Progress Is Impossible Without Change
“Progress is impossible without change; and those who cannot change their minds cannot change anything.” - George Bernard Shaw
When the facts change, I change my mind.” - John Maynard Keynes
The word “crisis” is an uncomfortable one. Intending to be used for situations that are chaotic and troubling, it is a word meant to illicit emotion and garner attention. In our current times, it is also a word that gets used so often that some of its’ meaning is lost. As I write this on June 22, 2020 there is the Covid-19 crisis, the civil and social injustice unrest crisis sweeping the world, the economic crisis of the quarantine, and on and on. On a somewhat smaller level, but still incredibly important to our human psyche, we could talk about the crisis of not having all the things we normally love and look forward to; cinema, professional and youth sports, live theatre and concerts, festivals, etc…Things that normally provide us joy, excitement and togetherness; all currently on hiatus.
When we talk about crisis, there are things that most people can easily agree on, such as the importance of finding a vaccine for the covid-19 virus, or working together to fight climate change. There are many important issues, however, happening around us do not get labeled a crisis. Usually in fear of not wanting to sound hyperbolic or inflammatory. Unfortunately, even with all the ills occurring in the world today, The current health care climate in the United States regarding medical cannabis should be labeled as nothing other than a CRISIS.
A recently published medical study in The American Journal of Preventive Medicine (www.ajpmonline.org/), found that less than 12% of U.S. Physicians had a positive view of medical cannabis. More than 60% of the 1,500 licensed clinicians that were polled still maintained a negative, or uninformed, view of medical cannabis, which in itself is a large problem since they are the ones most likely to prescribe it or discuss it with their patients. This basically means that even with all of the growing research showing the positive benefits of cannabis and the negative effects of opioid pain medicine, and prescription sleep and anti-depression medicine, no more than 10 or 11 doctors out of 100 would even consider cannabis as a treatment option.
This leads to situations that are unsettling, confusing and somewhat un-natural; Talking to your trusted and respected physician, but feeling that you are more educated about a medical subject than your doctor. The data shows, however, that this is the current “normal” in our health care system.
In a recently published blog post in the Journal of American Medicine (www.Jamanetwork.com), and also published on the Stanford University Medical website (www.scopeblog.stanford.edu) Dr. Nathaniel Morris talks about the lack of teaching in medical school about medical cannabis. “The real problem,” he said, “is that many physicians are unprepared and poorly educated about cannabis and its health effects and benefits. Nothing is taught to us in medical school, and there are no major movements to change curriculums. This is partly because government restrictions have made it difficult to study cannabis, and the published research on cannabis is very limited to guide clinical decisions.”
The Association of Medical Colleges database revealed that as of 2018, only nine percent (9%) of medical schools teach their students about medical marijuana. There are 154 medical school programs, so that means only 13 or 14 of them offer any teaching whatsoever on cannabis. In another recent survey of medical residents, Curriculum deans at over a hundred medical schools administered surveys to graduates about marijuana education. More than 67% of graduates claimed they were not prepared to prescribe medical marijuana and 25% of the graduates said that they would not be able to answer questions related to medical cannabis. In yet another recent poll of 258 medical residents, conducted The Journal of Drug and Alcohol Dependence (www.sciencedirect.com), 90% of those polled were unprepared and uncomfortable prescribing medical cannabis to their patients. All of the data says the same thing; that U.S. medical schools are simply not preparing their graduates with nay knowledge on cannabis as a viable treatment for health conditions.
There is some hope and positive news however! As more states legalize cannabis and access to patients and data expands, more doctors are cutting through the fog and truing to change things systemically for the better.
The Healthy Swap team recently sat down with Dr. Steven Salzman, a world renowned Trauma Surgeon and one of the founding partners of Green Care Medical in Suburban Chicago (www.greencaremedical.com). Dr. Salzman and his team have created the largest and fastest growing medical cannabis practice in the region and have seen over 2,000 patients in the last two years.
“Doctors are trained, educated and comfortable using single-action, targeted pharmaceutical medications,” says Dr. Salzman. “This is what they are taught in medical school, what they have experience with and what they are shown by pharmaceutical companies and their sales reps. Cannabis is a Botanical medicine comprised of different compounds, and it often requires more patient education and hand holding than most clinicians are comfortable with. Being a doctor is already stressful and requires the need for constant learning and adapting; so trying to convince a doctor to learn about and prescribe a medicine that is still federally illegal is a challenge. Additionally, no insurance companies currently cover any type of medical cannabis as proven treatments, so there is a structural and systemic block for doctors to be incented to learn about the virtues of medical cannabis.”
“There is absolute and definite proof that medical Cannabis can help people. We are on the bubble of the revolution. There is just a process to help people, compile data and then we can change the world. What I saw early on in my practice, as we saw hundreds and then thousands of new patients, was that 100% of patients suffering from chronic pain had some form of insomnia or sleep trouble. Not 50% or 60%, but 100%. Every patient with chronic pain had trouble sleeping, which in turn led to depression and anxiety. We created the “Green Care Triangle of related symptoms” to help people understand the correlation between these symptoms. Insomnia – Depression – Anxiety. 100% of the patients were somewhere on this triangle, so we realized that until you fix a patient’s sleep; nothing else can be done. The diet change recommendations, the lifestyle changes we advocate, mindfulness and breathing, none of it mattered until we fixed the sleep. When I started following up with patients (all Green care patients are required for direct follow up visits with Dr. Salzman) as soon as they tried medical cannabis solely focused on sleep, their day-to-day feelings (The Green Care Life Score) improved by 40-50%. We are gathering such incredible data, and the research we will be publishing will absolutely change medicine and clinical treatment going forward.”
OK, so what is the average person to do!? One the one hand, there is a growing wealth of information and data showing that medical cannabis is beneficial and helpful for so many serious ailments and should be part of a healthy lifestyle. On the other hand, however, the vast majority of the medical professionals we place our trust in, have little to no training at all on the subject, and are not incented in any way to incorporate it into their practices.
At Healthy Swap, all we can do is to encourage taking control of your health and general wellbeing. If your doctor is absolutely opposed to medical cannabis, then perhaps it is time to look elsewhere for other (more enlightened) opinions. If your doctor is open to the idea, but is personally uncomfortable prescribing cannabis or offering referrals to a cannabis-focused medical practice, websites like www.marijuanadocs.com, or www.leafwell.co are excellent resources to help you find a local physician to help. Always make sure to take control of your health, ask questions, and find your way to a healthier and happier lifestyle.