Health Tips for a Better Life

Of course, no one should blame the Boomers. They just happened to be the largest group to challenge the political and medical communities’ view that marijuana (aka cannabis) was a dangerous drug and its use should continue to be a crime. The establishment ignores the facts. In many countries around the world, marijuana is considered a medicine and routinely used both for inhaling and as an infusion for drinking. But what they do in other countries should have no bearing on what happens in the US. Libertarian arguments that all drug-taking is victimless has also never really taken off. The cost of lost production forces us to pay higher prices for goods and services. The cost of hospital treatment for drug abuse means every taxpayer is a victim. So the Republican “tough on crime” policies have always favored the use of the criminal law to penalize those who abuse drugs.

Yet, looking around the US today sees a different landscape. Fourteen states have passed laws allowing the use of marijuana for medicinal purposes. Leading the way, as always, California has a proposition in the November midterms to legalize marijuana outright. What has happened to produce such a revolution? There are two answers. The first has been a general toning down of the rhetoric in favor of scientific debate. When marijuana was first criminalized back in the 1930s, the medical profession stood together and denounced the drug as a tool of the Devil, tempting people into sin and depravity. Today sees a significant number of doctors singing a different tune. First, a gesture to the traditional group: there is no doubt that smoking marijuana can and does cause lung cancer and, over time, there is evidence suggesting loss of memory and some brain damage. But there is also an impressive body of international evidence proving marijuana highly effective in giving pain relief. The use has to build up over at least six months. Once a stable concentration is achieved in the blood stream, it relieves chronic pain from arthritis, fibromyalgia, multiple sclerosis and cancers.

The second justification is fiscal. The sale of medical marijuana already makes a significant contribution to state funds through the tax system. In a recession, all contributions are gratefully received. If the outright legalization goes through in California, it is estimated the annual tax take will rise from about $200 million to $1.5 billion. It will also lead to a better system of regulation so that, like alcohol, its distribution can be controlled. None of this changes the need for “conventional” drugs to relieve pain. Tramadol in its different forms will remain the first response to moderate to severe pain. But in chronic cases, the continuing use of any drug can lead to dependence and the debate shifts. Which of the drugs is better when use may be indicated for years? In the fourteen states with Illinois perhaps about to join them, you have the possibility to buy marijuana rather than to buy tramadol is there to be freely made. Legalization has undermined the criminal gangs and reduced prices. The quality of the product is also guaranteed whereas, on the street, marijuana can be cut with many strange and sometimes dangerous substances. This is the practical reality on the ground and there is no point in trying to turn the clock back. Pain management in these states now includes marijuana. For those who disapprove, tramadol and the other traditional drugs remain available.

It’s always sad when a great story fails to stand up to the historians. We all like Longfellow’s version of the ride but, it seems, he was only one of many and never uttered the now famous warning about the Brits. Unfortunately, the modern warning will stand up to the test of history. It’s a matter of fact that there was a Boom in births between 1946 and 1964. Worse, it’s also a matter of fact that the so-called Hippie generation is more heavily into street drugs like marijuana and the legal highs of prescription drugs than any other group in the US. Ask anyone connected to the federal Substance Abuse Administration and they will tell you the same story. The number of people aged 50 and more who abuse drugs is rising fast. Why should this matter? Well, the healthcare service includes drug-treatment programs that are supposed to help people through the pain of withdrawal and to teach coping strategies for life after dependence. As the population ages, a wave of people who have consistently used a significant range of different substances is going to begin encountering health problems. You cannot abuse these substances indefinitely and avoid the adverse physical consequences. The expectation is that the treatment programs will collapse unless, at a minimum, the number of treatment facilities doubles over the next five to ten years. Worse, the older people are, the more expensive it is to treat them.

What is the main health problem going to be? As bodies age, everything slows down. In particular, the liver and kidney lose efficiency and do not clear drugs from the blood stream as quickly. If older people are also starting up new treatments, say for high blood pressure, the drugs could interact and cause major adverse side effects. There could also be problems for physicians as they try to diagnose diseases and disorders. For example, there is clear evidence that the long-term use of marijuana causes some memory loss. How is this to be distinguished from the memory problems stemming from the early onset of Alzheimer’s? At present, there is no clear evidence as to how often physicians ask their patients about substance abuse. Just as important, there is no evidence about how honestly patients answer questions about their sometimes illegal drug use. It is obvious to the federal government that there should be routine screening of all patients aged 50 or more. This would cover the spectrum of substance abuse from alcohol and nicotine to painkillers. All patients should be counselled on the need to quit. But patients may fear admissions of illegal drug use may end up on their records. At the least, this will damage their reputation, but it could result in prosecution.

In terms of prescription drugs, the most often abused are the anti-anxiety and treatments for insomnia, mainly ambien. There is a reflex in physicians when their older patients report problems in sleeping. This is an expected aspect of growing old. People lose their jobs. They start feeling socially useless. This leads to stress and some depression which interferes with normal sleep patterns. Only a few physicians are trained in geriatrics. They neglect to ask about lifestyles and just write the standard prescription for ambien. While none of this changes the facts about ambien which remains the best of the drugs to treat insomnia. It should alert all Boomers about the need to review lifestyle with their physicians and, if possible, cut down or quit nonessential drug use.