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Medicine or menace? The marijuana argument is rekindled

marijuana plantsCreative Commons/Guilhem VellutDr. Joseph Lee: “Some kids are going to smoke pot recreationally and be OK. But the kids who are vulnerable for addiction are more likely to be pulled in and use and more likely to justify their use.”

The argument over pot seems tiresome and worn out. But as more states move to legalize, including efforts in Minnesota, the debate is getting yet another hearing. In November, the Dakota County Prevention Partners hosted a forum to “expose the science, facts and myths” around legalization, featuring Ken Winters, a professor in the University of Minnesota’s Psychiatry Department and specialist in adolescent addiction, and Tom Gorman of the Rocky Mountain High Intensity Drug Trafficking Area Initiative. At about the same time, the UMD Center for Ethics and Public Policy hosted a panel discussion of legislators and experts, who debated (pro and con) a medical marijuana bill that’s expected to come up when the Legislature reconvenes in February.

The headlines are hopping: Former President Bill Clinton is still explaining himself, epileptic children are cured of their seizures, growers are generating greenhouse gases, and buyers can choose from Pineapple Express, Lime Haze and Cat Piss.

Of particular concern are young people, especially those who are vulnerable to addiction and who are exposed to substances before their brains are fully formed (at age 24-25). To get the perspective of someone who works with this population, I spoke with Joseph Lee, M.D., medical director of Hazelden’s youth continuum. These views are his own, and do not necessarily reflect those of his employer.

MinnPost: What will be the impact of the nationwide trend to legalize marijuana, especially among young people?

Dr. Joseph Lee: The issue is far more complex and nuanced than many people care to believe. I don’t think marijuana will be the downfall of society. It’s not going to save society, either. I’m not anti-marijuana. I just understand that some people can use and some people can’t. I know there are plenty of people out there who are struggling with it, and who can’t stop using. The discussion of legalizing cannabis has merit – on legal, criminal and medical grounds. And I’m not defending the ill-fated drug policies of a bygone era. But we can’t pretend that it’s a panacea for social ills.

There have been some data that suggest that medical marijuana dispensaries have not necessarily increased marijuana use among young people in states that have them. But juxtapose that with Monitoring the Future data [PDF], which clearly show that teen use has been increasing nationwide and that kids are perceiving marijuana to be “safer.” And that coincides with changing attitudes in society.

You have 1 in 10 young people who get addicted. Any time you want to legalize something that is potentially harmful to a significant minority of the population, you have to do the math and see if it’s going to be worth it. I would say that outside of caffeine there hasn’t been anything legalized in the history of mankind that has really offset the social costs. What you’re going to see with the marijuana trend is this: Some kids are going to smoke pot recreationally and be OK. But the kids who are vulnerable for addiction are more likely to be pulled in and use and more likely to justify their use. Research shows that when young people perceive any substance to be less harmful, they use more. That goes for marijuana, meth, cigarettes and prescription drugs. Pretty simple. 

It’s like any other public health decision: What will you do for a significant minority who have problems and who will impact society?

MP: What exactly happens to a young person who becomes a chronic marijuana user? What do you see in your practice?

JL: We have been so blighted by heroin and opioid use that our demographic has changed. But I do see a lot of kids who are addicted to cannabis who have a harder time coming to grips with it. They’ll say things like, “It’s not physically addictive.” Anyone who tells you that it’s not physically addictive doesn’t understand addiction. What they are referring to is that the physical withdrawal from cannabis is modest in comparison to alcohol or benzodiazepines or opiates. Addiction, though, is a process that is physiologically driven through your brain. So fundamentally all addiction is “physical.” I think people like to say that marijuana is not physically addictive to minimize its gravity. Gambling is another well-known addiction that some might say is not “physical.” But gambling addiction is very real and very crippling. 

Dr. Joseph Lee
Courtesy of HazeldenDr. Joseph Lee, M.D., medical director of
Hazelden’s youth continuum

I see a lot of kids who have psychotic symptoms from marijuana. They get paranoid. They start talking about the Illuminati. They start talking about government conspiracies. They believe there are intricate hidden messages that link lyrics, cars that drive down the road, people looking at them. … Some get really confused and can’t get their words out the right way. I saw three last week and more than 30 this year. Marijuana increases the risk of youths having a psychotic episode by at least two- to threefold. It’s a few people out of 100, but it’s more than a couple.

The harm that comes from cannabis is insidious. It’s not overdose. It’s not DUIs. It’s looking in the mirror 10 years later and wondering why your life isn’t where it should be. It hits people below the belt. For all the rhetoric, when kids who are “pro pot” sit down in my office and look me in the eye, that’s what they tell me. More or less already at the age of 18, 20, 22, their life is full of regret. Regret is possibly the worst thing in life. And these young people have so much regret.

You can always find poster children for any cause. There are some people who smoke or drink way too much and for some reason are able to walk the tightrope. You can always find those people. But what do you do with the vulnerable population? That’s the population I’m here to serve. These kids get stuck in this kind of Dante’s inferno over what level of hell, what drug, is worse? What they don’t understand is that their brains are wired differently.

MP: And what are you seeing about costs to the culture at large?

JL: For a lot of people, even people who aren’t addicted, marijuana use is associated with higher dropout rates and lower quality of life on almost all the physical- and mental-health measures.

A University of Maryland study of 1,000 college kids found that 25 percent drop out over four years – that’s the baseline for those who don’t smoke at all, sort of the norm. Among the college kids who smoke a lot of pot [more than 17 days a month], about 41 percent drop out. Even infrequent smokers had a much higher rate of drop out. And in fact even infrequent smokers had on average a worse quality of life on all sorts of measures.

And here’s the rub: These are college kids, so they’re technically adults. But there is clear evidence that even for people who are technically adults, marijuana impairs them.

There’s also a study done in New Zealand that tracked 1,000 kids before and after they smoked pot. The study, which tracked its subjects over 25 years, found that the kids who smoked a lot of pot showed a drop in their IQs, and the longer they smoked pot the lower their IQs stayed.

That study has been incredibly controversial, although the authors have been able to successfully defend it.

There is one counterargument that has merit, which is that kids who use drugs like marijuana are vulnerable anyway, so these kids are not going to do so well in life, period. So they argue that marijuana, though it can complicate things, is more of a red herring – these kids are vulnerable inherently and wouldn’t do well in life regardless of whether they smoked marijuana. Frequent marijuana use then is a marker for vulnerable youth but not the driving cause of their struggles. I believe there is truth in that, but I don’t think it’s all one way or the other.

Just look at the statistics: If you have a family issue with addiction, the earlier your child is exposed to a substance, the more likely your child is to be an addict. Period.

MP: What do you think of the nature of the debate, and how do you answer charges of hypocrisy – comparing marijuana use to alcohol use, for example?

JL: The biggest problem I have with the public-policy debate is that it’s not balanced. People who have problems with marijuana, and there are many, can’t have a voice. They’re told, “You don’t have a problem.” And that’s a problem. With other substances, we can have that discussion. But this is much more polarized than that. Lady Gaga came out recently and said she was addicted to pot. She has been under some scrutiny for saying that. It’s almost as if she would have had more credibility if she said she were addicted to video games or shopping. 

In discussions, I sometimes find proponents of cannabis to be disproportionately angry. Where does this vitriol come from? I wonder if a lot of them look at their lives, and know on some level that they smoke too much pot. Yeah, they hold down a job. Yeah, they have a family. But their lives didn’t turn out quite like they wanted them to. It’s always easier to blame a third party.

When I was growing up and watching Cheech & Chong movies, it used to be that if you laughed at people being stoned and lazy who can’t remember anything it was funny. But now if you bring it up in a public forum, they [legalization advocates] get offended. It strikes me as very ironic.

I understand that we treat substances hypocritically. I just want to have a balanced discussion so that we can discuss whatever merit it may have, and also be able to say in the same sentence that a significant minority of people may struggle with it – and what do we about those people? There isn’t a one size fits all here. And that’s the discussion that needs to be had, and it’s very hard to have in a public forum because everybody just knows their own experience.

I will say that alcohol and cigarettes have been around long enough so that a balanced conversation can be had. Hyper vigilance is always the mark of immaturity. When you talk about a social or public-policy issue, whenever something hasn’t fully formed and there’s still a lot of insecurity about it, people tend to be very black and white. And I think with marijuana, the discussion is still in its infancy. There are a number of people who are incredibly vocal about it. There is a silent majority of people who can’t really see why it’s illegal but who aren’t protesting on the streets. And there are some people who are scared because they have family members who are affected by it.

If people want to research it, fine. If people want to legalize it because they see hypocrisy compared with other substances, fine. But we need to have a balanced discussion, one in which we can also say that it’s not as harmless as people think. The loss of productivity and the mental-health problems are real. It may not impact a lot of people, but those few people impact everyone. Isn’t it 5 percent of the population that accounts for 50 percent of health-care expenditures? That’s what we’re talking about. It’s not just “live and let live.” I don’t think people understand that in the end we all pay for those decisions.

MP: Do you see other flaws in the arguments, including claims of marijuana’s medicinal value?

JL: If scientists are able to isolate a chemical compound in marijuana that is medically valuable, I’m all for it. But to decide whether marijuana can be medicinal in the popular forum is ridiculous. We wouldn’t do that for a heart catheterization procedure – or anything else.

There’s a blurring of the line between what science is dictating and what people want. Proponents of legalizing marijuana use harsh words like “apartheid.” We’re talking about pot, not Nelson Mandela. People want to frame this as a life-and-death freedom issue, and it’s not.

The whole “medicinal marijuana” thing is just a sham. Again, that’s not to say there can’t be medicinal value found in marijuana. But the great majority of people lined up outside a dispensary do not have terminal cancer, glaucoma, seizures or intractable pain.

There’s also this notion out there that if you would just legalize pot, kids won’t choose other more harmful substances. If you look at the Monitoring the Future data though, alcohol and tobacco use in the country among 8th- to 12th-graders has gone down in the past decade – long before any powerful rhetoric came out about pot. So people who are promoting pot can’t really take credit for that trend, because it was already occurring.

But young people who are vulnerable to addiction are going to use marijuana and other substances, as opposed to marijuana or other substances. This is not to say that I subscribe to a “gateway” hypothesis for drug use, but rather the truth that many addicts are poly-drug users. People who use a lot of one thing use a lot of other things [PDF]. If you snort a lot of cocaine, you’re probably going to drink alcohol. If you drink a lot of alcohol, you’re probably going to smoke pot. If you smoke a lot of cigarettes, you’re probably going to smoke pot.

So this idea for the very highly vulnerable population that they will chose one or the other just doesn’t work out. And that matches up with brain science, because fundamentally the problem is in your reward system and other parts of the brain. You may prefer one thing over another, but in the end it’s your brain that’s the problem.

MP: What does legalization look like in the long term?

JL: What I predict will happen is that it will become a business. Capitalism will dictate things. And capitalism demands bigger, better, faster, more. We already have potent concentrates (marijuana dabs, wax, earwax). Young people are coming up with ways to basically make the marijuana equivalent of “crack.” They’re purifying it and they’re able to get an incredibly powerful high from it.

We don’t want to be doomsayers, but I think there’s this notion with marijuana that it will be this natural, local, organic kind of movement. And I think people might be blindsided by what a big business it could become and by how much capitalism will likely drive this. 

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Comments (26)

  1. Anonymous Submitted by Anonymous on 12/04/2013 - 09:49 am.

    Exactly the kind of baloney you’d expect from someone who makes his living off of “addiction.”

  2. Anonymous Submitted by Anonymous on 12/04/2013 - 09:50 am.

    Plus I don’t see any condemnation of the practice of locking up non-violent cannabis users en masse.

  3. Submitted by Brian Kelly on 12/04/2013 - 11:35 am.

    Shame on MiniPost.com ! This Is not News! More Reefer Madness!

    In the prohibitionist’s world, anybody who consumes the slightest amount of marijuana responsibly in the privacy of their own homes are stoners and dopers that need to be incarcerated to protect society.

    What message are we sending our children when it is easier for them to obtain marijuana now with it being illegal than it is for them to buy alcohol?

    It doesn’t take the intellect of a genius to understand that stores card kids for I.D.. Thugs and gang members do not. They also push the real hard drugs on children. Stores do not.

    Marijuana legalization will make it harder for children to obtain it.

    What message does it send our children when the President of The United States himself alongside a long list of successful people openly admit regular pot use at one time or another in their lives?

    W While we tell our kids how it will ruin their futures, and then ensure so, by allowing our government to to jail our children and give them permanent criminal records when they get caught with a little Marijuana? Especially if they are the wrong skin color or from the “wrong neighborhood”. Which in turn, ruins their chances of employment for life.

    The Prohibition of Marijuana is the wrong message to send our children while we advertise and promote the much more dangerous use of alcohol like it’s an all American pastime.

    The worst thing about marijuana and our children is what happens to them when they get caught up in the criminal justice system due to it’s prohibition.

    The “War on Marijuana” has been a complete and utter failure. It is the largest component of the broader yet equally unsuccessful “War on Drugs” that has cost our country over a trillion dollars.

    Instead of The United States wasting Billions of more dollars fighting a never ending “War on Marijuana”, lets generate Billions of dollars and improve the deficit instead. It’s a no brainer.

    The Prohibition of Marijuana has ruined the lives of many of our loved ones. In numbers greater than any other nation, our loved ones are being sent to prison and are being given permanent criminal records, which ruin their chances of employment for the rest of their lives, and for what reason?

    Marijuana is way safer, and healthier to consume than alcohol. Yet do we lock people up for choosing to drink?

    It is also safer than tobacco and caffeine. Marijuana is one of the safest and healthiest recreational substance known to man.

    Even The President of the United States himself, along with a long list of successful people have used marijuana. Has it hurt their chances at succeeding in life?

    If the President had gotten caught by the police during his college years, he may very well have still been in jail today. Beyond that, he would then be fortunate to even be able to find a minimum wage job that would consider hiring him with a permanent criminal record.

    Let’s end this hypocrisy now!

    The government should not attempt to legislate morality by creating victim-less “crimes” because it simply does not work and costs the taxpayers a fortune.

    Marijuana Legalization Nationwide is an inevitable reality that’s approaching much sooner than prohibitionists think and there is nothing they can do to stop it!

    Legalize Nationwide! Support Each and Every Marijuana Legalization Initiative!

  4. Submitted by Todd Hintz on 12/04/2013 - 12:09 pm.

    Angry People

    If Dr. Lee is wondering why pot proponents are angry about the current situation then he either hasn’t been talking seriously with them or he’s deliberately being obtuse. In either case there’s a lot of egg on his face for not following up on a very important detail of the whole debate.

    Perhaps the question got cut from the published interview, but I don’t see any discussion about the costs of prohibition. A quick Google search says that nearly one in eight prisoners are incarcerated for marijuana offenses. What are the societal costs of broken families, missed job and career opportunities due to a felony record, and money that’s funneled into law enforcement personnel, equipment, and prisons rather than more productive areas of society?

    That doesn’t even touch on the tax revenue side, where the production and distribution of the product is done on a cash basis, invisible to the IRS.

    So yes, count me as one of the angry proponents of legalization. Where does this vitriol come from? It comes from the colossal waste of lives and resources that comes with prohibition. And contrary to what Dr. Lee says in his interview, I am not a pot smoker. If the good doctor wants to have a measured reasonable debate about the issue, then he should at least be willing to examine all the aspects of the proposals and not just the ones that bolster his point of view–it makes him look biased and not impartial.

    • Submitted by Joseph Lee on 12/04/2013 - 09:02 pm.

      Voice for the voiceless

      Todd, not covering one issue important to you does not make this Q and A unreasonable. The issues regarding criminalization are also more complex than you think. I write dozens of letter every year to various courts on behalf of young men and women who’ve made some poor decisions via drug use. If you still think I am obtuse after knowing that, you are entitled to your opinion.

      Anyways, the point of this article was to highlight contentions rarely if ever brought up in discussion. The main thesis though is that the overall talk of cannabis in the popular forum is unbalanced. If we were discussing the opening of new casinos, it would be appropriate to weigh the social costs of those who might develop problems gambling. We wouldn’t want to minimize gambling addiction or belittle those who try to talk about that, whether we decide to build the casinos or not.

      There are people who struggle with marijuana use. They shouldn’t be bullied and sneered at when they ask to have a voice. How is that unreasonable. Find us a pro marijuana article that does any more than a passing lip service to the problems it might cause. I think we should be able to say that some people will have problems with marijuana and that a discussion of legalization has merit all in the same sentence. The “vitriol” in the comments clearly indicate we are not ready to have meaningful dialogue.

      • Anonymous Submitted by Anonymous on 12/05/2013 - 08:08 am.

        Menace?

        Vitriol in comments means we’re not ready to dialogue? Ha ha. Look at the headline for this interview – questioning whether cannabis is a “menace.” Who’s dialing up the hyperbole here?

        • Submitted by Joseph Lee on 12/05/2013 - 09:43 am.

          Vitriol

          I didn’t choose the title of the article Rob Levine. If the title were more neutral, are you then saying that you wouldn’t be angry? Looking at the history of comments from some of the users to other articles in the past, it is obvious to anyone that 1) your vitriol started way before the headline of this article and 2) the anger is not exclusive to this issue. I don’t have animosity to those who want to legalize. I understand many of their points.

      • Submitted by Martin Wuestewald on 12/11/2013 - 05:09 pm.

        THC is only as addictive as coffee, a 9%. Ignorant much Dr?

        It seems your lack of knowledge, Dr., is the reason we aren’t having a meaningful conversation. I’d like to refer you to Dr. Gupta’s film “Weed”, you can’t watch it on youtube. If you’ve seen it already, I recommend you watch it again and pay more attention this time. Cannabis is only as addictive as coffee, with no withdrawl sypmtoms. Every single person on this planet has an endo-cannabinoid system, so your argument is basically invalid, as we’re all meant to consume it. If it was legal for us all to consume in diet, then most people wouldn’t need to smoke it or heat it to make it psychoactive, and if it were legal, it would be harder for children to obtain. The only studies that show that cannabis use can affect the brain negatively are if it’s used by teenagers, and it still cuts the suicide rate down by 300%, which not a single SSRI or any other medication can do more than “claim” to do. Get yourself an education or admit that you’re spreading misinformation intentionally, which is the more likely scenario. This is a time where we need to be more accepting of cannabis for the sake of sick people, children especially. Another little girl with Dravet’s died in NJ last week waiting on politicians to change the laws…her siezures would have been almost completely prevented. What you are doing right now is dangerous and selfish, don’t hide behind the concept of trying to balance the cannabis conversation, you’re trying to sabotage it if anything. :]

  5. Submitted by Kurt Nelson on 12/04/2013 - 12:17 pm.

    Think of the children

    We must think of the children, because if we don’t they will no doubt slide into the pit of despair, all while high from marijuana, and not just some of them, but all of them.

    Should teens use marijuana- no, probably not, but to base policy on whether or not a group might use/abuse a drug is nonsensical. Look at Portugal, where most drugs are legal, and the rate of teen use has dropped. Now this is a different culture, but this fact cannot be ignored or pushed aside because it might be inconvenient

    Of course the doctor has a rather imposing conflict of interest, and is hardly free of bias, so when he states medical marijuana is a sham because the “great majority” of those with medical use cards are not suffering from cancer who is to doubt him, unless of course he is unable to produce citations to that end.

    Lots of generalities and platitudes about the harm, and some might be true, but like alcohol, some will abuse, some will use without incident, and some will choose to be drug free. But think of the children

    • Submitted by Joseph Lee on 12/04/2013 - 09:41 pm.

      Dear Kurt Nelson

      Culture is more important than you think. We are the culture of free refills, big macs, more is better. We are not Portugal. That doesn’t mean we shouldn’t study other countries but their policies don’t apply any more to us at face value than my home rules apply to your family.

      About the conflict of interest, where is the logic in that? Should internists not discuss diabetes because that is what they treat (conflict of interest?) That doesn’t make any sense.

      I suppose the other argument is that those who treat addiction have nefarious fiscally motivated ulterior motives. If that were the case, you would find addiction professionals advocate for the legalization of everything. That way the most vulnerable would surely fall through the cracks.

      • Submitted by Kurt Nelson on 12/05/2013 - 02:19 pm.

        Your conflict of interest is your position at a for profit addiction treatment facility. You are not paid to be without bias regarding treatment methods, but you are being paid to get people in the door. Some might be able to reconcile the two, but again, where is your motivation in doing so. This does not mean you are acting with malice, just that you have bias in favor of treatment, when treatment might not be the only answer.

        Hazelden, like many other facilities around the country does good work; I would not try to deny that, but the fear of a coming drug menace if marijuana becomes legal in more states is untenable.

        The tide is turning, and both Washington and COlorado will be forefront in the challenge to remove weed as a Schedule 1 drug (and only Congress can make that happen). Once removed, scientists will have the freedom to do actual research, rather than the very controlled access currently. This research might show the benefits of medical marijuana, and it might show that smoking weed for cancer does no good. But, until the choke hold on researching marijuana is removed we won’t know.

        This is not going to happen overnight, but now we have two states in open defiance of federal law, and a recent Gallop pole favoring legalization in the majority. Part of this whole equation will be how to effectively deal with and treat those who abuse; whether teens or adults.

        At some point soon, the Court will be forced to address the conflict between state and federal rights for marijuana, and though the Court does not rely on public opinion, they are certainly cognizant of the current trends. Read Riach and in particular Justice Thomas’ dissent to see where the Court might go with regard to moving into states rights and weed.

  6. Submitted by Todd Hintz on 12/04/2013 - 01:55 pm.

    I Love You Guys!

    I have to say my hat is off to the commentators here on MinnPost. You guys don’t hesitate to talk truth to power and if someone’s article has holes in it the size of the Lowry tunnel, well, you’re more than happy to drive a whole fleet of semis through it.

    It makes me proud to pop onto MinnPost every day and read your well written commentaries, which in many cases is better thought out than the person being interviewed for the article.

    At the end of the day people like Dr. Lee need to realize that if they’re going to pop out here, they had better put their best game shoes on and make sure they have a reasonable, balanced, and well articulated position to defend or sure as it’s snowing outside, someone will shine the ol’ spotlight on the emperor’s clothes.

    And for god’s sake, won’t someone please think of the children?

    • Submitted by Joseph Lee on 12/05/2013 - 09:47 am.

      Love?

      There is no academic achievement in reducing those who have an opinion different than yours into a 2 dimensional construct (dumb jock, out of touch doc, etc). To then attack that artificial construct and celebrate communally as if you have done something productive is odd at best, uncivil at worst. No newspaper article is comprehensive, so to raise a point it does not address is not a feat.

      The bigger point is this. I’ve done enough of these articles to know what to expect. From a meta perspective, I hope you can see that the angry comments from some of the users only prove the contentions in the Q and A.

      • Submitted by Dan Hintz on 12/05/2013 - 04:24 pm.

        Civility

        I have to laugh at you calling the responses here uncivil and unacademic given the tenor of your article and comments. Dismissing medical marijuana as a sham? “Dude, are you stalking me?” as a response to a comment? Stay classy Mr. Lee.

        I also marvel at the fact you feel vindicated by getting the same responses to your articles. My take on that would be that people are universally able to see the holes in your arguments.

        I would also express my love for the Minnpost commenters here, as well as commenters in other forums who also recognized the flaws in what you wrote. Props to everyone interested in the truth.

        • Submitted by Todd Hintz on 12/06/2013 - 12:43 pm.

          Article

          It’s my impression that the good doctor is just a wee bit thin skinned. The article popped up, the comments flowed, and Dr. Lee felt it necessary to create an account and come out here to reply to just about every message posted.

          If people are directing anger your way that’s simply society’s way of saying “you’re doing it wrong.” At some point in the article Lee could have mentioned the objections people have to prohibition as those people have some very valid points. Instead he choose to play the obtuse card and disingenuously claim he had no idea what they’re so worked up about.

          At the very least he could have come to the forums to say “I see what you guys mean. Those are good points that I will take into consideration in future interviews I give.” That would have given him some credibility with the community and position him as an authority on the subject rather than a biased participant with an ax to grind.

          Full disclosure for the record: to the best of my knowledge I am not related to Dan Hintz. Maybe somewhere back on the family tree we intersect, but I haven’t seen him anywhere on the byzantine family chart mom has been putting together.

          • Submitted by Dan Hintz on 12/06/2013 - 05:49 pm.

            Relatives

            I have the Hintz side of the family tracked from Germany via England in the early part of the 20th century. I have been thinking about doing Ancestry.com to see if I can track it further back, so something may turn up. My understanding is that Hintz is a pretty common German name, though.

            • Submitted by Todd Hintz on 12/09/2013 - 12:34 pm.

              You Yahoos

              It seems my Hintz branch of the family came from Pomerania, which is now a part of Poland. Once you tap into Ancestry.com and can trace back a few branches of the family tree you may find that they tie into research that other people have done. That makes the research part of the project so much easier.

              Good luck and let me know if you turn up anything interesting. Here’s hoping your family tree isn’t a wreath.

          • Submitted by Joseph Lee on 12/06/2013 - 10:36 pm.

            People who post comments

            Todd, Dan…I thought you two were related.

            psychology lesson: if anyone posts something and says they are laughing at you or “ha ha” or something like that in the context of a diatribe, they are doing anything but laughing. so don’t write that, it is obvious.

            I really don’t have anything against anyone on the comment board. First though, recognize that you do NOT speak for society. Go to any comment section of ANY controversial story on ANY website. Almost always, the more extreme/ critical sides are the ones to comment, they are rarely balanced, not even on more academic websites.

            There is a specific psychology of comment sections and it gets nasty quickly everywhere (espn, youtube, even NY times). I don’t think people would talk like this if face to face. It has to do with poor mentalization, ego, and open source hipsterism (“I read the new yorker and 2 tweets so I am a middle east expert”) and is a fascinating area to research (our internet personas) but no time to explain that. I’ve received dozens of emails and calls thanking me for the article already and of course you are already thinking they too must be biased to be credible without knowing them.

            A lot of people want change in our policies around MJ and at legalization of some kind (I certainly support researching it). Asking for a balanced discussion so that the vulnerable are included in the talk is a simple and honest request. I had no input on the title but you must understand some would find the word “medicine” equally offensive as “menace.” Just depends on who you are.

            You can question any expert’s bias but no one is free from that criticism. The fact that no one offers any actual counterpoints to what I have said in the article speaks volumes. The critiques are all (you are biased because x, you have conflict of interest because y, followed by what appears to be political platforms).

            Let’s face it, everyone was surprised when I replied to the comments as it is not custom. Docs of my generation though will do this more frequently so be ready. I have already changed how some here will approach commenting on other articles of this kind in the future psychologically which was the point.

            I do apologize if you feel I have overstepped in responding in kind to some of the comments (not the article content). I respect your right to express your views. It is a part of the democratic process I believe in.

            I’m moving on, you should too.

            • Anonymous Submitted by Anonymous on 12/07/2013 - 04:17 pm.

              It’s not that people are choosing not to engage your arguments; it’s that we’ve heard them forever – ever since Reefer madness. Saying we “need more study” is bogus – is there anything that’s been more studied than cannabis?

              And for a scientist you use decidedly squishy language:

              “some people can use and some people can’t. I know there are plenty of people out there who are struggling with it, and who can’t stop using. The discussion of legalizing cannabis has merit – on legal, criminal and medical grounds. And I’m not defending the ill-fated drug policies of a bygone era. But we can’t pretend that it’s a panacea for social ills.”

              “Some people” ???” “Plenty who are struggling” ??? You remind me of the cops who deal with the worst neighborhoods and end up being racist. Your perspective is valid given your profession, but your patients are hardly representative of those who choose to light up.

              And who in the world says cannabis is a “panacea” – that’s a red herring.

              • Submitted by Joseph Lee on 12/09/2013 - 03:13 pm.

                Let’s hug it out bro

                Because that’s what we need to do Rob. I am not your enemy. If I have time I will respond to your first post and I think you will see we are not diametrically opposed. Seriously, happy holidays man.

                • Anonymous Submitted by Anonymous on 12/10/2013 - 11:01 am.

                  OK

                  I do like your attitude of showing up here to dialog. It’s a practice that more MinnPost writers should follow.

  7. Submitted by charles thompson on 12/04/2013 - 02:11 pm.

    Dr.Lee

    The good doctor is blowing smoke from start – “I’m not defending the ill fated drug policies of a bygone era.” – to finish – “Young people are coming up with ways to make marijuana the equivalent of crack.”

    • Submitted by Joseph Lee on 12/04/2013 - 08:44 pm.

      dear blowing smoke

      the ill fated drug policies of a bygone era were moralistic and used punishment as deterrent. I don’t think any physician supports such policies. The young people coming up with new ways to get a bigger bang for buck refers to capitalistic influences. This isn’t to scare people, it just is what it is. Look at caffeinated beverages or a number of other consumer examples. Over time, some people demand more and the market provides it. Two different themes Charles.

  8. Submitted by Tom Lehman on 12/04/2013 - 05:17 pm.

    Read the Minnesota bill

    This article mixes apples and oranges. There are two issues here: 1) is marijuana beneficial for some patients under some conditions?; and 2) should marijuana be legalized for recreational use? The headline of this story asks question #2, but the focus of the interview is on question #1. The reality is that Dr. Lee apparently hasn’t read the pending Minnesota legislation (https://www.revisor.mn.gov/bills/text.php?number=HF1818&version=0&session=ls88&session_year=2013&session_number=0). This legislation would allow a limited number of patients with identified chronic and terminal illnesses to use marijuana if their Minnesota-licensed provider recommends its use. Dr. Lee also apparently hasn’t read the articles published in medical journals by the American College of Physicians, the American Academy of Neurology and dozens of other peer-reviewed medical journals documenting clear benefits of marijuana use for some patients dealing with pain, nausea, appetite restoration and muscle spasticity, such as in cases of MS or ALS. Marijuana is not a miracle cure for cancer patients or MS and ALS patients, but it clearly provides benefits to many patients. The pending bill in the Minnesota Legislature seeks to make it as easy as possible for qualifying patients to legally obtain marijuana if their physician thinks it could be beneficial and as difficult as possible to obtain by persons that seek to abuse the program. The response of some Minnesota law enforcement organizations is to warn that passage of a medical marijuana bill in Minnesota will lead to the collapse of our State, while ignoring the fact that 19 States now allow patients to use marijuana for medical purposes and none of those States have collapsed. Also, in none of those states are any law enforcement organizations seeking repeal of the law. If medical marijuana is so bad, why isn’t law enforcement in the 19 states trying to repeal it? 1) It works for many patients; and 2) therefore it is popular with voters. Minnesota voters support allowing patients and doctors to make decisions about marijuana use for certain conditions by a 2:1 margin. It’s time that Minnesota considered this issue based on facts and science and not on rhetoric about issues unrelated to medical marijuana.

    • Submitted by Joseph Lee on 12/04/2013 - 09:32 pm.

      How do you know what I have read?

      Dude, are you stalking me? How do you know what I have read and haven’t. Your comments almost seems more apt for a different article, like you had a bunch of sound bites ready to go and were just looking for something to aim at.

      My point is very simple. Some people have problems with pot. The problems are insidious. They deserve a voice in the discussion. That voice is hard to find. Just because we discuss the potential harms does not mean we have to be against it. But we can’t minimize the pitfalls for political reasons.

      I don’t doubt that we might find more medicinal value from marijuana. Most of the studies you cite are small (low “n”). I look forward to their replication and gladly welcome positive findings. I have no qualms with a chemical having both beneficial and harmful effects.

      The interesting thing is this. If you look at small populations (i.e those with fibromyalgia), they tend to subjectively report improvement in symptoms from marijuana. Contrast that with much larger studies (n=500 to 1000+) in the general population who subjectively report a lower quality of life with pot (association). Strange?

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390463/
      http://www.ncbi.nlm.nih.gov/pubmed/22730275

      Finally, some physicians are complicit in this too. They advertise licenses to get pot from dispensaries for a fee, no questions asked. I’m ashamed they are in the profession. I see kids (young adults) from CA, CO, etc, and they all laugh about the “medical” part of it. They admit to just going to get high and like the quality. I’m sure there are others in line that might really benefit from a need. Lot more gray areas in this than you might think.

      I don’t have a position on the upcoming bill. I do find it interesting that after listing some rather serious illnesses, there is a clause that says “(4) any other medical condition or its treatment approved by the commissioner.” Hmm.

  9. Submitted by Steve Hoffman on 12/04/2013 - 06:19 pm.

    By Contrast

    … In the United States, 7,600 people die annually from “Non-Steroidal Anti-Inflammatory Drugs Such As Aspirin” and somewhere around 150 to 200 people die in the U.S. each year because of food allergies; about 50 percent to 62 percent of those fatal cases were caused by peanut allergies. While we’re at it, we should note that this year, four people died in Black Friday shopping incidents.

    On the other hand, nobody has EVER died from marijuana. You know, the Demon Weed With Roots In Hell. Uh-huh.

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