Medical Marijuana – The Enigma of the Stigma: The Physician’s Predicament

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In this CBN exclusive, a local physician has agreed to come out from beneath the shadow the enigma of the stigma casts upon many mainstream medical practitioners.  This is the first time this physician has authorized the public use of his name in terms of his support for medicinal cannabis. 

 
Redmond Mayor George Endicott recently stated in an email that “the ONLY people I heard in favor of allowing the dispensaries was last night ( a half dozen local residents who spoke publicly in support for medical  cannabis dispensaries at the March 25, 2014 segment of the Redmond City Council meeting – considering the medical marijuana dispensary moratorium issue). I have probably heard from 70 or 80 people who do not want the stores in Redmond. They also have a voice.” 

 
Having interviewed dozens of residents in Central Oregon about the medical cannabis issue – one thing has become clear: many folks in this region are simply reluctant to have their names associated with public expressions of their personal support for legal access to and use of medical cannabis. I call it, The Enigma of the Stigma. 

 
An enigma is defined as a person or issue that is mysterious, puzzling, or difficult to understand. Other words typically used to describe an enigma are conundrum, paradox and quandary. A stigma is defined as a stain on one’s reputation or something that may possess the ability to cause shame, disgrace or humiliation.  As it relates to the public expression of support for access to and use of medical marijuana, some folks are concerned that their public expression may cause them to be perceived negatively by others. In some cases, the risks are more tangible (potential loss of employment, housing, a professional license, etc.). The enigma of the stigma applies to physicians, patients, producers, politicians and the public.

 
In this CBN exclusive, a local physician has agreed to come out from beneath the shadow the enigma of the stigma casts upon many mainstream medical practitioners.  This is the first time this physician has authorized the public use of his name in terms of his support for medicinal cannabis.

 
On April 2 WebMD reported the results of a survey of doctors from 48 states in more than 12 specialties. The bottom line: “A majority of doctors say that medical marijuana should be legalized nationally and that it can deliver real benefits to patients. The survey found solid support for legalization efforts, with most doctors saying medical marijuana should be legal in their states. They agreed that medical marijuana should be an option for patients.”

 
Enter Bend’s Dr. Christian Le – board certified in internal medicine and pediatrics. He has been in practice for the past 15 years, including several in Bend. (Le is pronounced lay). Dr. Le began studying botanical medicines a number of years ago. During this time, he began examining patients and reviewing patient medical records in authorized clinical settings. These patients were seeking the required medical authorization to obtain a state authorized medical cannabis user card (OMMP card in Oregon). He now practices through several clinics in Oregon, and is currently looking for a Bend location to open Green Earth Medical Clinic.

The objectives of the Bend clinical practice are to:

 
• Educate patients, the public and medical professionals about botanical medicines.

• Perform secondary evaluations of patients – as a supplement to their primary care doctors.

• Practice as a cannabis specialist (Dr. Le is quick to point out that he is only authorized (as are all licensed physicians by the Oregon Medical Board) to examine patients and their medical records and determine if the patient is “medically qualified” to apply for an OMMP card. He cannot and does not provide medical advice on which available cannabis products to use – or how to use the same (frequency, dosage, etc.).

 
According to Dr. Le “We now have enough science and clinical information that physicians require resources for ongoing education and training from those who possess extensive, tangible clinical experience working with patients who have benefitted from the use of botanical medicines. However, there is too much anecdotal information out there. We must begin to share what we know about the use of botanical medicines – including the use of legal, duly authorized medicinal cannabis products – with our healthcare colleagues, and the public.”  Dr. Le is a member of the Society of Cannabis Clinicians (Physicians and Allied Professionals Employing Medical Marijuana in Patient Care). 

He is also a contributor to Project CBD – an educational service dedicated to encouraging and disseminating research into the medical usefulness of cannabidiol – including providing updates to physicians and patients on the ongoing progress in cannabinoid science and therapeutics.

 
The patient maladies – those seeking a botanical medicine alternative – and their demographic characteristics – Dr. Le has observed in his clinical practice, include the following:

 
• The most common ailment reported are those patients suffering from chronic pain. The majority are seeking alternatives to prescription pain medicines due to their “horrible side effects, and their addiction potential.” Dr. Le points out “heroin use in the U.S. has increased dramatically over the last decade as physicians become more aware of the side effects and addiction potential of opioids – and have reduced their prescriptions of the same.” (Opioids are a common ingredient in many of the most frequently prescribed pain medicines – particularly in the cases of chronic pain sufferers).


• Other patient ailments include those with leukemia, nausea, persistent acid reflux conditions, bowel disorders, muscle spasms, arthritis, loss of appetite due to the effects of chemotherapy and radiation, PTSD and seizures.


• Dr. Le has observed an increase in the number of PTSD patients seeking alternatives to prescription medicines. “This is particularly true for rape victims, veterans and sufferers of anxiety disorders.”


• The age demographic characteristics of patients Dr. Lee has examined include:


1. 50% are above the age of 30.

2. 20% are above the age of 50 – a demographic that is “growing rapidly.” 

3. 30-40% of patients are “absolutely new to exploring medicinal cannabis. This particular demographic is very true with patients over 50 who are experiencing the onset of disease conditions that correlate with aging.”

4. Increasing – Patients suffering from seizures seeking alternative medicines.


When queried about the uncertainties and health risks associated with the use of medical cannabis in particular, Dr. Le states that his medical concerns are primarily related to child brain development and lung toxicity (for those who smoke medicinal cannabis products). He is quick to point out that many patients choose to use medicinal cannabis in a way that does not involve smoking. These patients choose a topical medicinal cannabis application (ex. Iraq War vets with persistent skin lesions), tinctures (a concentrated cannabis oil extract ingested orally) – whose effect is longer lasting – for those patients whose condition requires daily maintenance, and other edible products.


“Medicinal cannabis is driving Big Pharma nuts in the U.S.” declares Dr. Le. “They are spending millions in an attempt to derail access to medicinal marijuana for millions of patients who desire access to it. They cannot patent the plant.” Pharmaceutical firms  run the risk of losing millions from patients and physicians who elect to pursue medicinal cannabis alternatives.


What are the risks for Oregon medical practitioners for coming out publicly regarding the benefits of the use of medicinal cannabis as a legitimate alternative for some patients? These may include negative reactions from colleagues in the healthcare community, prospective actions by medical practitioner licensing authorities and the loss of employment. 


Bend’s Christian T. Le, M.D. – a local medical practitioner has now emerged from the enigma of the stigma. 


Next: Medical Marijuana – The Patient’s Paradox

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