Examining the debate on the use of medical marijuana
Examining the debate on the use of medical marijuana
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DOI：
10.1046/j.1525-1381.1999.09252.x
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发表时间：
1999-03-01
期刊：
影响因子：
--
通讯作者：
DuPont, RL
中科院分区：
文献类型：
--
作者：
DuPont, RL
鸦片罂粟和古柯叶为当前医用大麻的争议提供了有用的视角。在这两种情况下，古代民间药物中生物活性成分的纯化合成类似物已经成为医疗支柱，而不会破坏减少非医疗药物使用的努力。十年前，一场运动致力于将海洛因合法化，以同情地治疗绝症患者的疼痛。就像目前的医用大麻合法化运动一样，许多好心人也支持这一努力。科学阻止了医用海洛因的运动，因为双盲研究表明，在治疗严重的癌症疼痛方面，海洛因与标准的阿片类止痛剂相比没有任何好处。科学医学要求提纯的化学物质的剂量受到严格控制，而不会污染有毒物质。有一天，医生会开出焚烧树叶的处方，这是不可想象的。《管制物质法》和国际条约限制滥用药物或药物的使用。与吸烟的大麻不同，大麻中的特定化学物质，或者更有可能是合成类似物，可能被证明对一些患有特定疾病的患者有好处。大多数反对医用烟熏大麻的人对医用纯化合成类似物甚至合成四氢大麻酚(THC)并不怀有敌意，自1985年以来，合成四氢大麻酚(THC)一直在美国供任何有执照的医生开处方。相比之下，大多数吸食大麻的支持者对使用从大麻中提纯的化学物质怀有敌意，坚持只将吸食的大麻叶用作“药”，清楚地表明他们的动机不是科学药物，而是走后门让大麻合法化。
The opium poppy and the coca leaf offer useful perspectives on the current controversies over medical marijuana. In both cases, purified synthetic analogues of biologically active components of ancient folk remedies have become medical mainstays without undermining efforts to reduce nonmedical drug use. A decade ago, a campaign strove to legalize heroin for the compassionate treatment of pain in terminally ill patients. Like the current campaign to legalize medical marijuana, many well-meaning people supported this effort. The campaign for medical heroin was stopped by science when double-blind studies showed that heroin offered no benefits over the standard opioid analgesics in the treatment of severe cancer pain.Scientific medicine requires purified chemicals in carefully controlled doses without contaminating toxic substances. That a doctor would one day write a prescription for leaves to be burned is unimaginable. The Controlled Substances Act and international treaties limit the use of abused drugs or medicines. In contrast to smoked marijuana, specific chemicals in marijuana or, more likely, synthetic analogues, may prove to be of benefit to some patients with specific illnesses. Most opponents of medical use of smoked marijuana are not hostile to the medical use of purified synthetic analogues or even synthetic tetrahydrocannabinol (THC), which has been available in the United States for prescription by any licensed doctor since 1985. In contrast, most supporters of smoked marijuana are hostile to the use of purified chemicals from marijuana, insisting that only smoked marijuana leaves be used as "'medicine," revealing clearly that their motivation is not scientific medicine but the back door legalization of marijuana.