Where Does Marijuana Fit In?

You’re only as Young as Your Back
April 19, 2010
The Momentum of Obesity
May 3, 2010

Last Saturday finally provided me with a sunny morning without rain or early morning commitments so I used it as an opportunity to go on my first bike ride in 2010. I headed up a winding road that climbs steadily up into the Santa Cruz Mountains outside of Saratoga. Many folks use pristine Saturday mornings like this to take their bikes, motorcycles, or cars up this road where they can quickly and easily access natural beauty with just a short trip from wherever they call home. I must say, one of the benefits of all of the rain was listening to the various creeks rustling by with fresh water as I made my ascent. All in all, it was a great spring day.

I have to pass on one thing that happened on this ride that I can’t seem to let go. Lots of bikers go up this road each weekend, and the cars typically drive around them in a mindful fashion, taking into consideration the bends and twists of the road. As one of these cars whizzed by me, what I received in my nostrils was not a whiff of the typical exhaust fumes that I normally get, but rather a generous cloud of freshly smoked marijuana. “Hmmm,” I thought. “Do I really want somebody driving a car next to me while I’m peddling around this delicate turn that is smoking weed when they should be paying attention to not running me over?” Well, not really.

I bring this up, because I get asked a lot about using marijuana for medical reasons and as a pain treatment. This is currently a hot political topic in a number of states. My example above serves as a reminder that whatever decisions are made about how an individual receives medical treatment, that it will impact not just the person with the disease but the whole world around him. In other words, if you choose to use marijuana for medical purposes, your decision will in fact affect a lot more people that just yourself.

As physicians, we often focus primarily on the patient sitting in front of us as we try to make recommendations that will fulfill their needs. It is easy to ignore the implications of what we do on society as a whole, but I think this laissez faire attitude is short-sighted. There must be a sense of social responsibility that we all bring to the table when we practice our respective professions.

I see insurance companies guilty of this same type of tunnel vision every day. Certainly their decisions about what care they will and won’t authorize for each individual patient can impact the lives of all of us. I see people go on to become dependent on government run institutions like Medicare, state disability, and Medicaid every day in part by insurance decisions that pay no attention to the ramifications that they may have on the big picture. Call it the It’s Not My Problem Syndrome.

I think it was Dr. Spock of Star Trek fame who said “The needs of the many out-weigh the needs of the few,” giving us yet another topic to think about as we revise health care practices.