The opium poppy and the coca leaf offer useful perspectives on the current controversies over medical marijuana. In both cases, purified synthetic analogues of biologically active components of ancient folk remedies have become medical mainstays without undermining efforts to reduce nonmedical drug use. A decade ago, a campaign strove to legalize heroin for the compassionate treatment of pain in terminally ill patients. Like the current campaign to legalize medical marijuana, many well-meaning people supported this effort. The campaign for medical heroin was stopped by science when double-blind studies showed that heroin offered no benefits over the standard opioid analgesics in the treatment of severe cancer pain. Scientific medicine requires purified chemicals in carefully controlled doses without contaminating toxic substances. That a doctor would one day write a prescription for leaves to be burned is unimaginable. The Controlled Substances Act and international treaties limit the use of abused drugs or medicines. In contrast to smoked marijuana, specific chemicals in marijuana or, more likely, synthetic analogues, may prove to be of benefit to some patients with specific illnesses. Most opponents of medical use of smoked marijuana are not hostile to the medical use of purified synthetic analogues or even synthetic tetrahydrocannabinol (THC), which has been available in the United States for prescription by any licensed doctor since 1985. In contrast, most supporters of smoked marijuana are hostile to the use of purified chemicals from marijuana, insisting that only smoked marijuana leaves be used as "medicine," revealing clearly that their motivation is not scientific medicine but the back door legalization of marijuana.

Cannabis↗

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Medicines and drug testing in the workplace.

Drug testing at work is rapidly becoming the standard in the United States. For drug testing to fulfill its promise as a vital part of the effort to end the drug abuse epidemic, it is essential that the tests be reliable so that people who are not using drugs are not falsely accused and that legitimate medical use of controlled substances not expose employees to harassment or labeling as drug abusers. To merit employee confidence, workplace drug testing needs to be made part of a program that includes these basic elements: (1) a clear and comprehensive policy; (2) secure collection; (3) chain-of-custody procedures; (4) retained positive samples; (5) an initial screening test; (6) a sophisticated confirmatory test; (7) a medical review officer; (8) a retest of retained positive samples in disputed cases; and (9) a system of quality control. In addition, this drug testing program needs to be built on a solid foundation that distinguishes between legitimate use of prescribed medicines and nonmedical drug use. This differentiation is the primary responsibility of the medical review officer.

Drug Therapy↗

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Violence and drugs.

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Alcohol Drinking↗

PubMedDate not supplied

Control of alcohol and drug abuse in industry--a literature review.

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Alcoholism↗