Bestowing the gluteus maximus of a rodent

Mark Kleiman and the Drug Czar both link approvingly to Physicians unlikely to embrace marijuana as medicine by Keith Humphreys.
We know the drug czar’s motivation — he doesn’t give a rat’s ass about sick people today and is willing to sacrifice them in order to demonize recreational marijuana. I’ll hold off characterizing Kleiman’s motivation.
Now to be sure, Mark properly refutes some of the more outrageous omissions and mischaracterizations in Humphreys’ OpEd (a dreadful piece lacking basic scientific knowledge about the state of medical marijuana research). And I commend him for that diligence. And he does go on to say:

If morphine is a medicine, there’s no reason why vaporized or nebulized cannabis extract can’t be a medicine.

But ultimately, the premise of Humphreys’ article is nonsensical.
Humphreys says that mainstream medicine is unlikely to embrace marijuana as a treatment. When it comes to reasons why he believes this, about all he can muster is:

1. Doctors are gun-shy because of the damage caused by cigarette smoking, and so are unlikely to accept a smoked medicine (this sounds like an indictment of the medical community — that they’d make decisions not based on facts, but on fears).
2. Doses are hard to regulate (this is an old one and may end up being important in some situations, but it’s completely irrelevant in others — in fact, smoked marijuana is easier to self-regulate than most pharmaceutical drugs, and doctors know full well that one pharmaceutically regulated cold capsule dose could have no impact on one patient while knocking another patient out completely.)

And Kleiman accepts the premise…

His basic point: medicines may be developed from cannabis, but American physicians simply aren’t going to have their patients smoke their medicine.
That seems right…

and his RSS teaser:

Can cannabis be a medicine?
Sure. But not smoked in joints or bongs.

Why not?
So let’s go back to the premise. Mainstream medicine will not accept smoked marijuana.
What does that mean? If it means that pharmaceutical companies will not accept smoked marijuana, then, yes, you’re absolutely right. They stand to lose billions of dollars of our money.
However, if you mean doctors, then that’s just hogwash.
Despite the lack of support from the medical establishment, and the harassment from the federal government, there are tons of well-trained, licensed physicians who are fully prepared to recommend smoked marijuana to their patients, and who do so on a daily basis, in accordance with state laws.
And that should be the story. Not what some mythical “mainstream medicine” may eventually decree.
To me, mainstream medicine is what happens between a doctor and a patient, not between a pharmaceutical company and a professor of psychiatry. Sure, some doctors may not wish to prescribe marijuana. Some patients may not wish to smoke it. For some patients, Marinol or Sativex may work better. Others may find brownies effective.
Those of us in the drug policy reform community want scientific research to continue — we want the drug companies to investigate cannabinoids in various forms, and develop pills, and sprays, and injections, and rectal suppositories, and whatever else they find is effective for various illnesses.
But in the meantime, there are patients who benefit from smoked marijuana, and there are doctors recommending it. And it is completely irresponsible for politicians and academicians to tell them they can’t or shouldn’t. Or that patients should just tell their pain or their nausea to wait until a “proper” medicine has been synthesized that they can buy at premium prices from the Rx Lords.
Because marijuana is so effective and safe (and by any human standards, marijuana has been proven both safe and effective beyond any doubt) and so easy and cheap to manufacture, and because it is associated with recreational use, it is going to make certain people uncomfortable. So be it. It’s past time to shake things up and say not that marijuana can become a medicine, but that it already is, and you’d better get on board or you’ll be left behind.
Full Disclosure: I am a legalizer. I believe that marijuana should be legally available for recreational use within a regulated system that takes it out of the black market. However, I also happen to believe that sick people should be able to take safe and effective medicine that has been recommended by their doctor. That’s not opportunistic; it’s merely consistent. Yes, I give a rat’s ass about sick people.