Jesus Christ, what a hypocritical world we live in. Such Orwellian doublethink to maintain the pretense that only 'patients' are receiving 'medical marijuana' from 'dispensaries', otherwise the powers that be might shut the whole thing down in a fit of 'reefer madness' paranoia about the collapse of society. Maybe it'll take two or more generations of maintaining this ridiculous charade, everyone admiring the Emperor's rather fine clothes (in this case, an imaginary white coat and scrubs), before recreational use becomes so normalized that everyone can just drop the game. I mean, I don't live in the USA so I don't know what it's really like there on the ground, but does anyone really believe this "medical marijuana" business at face value?

You are exactly right.

As a doctor who sees patients with a legitimate use for compounds that come from the cannabis plant, the people who want recreational access just bog down the health system.

I am strongly in favor of federal recreational legalization, if for no other reason than to get it out of my office.

Prohibition has failed, and legalization is a far superior public policy option.

Recreational use should be available through places like Meadow, and medical use should come through conventional pharmaceutical manufacturing methods (like you would want for any other medication you take).

> Prohibition has failed

In a sad way, it's been very successful in the context it was enacted: as a tool to oppress "minorities". It was never about actual dangers from cannabis itself.

You're correct. John Erlichman, convicted Nixon aide, said as much:

"The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did."

1994, talking to journalist Dan Baum, Legalize It All: How to win the war on drugs, Harper's Magazine, April 2016

Such revelation should cause heads to roll, people being released, pardoned and being paid compensation beside the end of prohibition. But there is not much happening. Why people are in such apathy?

In California (pre-recreational use) I got the impression that it was entirely outside of the health system. To get your recommendation you saw a doctor that only handles cannabis recommendations, and often that's via video conferencing. There's a cursory health check (blood pressure, pulse, etc.), but nothing too in-depth and it was done by a technician. Insurance doesn't cover it, so you pay out of pocket and you're done.

Doctors either only did cannabis recommendations, or they didn't do them at all, so conventional doctors weren't bogged down by this.

I think you should also direct some of that angst towards the "non-patients" to also the doctors that advertise on websites listing weed-friendly docs. I don't partake, but even I know how easy it is to find a friendly doc to write a script.

Out of curiosity, does medical ethics as governed by official medical bodies say anything about whether it's ethical for doctors to prescribe drugs for recreational, rather than medical, use?

I would argue it from the other direction: it's unethical for a doctor NOT to recommend cannabis to a patient seeking it. Based on the evidence we have available today, incarceration causes more health problems than cannabis use.

It's worth calling out that this article is from August 2017. As of January 2018, California has legalized cannabis, so the "medicine" doublespeak is no longer necessary in this specific case.

People are literally medicating themselves with it, though. People drink alcohol to medicate. They reach for Xanax, Valium, or other for the same. Those who are feeling happy and fulfilled but just want to experience a psychedelic experience are probably more of an exception than the norm. Maybe this will be studied one day and we'll know better.

I use medical marijuana to treat anxiety and back pain. It's effective. I also have a PhD in biophysics with a specialty in drug design so if you want to talk about the pharmaceutical value of thc and cbd we can do that.

My state, CA, has legalized recreational, but I am keeping my prescription (obtained legally from a doctor).

Note also the FDA just approved a cbd med.

What do you think of CBD only oils versus THC:CBD in terms of treatment of pain?

I've never tried pure cbd at all. I use 99.9 percent thc.

When does pot increase or decrease anxiety? A bit of a puzzle here.

Interesting question. For me, it reduces anxiety when I have a challenging deadline and I have OCD thoughts that prevent me from making progress. It did increase my anxiety in some ways- I always had to worry that somebody would find out and it would have consequences. That anxiety is now gone because it's legalized.

It actually can do both. It depends on the specifics of the person and the strain. In particular, I think Indica strains are supposed to be less likely to create or exacerbate anxiety.

Honestly, the science is still incomplete. We do know that there is quite a bit of genetic variation that comes into play with regards to how THC affects the user though.

Where "on the ground" in the US? Much like Amsterdam differs from the rest of the EU on cannabis, cannabis in the US ranges from being legal for recreational use in California (yes, really!), to being jailed for 20 years for trace amounts in your car in other states.

There are cannabis products that happens to be (gasp!) enjoyable, so it should just be available next to beer and wine in stores as well. Puritanical attitudes about fun aside, look where banning alcohol got us. It's not about having fun though.

When was the last time when, because you like drinking beer so much, that you called your local politician to support beer? Medical marijuana did not come about from a bunch of 20-something college students who merely enjoy getting high. The "recreational" aspect is, honestly, derogatory towards legitimate medical applications

Cannabis has practical medical applications. DEA restrictions have successfully prevented any real research into the compounds that make up cannabis, however the tide is slowly turning. Just yesterday The FDA approved Epidiolex[0], a cannabis-derived treatment for epilepsy. Cannabis treats certain kinds of chronic pain like nothing else known to man, without the same possibility of death when used improperly like morphine, heroin or fentanyl. Just like asprin or acetaminophen (Tylenol) is available over the counter, so, too, should other types of products that treat pain.

The context for this, is in the US, over the counter, is a box of 50 packets of 1g acetaminophen pills, next to a bottle of 200 ibuprofen pills, at 200 mg each, each costing around $20. Last time I was in Europe, that kind of thing was not readily available. Small amounts of various NSAIDs for acute pain were available, but not the chronic, "alternate OTC pain medication to make it through the day" amounts. I am not bragging about how "things are bigger in the US". This is "some people are regularly in this much pain, untreated (!) by our healthcare system" admission.

The heart of the matter is how poor the healthcare treatment is for poor people in the US, and life-improving surgery is often not performed due to lack of money. That missed surgery often results in a lifetime of unimaginable intolerable pain, and patients are simply told to "deal with it".

Cannabis can help them.

It isn't a sham.

Our healthcare system is.

[0] https://www.nytimes.com/2018/04/19/health/epidiolex-fda-cann...

I live in Europe an sadly only viable option to treat chronic pain is to use black market. This is tragic. I wish I had quality of life people can have in legal states. But drugs are immoral heads in the TV say. Sometimes I question what is the point to live in this world.

The only negative thing about it I see is that doctors are willing to give you a BS script.

Friend of mine went to a doc and complained about an old knee injury to get medical weed and the doc just wink-winked him a prescription.

Then again, I would do it if I was in the US and smoked and anything to decriminalise this is a good thing.

In California, there is no such thing as a “prescription for weed”. You don’t get one from a doctor, the dispensaries don’t describe it as such.

What you do get is a recommendation by a doctor that you would benefit from cannabis. This is a critical difference. It’s merely a doctors opinion you would benefit.

And as many have noted, sone doctors appear to hold the opinion most adults would benefit. They might not be wrong.

Btw, old injuries can have lasting pain for the rest of your life. Difficult to control pain. Medicine recognized this in the 90s, and one result was the opioid crisis. (Turns out opioids aren’t great for chronic pain.)

Oh and it isn’t a bs script either. Because it’s not a script. As I noted above. To quote a certain movie, that’s funny not a single word you just said was correct.

Given that California legalized recreational use as of Jan 2018, you are technically correct as to the mechanics of medical cannabis, but that's not the best kind of correct.

In Oregon there is a real distinction, and patients do need a doctor to refer them to get a card[1], which gives them lower prices than recreational customers get at dispensaries.

1: https://ommpsystem.oregon.gov/

Perhaps I did just completely misquote what my (Californian) friend told me.

He's splitting hairs a bit. It's true that a doctor gives a patient a recommendation instead of a prescription (so you can purchase cannabis legally), but otherwise what you wrote is correct.

I disagree, and the reason Is that the word prescription is a legal and medical jargon term with specific meanings and ethical requirements.

However an opinion is not. Thus building a moral barrier there.

Some other opinions that many doctors have: everyone should drink more water. Everyone should exercise. Many people will get this advice/opinions without a prescription for such.

Right, but a doctor is bound by the Hippocratic Oath, and because the recommendation, specifically, for cannabis has legal implications (i.e. the patient can now purchase it under the law), a cannabis rec has similar ethical considerations as a prescription.

Doesn’t the charade corrupt the integrity of the medical profession?

No, that's what happened when you disconnect medical science from law and instead use culture and moral as legal basis.

There is no good decision here, the alternative, refusing on medical ground is not correct either. There is no medical ground to refuse the guy some weed, when it is perfectly legal for him to buy unlimited quantities of alcohol which, medically, is as bad or worse.

In both cases, the law puts the doctor in a position where he needs to bullshit. Some will chose to ignore the global context and look at the patient request in isolation, other will do the opposite.

edit: also "pain" is intrinsically difficult metric for a doctor.

It does, actually.

The doctors who do this (largely running a cash-only practice) are really a disgrace to the profession.

It's good to be willing to think outside the box and practice with compassion, but it's another thing entirely to create prescriptions for surreptitious indications that is motivated by personal profit.

Could they be motivated instead by the belief that by giving the recommendation for cannabis they are reducing the overall potential for harm to the patient?

How dare a doctor with experience in a medical marijuana state speak the truth...

I live in Colorado. Unlike California, this state never had a very scammable medical mmj system that acted as a quasi rec system in disguise.

Instead, they went full rec a few years ago, and now we all admit that most people smoke weed because it's fun.

It has legitimate medical effects, but the vast majority of med patients are fakers looking for a discount here. I know a few.

I agree it's a silly workaround. What's done in your country?

cannabis is real, legitimate medicine for many conditions - with real science to back it up - that's doing real good for many people in pain.

Your dismissive attitude is counter-productive.

It's not that there are no legitimate medical uses, but that medical is a front for recreational use. Judging by the number of medical dispensaries the entire state of Colorado is on chemo and has glaucoma. Even after legalization the price difference between medical and recreational is enough that there are far more medical dispensaries than pharmacies and liquor stores combined.

This "article" feels more like a marketing pitch. Does TechCrunch run paid content?

Yes. And so does every single other blog with any sort of popularity.

It's rare to see Amazon as a positive comparison these days, at least on HN. I was expecting the article to be about how Meadow was strangling the life out of its competitors or abusing its market dominance or something.

Was marijuana the blockchain of 2017? Where as long as you aligned your product with weed, even if it was actually a pretty generic product, there was suddenly extra interest?

Blockchain was the blockchain of 2017...

Weed is not a generic product because it's still illegal on the federal level, and tightly restricted on the state level even when legal. The article does a pretty poor job of explaining what Meadow provides specifically to deal with this though; for example, most credit card processors won't touch marijuana.

Surely, companies will be able to use regular POS systems, as this becomes more and more legal? And the more legal it becomes, the less market this company has...

I’m not convinced of the long term viability of this business model. Lots of people buy pot from these places as a novelty, like when friends visit from out of town or when the shops first open. Pot nowadays is so strong than your normal 9-to-5, weekend pot smoker can make do with very small quantities that last a while. The green rush seems like a very short boom and bust cycle, maybe 2 years at best.

i think you underestimate how many people enjoy being intoxicated

you would likely say the same thing about bourbon. then you realize you can mix it in cocktails and that the market will adjust the product for the consumers.

the industry will do fine

Does this mean Meadow sells counterfeit marijuana, pays such low wages that many of their employees need food stamps, and fosters an environment where employees feel the need to piss in bottles to avoid bathroom breaks?