Marinol vs. Marijuana
This just in today from the "Hello MD" e-mail list. Hello MD seems to be run, or at least contributed to, by doctors sympathetic to medical uses of marijuana. Today's e-mail deals with differences between marinol and actual marijuana. It caught my attention because I had occasion to use Marinol last time I was in the hospital at UCSF.
It seemed like pulling teeth to get some. I'd asked my doctor's nurse using an online form if they could provide me a medical marijuana card. She said they could, and implied one would be forthcoming. That was it.
When I got to UCSF I brought it up with some other doctors and they suggested talking to my doctor as "he's all into that". Turned out that wasn't true. It seems most down there point their fingers to someone else to hit up for 215 cards and then scurry away not wanting to take the responsibility themselves.
So one evening they came in to give medications and mine included a marinol capsule. I have no idea who authorized it as most doctors I brought up the subject with seemed to ignore the issue. So I took it and after a while dozed off. I woke up some time later and felt that giddy feeling I hadn't felt since the '80s. I felt like giggling and wondered what was going on. Then I remembered the marinol and realized that's what I was feeling.
It wasn't real strong, though, and I realized if I'd smoked some pot it would have been much stronger, but I still felt good. One thing I noticed right away and mentioned to doctors later is it did seem to put a damper on my anxiety. I'd been somewhat upset being in the hospital with no apparent end in sight. The marinol made me not really care about that anymore. For that reason alone it was worth it.
Another thing I noticed is I started feeling even sleepier than I normally would have been at that time. Then I remembered that was one thing I didn't like about smoking pot: it made me sleepy. I told myself then, and the nurses every morning they'd offer me some with my medications, I didn't want to take it in the morning as it would probably make me sleepy all day. I told them that time and again yet they'd always offer me it each morning apparently not remembering what I'd told them the day before. In fairness to them, I suppose they still felt like giving me the choice. I can't fault them for that.
One thing I didn't get from marinol I would have gotten from real pot is increased appetite or " the munchies". It didn't affect my appetite at all.
So marinol worked for me but smoking or eating pot would have worked better I'm sure.
As that WebMD piece points out: "If patients were legally allowed to use marijuana, relatively few would choose Marinol.". From my own experience, I fully agree.
After I'd gotten out of the hospital, I went back to see my doctor and broached the subject of a 215 card for medical marijuana. Turned out he "wasn't all about that" as one of the other doctors had said. Anything but. In fact, he got a bit surly with the subject brought up and seemed to want to ignore it.
At one point I pointed to claims of THC reducing tumors and such. He reacted angrily to that, saying it didn't, although he didn't say how he knew.
That kinda pissed me off and I figured he was just like the rest down there, joined at the hip with the pharma companies. Either that or, when push comes to shove and they have to sign something, they lose whatever enthusiasm they had for medical pot to begin with. I dropped the subject.
I guess I'll have to go with WebMD one of these days and see about getting a card through them. Marinol is fine but is no substitute for the real thing.
Or, if that AUMA proposition passes in November, maybe I wouldn't need one?
posted by Fred Mangels @ 2:39 PM
6 comments
6 Comments:
Fred, we've been through this before -- it's very easy to get a card, and there are numerous doctors in Humboldt who will issue you one no problem. You just have to bring them some basic documentation of your medical diagnosis. And about a hundred bucks, last time I checked.
The Marinol makes you very sleepy because it is a synthetic version of just one molecule -- THC (Tetrahydocannabinol). While this was for may years described as "the" active ingredient of marijuana, it's really just one of hundreds of compounds, dozens of which are known to have various different therapeutic effects. For our purposes here the one that probably matters the most, and isn't present in Marinol, is CBD (Cannabidiol). The CBD helps balance some of the effects that THC can cause, including (in my experience) sleepiness. The WebMD article is right, for most patients, if they were able to try Marinol for a few weeks, and then try plant-based cannabis (whether by edibles, vaporizing or whatever), very few of them would choose the Marinol. Why would they, since apparently it's often less effective, and has worse side effects, than actual plant-based cannabis preparations.
In my view, any Doctor that is in a state like California where high quality medical cannabis in various forms including edibles and vaporizables, should be proactively discussing those options with patients who might benefit from them -- and especially anyone undergoing treatment for cancer and experiencing side effects like nausea or loss of appetite, and anyone whose pain is severe enough that they're on prescription painkillers.
To ignore cannabis as an option, despite plenty of evidence that it can help alleviate symptoms and can reduce the need for other drugs with far more serious risks, like for example Oxycontin and Fentanyl -- is bordering on malpractice. And in a few years, I think refusing to even consider using cannabis-based medicines when appropriate WILL be considered malpractice.
"At one point I pointed to claims of THC reducing tumors and such. He reacted angrily to that, saying it didn't, although he didn't say how he knew."
In fairness, I think so far that's only been shown in lab rats. Which is promising, but far from definitive.
So I wouldn't blame a doctor for warning patients not to get their hopes up about medical marijuana causing their tumors to up and vanish. Heck, if that were the case we'd have virtually no cancer in Humboldt, and that's certainly not the case.
But he didn't have to be a jerk about it, and he certainly shouldn't be pooh-poohing the use of medical marijuana to treat symptoms related to cancer treatment, assuming that's what they were offering you the Marinol for.
By the way, I realize that in my last comment I said there were plenty of doctors in Humboldt who would issue you a 215 recommendation no problem (with documentation of your diagnosis, of course), but failed to give an example. So, here's one such outfit:
MediCann
2365 Harrison Ave, Eureka, CA 95501
Phone: (866) 632-6627
Call first to make an appointment, and they will let you know what you need to bring (which will include a CA ID, and some documentation of your medical condition). If you just stroll in without an appointment you will probably be disappointed. If you show up without any written documentation of your diagnosis, you will definitely be disappointed. If you just bring the few simple items they require you'll be in and out in something like 30 minutes, with a written recommendation that you can take right to a dispensary (and a few days later they will send you a laminated wallet-sized card version).
Oh, and by the way, even if recreational legalization happens (which seems pretty likely), taxes will be way higher on that stuff, and if you use more than a small amount you will almost certainly be better off paying the $100 or whatever to have the medical card. (In Colorado, I went to a combo medical dispensary / recreational store, with the recreational on the ground floor and the medical upstairs. The medical area had some options the recreational area didn't, and the prices were only half as high.
Thanks for the heads up. A bit short on cash now, though. I'll get to it as soon as possible.
Hmmm....this pisses me off. I see Google has added those stupid picture verification things again.
Marinol versus the real deal.
Fred, why do ya think marinol exists if marijuana plants are not going extinct, but expanding like a swarm of locusts?
Marinol is a part of a "faked american economy" where jobs are faux jobs, never needed except to hoard and miser the natural product into a pharma for profit product.
All these unnecessary, illegitimate jobs being created that have ulterior motives to something sinister for corporate/ gubbamint conspirators.
Fuck Pharma, Fuck Pharma people who have faux jobs.
Marinol versus the real deal.
Fred, why do ya think marinol exists if marijuana plants are not going extinct, but expanding like a swarm of locusts?
Marinol is a part of a "faked american economy" where jobs are faux jobs, never needed except to hoard and miser the natural product into a pharma for profit product.
All these unnecessary, illegitimate jobs being created that have ulterior motives to something sinister for corporate/ gubbamint conspirators.
Fuck Pharma, Fuck Pharma people who have faux jobs.
As pointed out, you want the cbd, Fred.
It must be tough finding any a left over dollar bill, let alone a hundred of them, with your travelling and medical expenses. I'm surprised there isn't yet a "pool" or a jar, for helping patients to get started. I'm hoping someone sets something up. Pay back the jar as you can, when you can.
Get well soon Fred.
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