanjay Gupta’s new pro-medical marijuana stance irresponsible?

Although I’m a fan of Dr. Sanjay Gupta and envy him for being able to report health stories on CNN using his expertise as a neurosurgeon, I’m a little skeptical about his full-frontal apology concerning his previous objections to using marijuana for medical purposes.

Yes, he has a documentary called Weed airing on Sunday. And yes, all the attention he’s getting over this apology is likely to be a huge ratings booster.

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But CNN is hurting, and I’m not going to fault them for engineering this clever publicity stunt.

I am, though, disappointed in Gupta for being like a pendulum and swinging too hard from one extreme to the other.

Where he first concluded that marijuana was a harmful, addictive street drug, he’s now convinced it’s safer and more effective than prescription painkillers that have been through the rigors of large controlled clinical trials to gain approval by the US Food and Drug Administration.

In discussing a type of chronic harsh pain caused by nerve injury, he writes that “the most common medications ... including morphine, oxycodone and dilaudid ... don’t work very well for this kind of pain, and tolerance is a real problem.”

That’s certainly true, as well as his concerns about accidental overdoses that can lead to death. I do wonder how he can conclude, though, that “marijuana has long been documented to be effective for this awful pain.” He links to a single study involving 50 patients that was conducted over five days. How do we know whether there’s any long-lasting relief?

Gupta also makes medical pronouncements based on his interviews with patients whose symptoms were alleviated by smoking medical marijuana. While I’ve used anecdotes in my own reporting, I think it’s irresponsible to use these as stand-alone facts where data is lacking to back up the case reports.

Charlotte Figi, Gupta said, had her seizures calmed by medical marijuana where other anti-seizure medications approved by the FDA didn’t work. Yet I couldn’t find any recent studies testing the use of marijuana for this purpose, and the handful of older ones questioned its safety as an epilepsy treatment.

That doesn’t seem to bother Gupta, and in fact, he wrote that he’s “come to the realization that it is irresponsible not to provide the best care we can as a medical community, care that could involve marijuana.”

I’ll give him the benefit of the doubt and will choose to focus on the word “could” in that sentence. Yes, medical marijuana could be an effective treatment—and yes, it might very well be safer than controlled opiates used to treat chronic pain—but we just don’t know at this point because rigorous research hasn’t been conducted.

Gupta makes valid points about barriers that are precluding such research—including having to get clearance from the US Drug Enforcement Administration—but I don’t think that lets doctors off the hook. They shouldn’t be extolling the virtues of an untested treatment and really should consider it a therapy of last resort, when all other options have been exhausted.

Even then, they need to be honest with their patients, telling them that more research is needed to prove tantalizing medical claims—for example, that marijuana improves appetite and reduces nausea in those with terminal diseases such as AIDS. A recent review found it wasn’t so beneficial for HIV patients.

A little cautionary note from Gupta on this front could go a long way even if it doesn’t give him the same ratings boost.

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