Dr. Phillip Drum - More about the Medical Marijuana Fallacy

The Addiction Podcast -: Dr. Drum, ⁓ I am excited to have you back on ⁓ I ⁓ really appreciated what you told me last we talked, but realized that ⁓ I could not speak about it intelligently. So the one thing I brought up to you, this isn't the order you gave me in terms of what you wanted to talk about, but the one thing I wanted to talk about, ⁓ I said to someone, there's no such thing medical marijuana. And they went, really? Well, how can that be? And I realized that I couldn't talk about it intelligently, whereas you can. So explain what you just started to talk to me about regarding the five-part test and where it came from.

Phillip Drum: Sure, first thing I wanna start off with though first is you call it medical marijuana and so do they, but yet they wanna call it cannabis too. So that when we're creating laws and things, they don't want you to think about that word marijuana because there's negative connotations with that isn't there. That's why they changed the name to cannabis.

The Addiction Podcast -: Hm. Hm.

Phillip Drum: So you don't really hear them talking about medical cannabis. You hear them using the medical marijuana. So let's talk about marijuana, because that's the word that I use. And that's what we also have in our laws. They call it marijuana, but our good friends in the marijuana industry want to change that term to cannabis. the question of how does a drug become a medicine? This was developed under the federal Food Drug and Cosmetic Act of 1938, which gave the FDA, the Food and Drug Administration, the responsibility to assess a drug as a medicine. So there's five parts to that. and so the first one is that the drug's chemistry must be known and reproducible. That becomes very problematic because remember from the last talk, I mentioned that marijuana, which they're trying to call it a medicine, is over 100 plus cannabinoids. 100 plus cannabinoids. I remember how I was asking, well, what's the dose for cannabinoid 100? What's the dose for cannabinoid 68? What's the dose for cannabinoid 16? And so their product has to be known and reproducible. And so that means the percentage of those various hundred plus cannabinoids has to be the same because remember what they claim. They need all hundred plus, which creates marijuana, not that evil THC by itself. They don't want THC by itself. That's already been FDA approved back in 1985. Remember, they want the full product of marijuana and hallucinogenic effects that they get with all those cannabinoids. So again, the drugs chemistry must be known, meaning it has to be, we have to know what those 100 plus cannabinoids are and what amount there is in each and how it gets cleared and how it gets metabolized and the drug-drug interactions. So there's no evidence that we have a standardized product that's consistently pure at fixed doses for all of those and have a measured shelf life by the FDA. We don't have that for marijuana. The chemistry of dispensary marijuana is not standardized. Again, and then we also have to deal with the fact that they're administering this marijuana by multiple means. And so with each means that you develop a drug, you have to then also show the absorption characteristics, the distribution characteristics, the elimination characteristics. And so that means the vape pen versus an edible versus You know, any other way that they want to, know, a topical cream, a vaginal insert, a patch of marijuana, whatever they want to create, we have to have all that information for all those various forms. We also know that the THC values have varied and you can't have that in a medical product, right? You have a five milligram product, you have a 10 milligram product of something. So they're going to... We have to have then product amounts, percentages of all those hundred plus cannabinoids that you need. It can't just be THC. It has to be all of those required elements that they claim make that product up. So we have to have those percentages of all those hundred plus cannabinoids. All we know is THC is what they tell us about. And that's not the entire product. Because if you want THC, I got it for you. It's called dronabinol. OK? That you don't need marijuana. So again, we know that THC can vary from 0.5 % in a plant all the way up to usually around up to 40 % or so now that they're getting in a plant. But then they also make vape pens that are now up to 99 % pure THC. And so they have a little bit of a problem of making consistency. They also have CBD that's in there as one of the cannabinoids. And we know that there's impacts that CBD have that kind of counter the THC. what's the percentage of CBD that's in a product? We know that then when they've created these products, there's variable amounts of CBD. So again, no consistency in their product. the number one, the drug's chemistry must be known and reproducible. Sorry, it's not meeting that criteria. It's also known that it has heavy metals, pesticides, fungi, bacteria are found in these marijuana, especially the products that are ⁓ that are the smoked, ⁓ you bud versions, but also found it's concentrated into those vape versions. So that's number one.

The Addiction Podcast -: And these are what, these are sold by pharmacies, right? No.

Phillip Drum: No, no, don't touch, again, remember, marijuana is a CS1 substance, pharmacies don't touch it, okay? Well, they're going to what I call drug dens. They like to call them dispensaries, which I find offensive as a pharmacist. It's not a dispensary, it's really a drug den, is where they go and buy them. Again, have no oversight, know, the state claims they have oversight, ⁓ and we've caught then again, the laboratories falsifying data.

The Addiction Podcast -: That's right. So where are people getting it? Where are they going? I got it.

Phillip Drum: not looking for all the pesticides, ⁓ creating whatever version that the seller wanted to have of the percentages, that they're not accurate. ⁓ And this has been going on for several years that the accuracy of what they claim to be in the products is completely inaccurate because it's not regulated by the Food and Drug Administration. It's supposed to be the states doing that regulation and we know they're really not. So let's go to number two. Number two, there must be adequate safety studies. So safety studies, again, one of the things you have to recognize with the drug is you have to recognize that it's a risk-benefit ratio. Risk-benefit ratio. Now all they wanna talk about is the benefit. And they make these fabulous claims about what it could do. And it could do anything, just like snake oil from the 1980s, or 1880s used to be able to treat gout and arthritis and pain and whooping cough and tuberculosis. Well, these guys are doing the exact same thing. that they're claiming, it works for anxiety and it works for pain. And we don't have drugs that cover all of this multitude that they claim that it works for. It helps with your immune system. And, you know, it's all fantasy. And so we have to have a study that shows this. Dispensary marijuana can't be studied or used safely under medical supervision if the substance is not standardized. And so that's why when they perform these studies, even the driving studies, that they have to get it from the Mississippi lab. Remember, the Mississippi Lab is the one that creates that standardized marijuana product that everybody uses. Again, that was changed to allow other people that want to grow marijuana, but they have to follow all the criteria of making sure the purity and the concentration and all that has to be the same. Again, they don't like having to do those types of all that rigorous work. And so pretty much the studies that are being done are done from the marijuana that's acquired from that Mississippi Lab. the federal government's lab, not the drug dens that the people are buying their marijuana from. So there's no consistency. Clinical research also looks at long-term side effects, and which again, these studies that they've created, that they claim are having at work, are very short-term studies. We need to look at the long-term effects of the THC in the body, because again, we know that it's fat soluble and it sticks around in the brain a long time. And so we know that We could see that, know, initially it works for anxiety, but if you start lengthening the length of the study, now all of a sudden they start getting more anxious while they're on the marijuana. And so again, they've taken these short-term studies and I always challenge people, tell me about the adverse effects that they've acknowledged in their studies that they want to claim. Show me those adverse effects. None? ⁓ isn't that amazing? Even placebo admits to having side effects, but not their substance, which again, kind of throws out the idea of, I'm sorry. So what are the long-term usage associated with addiction to marijuana or other drugs? know, loss of motivation, reduced IQ, psychosis, anxiety, excessive vomiting, sleep problems, reduction in lifespan. All these things have been seen with chronic long-term use of marijuana, which don't appear in their, marijuana works for us. studies. So we really need to because again if we're talking indefinite use of marijuana we have to look for those long-term side effects. Not done. So those adequate safety side effects, safety studies are not being done. That's number two. Number three is there must be adequate and well-controlled studies proving efficacy. Okay so we talked about the side effects. Let's talk about the benefits and so there have been 12 minute analyses of clinical trials scrutinizing smoked marijuana

The Addiction Podcast -: Right.

Phillip Drum: and cannabinoids and conclude there's no, no or insufficient evidence for the use of smoked marijuana for specific medical conditions. So again, when we've looked at these, again, they tend to do very short studies with very limited number of patients. Typically with the patients that they do use it in are chronic users as compared to a naive person because we also know that naive people sometimes don't respond correctly. And therefore, again, there's also the bias with those people that are chronic users that want to prove that it works. ⁓ And so they're always going to give the thumbs up for the efficacy and pain reduction and anxiety. And so again, we don't have those types of studies. There's no studies of raw marijuana, raw marijuana, which is what they want to approve, that ⁓ include high quality, unbiased, blinded, randomized, placebo-controlled, studied versus standards of therapy, or of long duration trials. So let me talk about the, when we approve a drug, we typically, they are approving some drugs and they tend to be for disease states that have a very small patient population. You know which one that was? Epidiolex, CBD. And so because they had a very, very, very, very rare seizure syndrome that they were trying to address, they compared Epidiolex in a couple doses versus placebo. placebo and so but most studies especially when you want to compare it to so let's just take the idea of pain management They claim it works for pain, right? The studies have proven otherwise But they they claim that they want to do it with pain show me this study that they've compared marijuana use versus a non-steroidal like ibuprofen or naprosyn Where's that study? So you compare it to a standard drug. Where is it compared to an opiate?

The Addiction Podcast -: Hmm.

Phillip Drum: In fact, the studies that I've seen, when they want to claim that opiate use ⁓ goes down, actually opiate use goes up. The opiate use going down that they were trying to compare themselves to were due to prescription drug monitoring programs, which we'll talk about later. That's what's helping drive down our opiate use, not medical marijuana. It's the prescription drug monitoring programs are actually helping drive that down. So again, Let's, you you want to say it's working for anxiety? We have FDA approved drugs for anxiety. Let's compare marijuana versus Ativan or Azepam for anxiety or sedation. Those drugs have been FDA approved for that indication. Marijuana hasn't. Let's compare it to a standard comparator and let's see how they do. Looking at efficacy and side effects. So there must be adequate and well-controlled studies proving efficacy. Don't have them. Number four, the drug must be accepted by well-qualified experts. This one, they fraudulently said that, well, we have so many thousands of patients on it. The funny thing is, is when we look back and saw how many providers are actually recommending, again, it's not a prescription, that are recommending marijuana, it's only 2 % of all medical personnel. 2%, 2%.

The Addiction Podcast -: Right.

Phillip Drum: So does that sound like it's well accepted? I'd also challenge you to go and look at the American Medical Association as to what they say about cannabis. Cannabis is a dangerous drug and as such is a public health concern. Again, don't believe, they don't like standard medical practices that we don't like those people because they're the ones in the white coats and they're the ones that are pharma. I have nothing to do with pharma. You know, I dispense pharma's drugs. I have no stock in pharma. I have no interest in pharma. I provide their drugs to the patients and I make sure they understand why they're taking their medication. ⁓ The American Academy of Children and Adolescent Psychiatry said, medicalization of smoked marijuana has distorted the perception of the known risks and proposed benefits of this drug. The American Psychiatric Association no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. The approval process should go through the FDA. And that they have not. And the FDA amazingly still hasn't approved it. There is no FDA approval for marijuana, period. There has been for THC, that's one of those hundred plus cannabinoids. That's what they don't want. They want all of the hundred plus cannabinoids. That's marijuana. Let's see the studies. Okay, so we haven't seen those. it's the drug must be accepted by well-qualified experts. Doesn't meet that criteria. It meets the criteria, I guess, if you're a marijuana user and a marijuana drug dealer, but it's not meeting the criteria for medical standard medical personnel. Again, 2%. And then when they even looked at the division because again, I you may recognize that physicians are MDs aren't the only ones that can prescribe medication as well. We have nurse practitioners, physicians assistants and other groups now that can prescribe medications. Again, this is not a prescription, but even in that case, almost half of those providers that are getting paid to give a recommendation for marijuana, half of them are not MDs.

The Addiction Podcast -: Mm-hmm. Hmm.

Phillip Drum: Okay, so it's a financial thing for them to get that medical recommendation, they get paid to give that to them. They're also supposed to have direct contact with the patient, be their primary providers and they never are, they are just the guys that are on the internet that they log into, pay their 50 bucks and get their written medical marijuana ⁓ approval recommendation. The fifth one is scientific evidence must be widely available. Still waiting for that. Like I said, we've done the studies. They've been quite negative. The evidence for approval of medical conditions have only been by state ballot or legislative initiatives, right? That's how we've approved our medical marijuana. It hasn't gone through the FDA. It hasn't gone through the scientific process and have the studies performed that show the efficacy. Again. Versus placebo, no, no, it really needs to be versus the standard of care for whatever indication they wanna claim it for, glaucoma. Okay, let's compare it to a glaucoma drug. Let's compare it to, again, a drug for sedation. But there's no studies that they're doing this with.

The Addiction Podcast -: And Dr. Drumm, you mentioned the last time we talked that there were like some 11,000 studies that had been done on marijuana.

Phillip Drum: Correct. Yes. Yeah. When you put in the term medical marijuana, or actually it was marijuana or cannabis. And those were over 11,000 studies that the government has paid for since 1985. And they've been studying it prior to 85. But from 85 on, we have the database where you could pull up all 11,000 studies. And they sent that to.

The Addiction Podcast -: Okay? And with all of those studies, the FDA has never approved it.

Phillip Drum: Nope, and as I showed you last time, there are drugs with under 100 studies that have three FDA approvals and they have under 100 studies versus 11,000 and zero FDA approved indication. One other thing I want to throw in and this has to do with the state of California, there's something called Prop 65. Very interesting, it was only off from Prop 64, which is their legalization bill. But Prop 65 has a list of chemicals in the state of California that must be, the people must be warned about. These are drugs that can cause cancer and can cause developmental disorders. Guess what substances on Prop 65's list? THC and smoked marijuana. Smoked marijuana is listed as a carcinogen causing cancer and Delta 9 THC is listed as something causing developmental disorders, meaning It could cause problems in a pregnant woman with a child. And so there you go. It's in our Prop 65 list. I would hope anybody walking into a drug den sees that warning on the wall. I know we have to have it in the pharmacy that says we are in an area that has substances listed on Prop 65 list. You can see it in Home Depot, anywhere that sells any substance that's listed on the Prop 65 list. You have to put that warning. in the room that people are in to warn them.

The Addiction Podcast -: Well then you can get it on foods. You get a warning. That's what that is, right? When you get a warning on various foods that could contain carcinogens or whatever per California.

Phillip Drum: Yeah, it's a little different because this is a state. Yeah, this is a state law that we have a list and it's quite lengthy as to how long this list is. I just had pulled it up. Let see how many pages it is. It's huge. Come on. It is 23 pages long of substances that that are listed on Prop 65 list. And so marijuana has been there for a while. Smoked marijuana and THC.

The Addiction Podcast -: Okay. Ha ha. Wow.

Phillip Drum: are on the list. So people be aware. Be aware what you're assuming to put in in your body. I don't think you are. ⁓ Because again, it's not FDA approved, it's not standardized, and it's on Prop 65's list.

The Addiction Podcast -: And then you have to... And then you have to, I have to wonder why a state would approve it ⁓ for medical purposes, which we already know is bogus, because there is no such thing. Sorry. Yeah, yeah. But they obviously were not fully informed about the product.

Phillip Drum: The people did. The people did. The public approved. ⁓ there's the rub. There's the rub. They weren't fully informed when they voted for this, were they? And so there's your problem. And now they're starting to see those adverse effects that we had been warning about. We knew about it in science. We've been warning about this for decades of the consequences and problems with marijuana. Now you're finally starting to see it. Hyperamesis is becoming a much bigger problem.

The Addiction Podcast -: Yep. Interesting. Yep.

Phillip Drum: And again, it only became a problem. What's interesting, it wasn't diagnosed until around 2004. it was, so hyper emesis is hyper meaning a lot, emesis meaning thrown up. So a lot of throwing up. So cannabis induced hyper emesis was designated around 2004. Probably as a result in 1996, as we all know, the state of California approved medical marijuana.

The Addiction Podcast -: I'm sorry, what's hyperemesis? ⁓

Phillip Drum: And they quickly learned that they had to increase the THC content because it was too low. That was back when it was around 3%. So they started down making more concentrated THC products. And as we know, the higher the concentration of THC, the more addictive it becomes, the more people are taking it. The amount goes up. And for some reason, it's causing this hyperemesis syndrome in which people are throwing up. And it's killed people because, again, throwing up will

The Addiction Podcast -: Yeah.

Phillip Drum: disturb your electrolyte balance within your body. You lose too much potassium and now that's ⁓ potassium regulates your heart rhythm and you start having a heart rhythm. You become dehydrated. It damages your kidneys. So these people typically have to be put on IVs to hydrate them because they're constantly throwing up. The only true cure for this, stopping their marijuana use.

The Addiction Podcast -: Yeah, like, yeah.

Phillip Drum: None of the drugs that we're using are 100 % effective.