politics

What You Should Know: The Pros and Cons of Medical Marijuana

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What You Should Know is an ongoing series covering a range of informational topics relevant to current and future healthcare professionals.
The numbers alone make it a significant issue: as of 2015, 23 states and the District of Columbia have legalized the use of medical marijuana – and 9 more states are currently working on legislation to do the same. Two more states – Washington and Colorado – have gone so far as to legalize its recreational use. It is likely, therefore, that medical students today will feel the effects of medical marijuana use when they go into practice for themselves.
Medical – and recreational – marijuana use is a complex issue with medical, political, and social implications. Below are evidence-based arguments for and against this use to give student doctors the opportunity to understand the finer points of this controversy.

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The Fatal Failings of Evidence Based Medicine

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The medical system (and much of the culture) these days is focused on group outcomes, not individuals. Personally, I think that stinks.
In medicine, this failing comes from improper use of what was originally a good idea—evidenced based medicine (EBM). EBM was developed to help overcome anecdotal medicine, in which a seemingly successful therapy in one patient gets adopted by a physician as the “way to go” and then preached to his trainees as the management of choice, and over time becomes unexamined gospel. “Anecdote-based medicine” is a form of groupthink, and groupthink is bad in general and particularly bad for the patient sitting in front of us on an exam table.
There needed to be some way to help doctors realize that an individual patient response is not generalizable to others.
EBM evaluates groups of patients to determine statistical responses to interventions. It was created (initially) to help doctors determine whether an intervention is likely to work in an individual patient. In that way, it was originally kind of the obverse of anecdotal medicine.

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