Monday, December 8, 2008

Medical marijuana

The latest The New Yorker (December 1, 2008) has Sasha Frere-Jones' article on Steven Ellison, a "a tall, soft-spoken twenty-five-year-old who works under the name Flying Lotus." He is part of a growing movement that is guiding hip-hop into the next decade via a road paved with a "fractal spidering of sounds, a backdrop of crackles, and prickling, feverish rhythms no human hands could play." I was actually intrigued by this description of his music. Although I am no fan of rap/hip-hop, I like the reincorporation of musical ideas into new compositions, like Eno and Byrne's My Life In The Bush Of Ghosts, or some of the better mashup artists like CCC. So I began reading the article.

The article describes the interior of Ellison's Northridge L.A. apartment, "typical of the twenty-first-century musician: a collection of laptops, keyboards, and processing units, none of them large and most of them portable." There is also this decorative touch:

A series of pharmacy bottles lined the wall behind his equipment. The clear orange cannisters were familiar, but not the names on the laser-printed labels: Grape Ape, Purple Haze. “Medical marijuana,” Ellison explained.

Huh? The picture accompanying the article shows a robust young man, leaning back in his chair and laughing heartily. He certainly didn't appear to be a cancer victim, or a glaucoma sufferer. Just what are the indications for medical marijuana usage?

According to Wikipedia, medical cannabis was shown to have established effects in the treatment of nausea, vomiting, unintentional weight loss, and lack of appetite. It is also indicated for treatment of certain types of glaucoma. So far, so good. The Wiki article goes on to note that marijuana is "indicated" in a variety of other conditions, such as epilepsy, asthma, migraines and arthritis. I can think of a number of drugs that are "indicated" as first-and even second-line therapy for these conditions, but I am unaware that there is extensive literature to back up the "indication" of marijuana usage in any of them. But that's okay, 'cause Dr. Tod H. Mikuriya of California has compiled a list of over 250 conditions that he has treated with medical marijuana, including (I kid you not) sedative dependence and opiate dependence. I am so behind the times, man.

As a person in recovery myself, I am baffled as to why anyone would consider treating substance abuse with another mind-altering drug.

The Wiki article does mention some of the concerns that the medical community has about smoked marijuana, specifically an Institute of Medicine study that concluded that smoking cannabis is not recommended for the treatment of any disease condition. The FDA has approved Nabilone and Marinol for the treatment of unresponsive nausea associated with chemotherapy, and the use of a vaporizer has been mentioned as a delivery vehicle for the active components of marijuana.

Perhaps there are valid indications for the medical use of marijuana, other than glaucoma and nausea. In this era of evidence-based medicine, more trials are needed to establish its usefulness as a treatment. To claim that it is somehow useful in such diverse conditions as PMS or Grave's disease or (and again I kid you not) Writer's Cramp (International Classification of Diseases 9 Code 300.89) is farfetched based on our available evidence.

The push to legalize medical marijuana has been couched in terms that suggest opponents to its use are mean-spirited prudes who would want to see cancer-ridden bulimic glaucoma sufferers waste away into an even earlier grave than is their due.Unfortunately, Mr. Ellison, with his drug store bottles neatly lined up next to his water-operated “gravity bong,” paints quite a different picture.

Far out, man.

(BTW, I did check out the Radiohead "Reckoner" remix on the Flying Lotus MySpace page. Not bad, but not great, either.)

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