Still, Bostwick said he would give marijuana to Marilyn.
"If it would help, why not? I say that, knowing that much of what we do in medicine is empirical, but knowing there are arguments for exploring the possibilities the whole endocannabinoid system might offer," he said. Bostwick explained that there are receptors for cannabinoids in the brain, the gastrointestinal system and immune tissues -- which suggests the body may be designed to accommodate or benefit from marijuana.
"The downside of trying medical marijuana is small. If she did not have a recent experience with [marijuana], she might not even like it," he said.
Bostwick believes the federal government should make marijuana, which is now illegal in the United States, a "schedule II" drug, thereby allowing researchers to study its safety and effectiveness. Schedule II drugs are considered to have a high abuse risk but also have safe and accepted medical uses. Schedule II drugs include morphine, cocaine, oxycodone (Percodan), methylphenidate (Ritalin) and dextroamphetamine (Dexedrine).
Bostwick argues that Marilyn's situation is a clear case for the need to apply clinical judgment: "In the context of an ongoing relationship, as one more treatment in a wide pharmacopeia, it's up to the doctor," he said.
To learn more about marijuana, visit the U.S. National Library of Medicine.
SOURCES: Robert DuPont, M.D., clinical professor of psychiatry, Georgetown Medical School, Washington, D.C.; J. Michael Bostwick, M.D., professor of psychiatry and psychology, Mayo Clinic, Rochester, Minn.; Feb. 20, 2013, New England Journal of Medicine online
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