Part 4. Marijuana and health risks – assessing the science

This is Part 4  of a series of six articles discussing marijuana’s use in medicine and health care. In this part, we discuss marijuana and health risks – even if there is evidence that marijuana had medical benefits, there must be a review of the risks of using it.

Only in junk medicine (see homeopathy or chiropractic, for example) is there a promise of great results with no risks. In real medicine, all benefits are balanced against the real risks of any medication or procedure.

The whole foundation of evidence (or science) based medicine is science – “it is the only set of methods for investigating and understanding the natural world.” Thus, the best factual evidence includes clinical research that describes not only the effectiveness, but also the risks, of a particular medical procedure.

In this article, I’ll look at marijuana and health risks – along with a skeptical analysis of those claims. Continue reading “Part 4. Marijuana and health risks – assessing the science”

Marijuana and cancer – what are facts and what’s just smoke

Editor’s note–this article has been updated and included into a multi-part series on marijuana and medicine. Check it out there. 

If you spend any amount of time on Twitter, Facebook, or just researching cancer treatments on the internet, you will run across something about marijuana and cancer – someone will claim that smoking pot, eating pot, hemp oil (which is manufactured from the seeds of cannabis plants that don’t contain much THC, or tetrahydrocannabinol, the active hallucinogenic agent of cannabis), or some other consumption of cannabis will cure or prevent cancer.

Of one hand, studies of cannabis’ effectiveness in reducing nausea and vomiting in chemotherapy, one of the the most common claims,  has generated negative results in some well done clinical trials and some positive results in others. But that has nothing to do with actually curing or preventing the cancer itself, just dealing with the effects of the treatment. Continue reading “Marijuana and cancer – what are facts and what’s just smoke”

Stopping dengue fever with genetically modified mosquitoes

Four hundred years ago, the world was so afraid of Galileo’s scientific ideas that the Catholic Church put him under house arrest for the rest of his life. And he was just describing heliocentrism, the astronomical model where the earth revolves around the sun. Very important to our understanding of the universe, but it was not a life or death matter. 

You would assume that if a new scientific idea that would help people live longer and healthier, then there would be no fear. However, that assumption is disproven again and again with the antivaccine gang and the Big Pharma ad hominems that we hear frequently.

As I’ve discussed on a number of occasions, genetically modified organisms, whether they be crops or animals or other organisms, seem to cause an irrational and unscientific concern. GMOs are generally safe, and we have lots of scientific evidence to back that up. But still, people get scared.

Continue reading “Stopping dengue fever with genetically modified mosquitoes”

Medical uses of marijuana–hitting the bong of science (updated again)

Marijuana_Cures_CancerEditor’s note–this article has been updated and included into a multi-part series on marijuana and medicine. Check it out there. 

As the push to legalize marijuana for personal or medical use gains traction in the USA, the “pro-pot” arguments become more enthusiastic and more off the beaten track of real science. I suspect, like legal same sex marriage, social norms have changed, and legal marijuana is something that will become commonplace across the country, except in some deeply conservative areas. The Federal Government has shown little enthusiasm in enforcing Federal law, which retains the highest authority in regulating certain drugs, in states that allow legal marijuana.

I personally have no issue with smoking marijuana, since other “drugs”, like alcohol, are completely legal and socially acceptable. I think that legalizing marijuana will reduce much of drug trafficking, reduce the burden of law enforcement and penal system costs, and have other beneficial effects to society.

I still want regulations such as control over public smoking (I don’t want second hand cannabis smoke wafting over me or my children, as much as I don’t want to inhale other people’s tobacco smoke), there needs to be regulations about when it might be illegal to be high (I don’t want my Delta Airlines pilot to be smoking weed before flying my jet, and I don’t want automobile drivers to be under the influence), and I want age regulations no different than there is for alcohol and cigarettes (despite . But I think those are reasonable boundaries for legalization of cannabis that would be reasonable to most people. But this isn’t the point of this article.

What troubles me about the “debate” about legalization of cannabis is that the pro-pot side seems to make claims about various medical benefits that appear to be only tenuously supported by real scientific evidence–in fact, some of the claims are downright dangerous. The reasons for doing this is probably, though I can only speculate, to make it appear that marijuana is some miracle product, so let’s speed up the legalization of it. It’s like the Food Babe telling us that kale is the miracle food, except that kale isn’t illegal. It does taste awful (but not the point). Continue reading “Medical uses of marijuana–hitting the bong of science (updated again)”

The twisted illogical gambits of the antivaccination cult

merck-vioxx-now-gardasilOK, let’s connect the dots. Merck produced and marketed Vioxx. Vioxx is bad. Merck produces and markets Gardasil. Gardasil is bad.

Yes, this is the logic of the vaccine deniers–associate Big Pharma with one of the mistakes it made in the past, then use that association to convince themselves everything produced by that Big Pharma company to be evil. This is a perfect example of the logical fallacy of Poisoning the Well, which states that one side of an argument pre-provides information that could produce a biased opinion of the reasoning, positive or negative.

Examples of this poisoning of the well abound throughout the antivaccination cults. There are numerous tired, hackneyed myths about the drug thalidomide, which, in the 1950’s was marketed by a German pharmaceutical company for the treatment of morning sickness in pregnant women (as one of its many indications). At that time, medications were not as strictly controlled as they are today for use during pregnancy, and thalidomide was given out rather freely to pregnant women. Unfortunately, nearly 10,000 children (half of them born in the former Federal Republic of Germany, also known as West Germany, but none in East Germany, because the communists did not approve it for use) were born with birth defects as a result of the drug.  Continue reading “The twisted illogical gambits of the antivaccination cult”

I am not, nor have I ever been, a member of the Big Pharma Shill Party

The official Big Pharma Shill t-shirt.
My official Big Pharma Shill® t-shirt. Thanks to the Facebook group, Refutations to Anti-vaxx Memes. https://www.facebook.com/RtAVM

Occasionally, I receive thinly veiled questions about my integrity and ethics in the comments of various posts, in emails, or on social networking sites. Mostly, I laugh about them since they are a form of Ad hominem argument, called the Big Pharma Shill Gambit, where one side of an argument tries to dismiss the scientific evidence of another side by accusing them of being a paid mouthpiece for pharmaceutical companies. My response is generally to state that I am “polishing the gold bars stored in the basements of Big Pharma offices,” and I don’t get paid very much to do that–it’s just about the only answer worthy of the stupidity of these accusations.

The problem with actually trying to dismiss these accusations is that it’s nearly impossible to dismiss the accusations with evidence, because as we know, proving the negative is almost impossible. I could post my investment documents, and you will see that I own many shares of stock and mutual funds that invest in biotechnology and pharmaceuticals. Companies I might discuss might make up 0.1% of the holdings of the mutual fund, which means I own around 0.000000001% of a single Big Pharma company. Now, I am certainly not arrogant enough to believe that what I write has any effect on some company’s stock price, but if it did, I reap the rewards of ½¢. Woo hoo. 

Of course, even if I did post my stock holdings, someone will accuse me of hiding my 2 million shares of Merck stock in my secret offshore bank account. Which probably is in the same vault as the shiny Big Pharma gold bars.  Continue reading “I am not, nor have I ever been, a member of the Big Pharma Shill Party”

FDA approves first vaccine to prevent H5N1 avian influenza

H1N1_versus_H5N1_pathologyOn 22 November 2013, the US Food and Drug Administration (FDA) announced that GlaxoSmithKline’s vaccine against H5N1 avian influenza was approved for use should the virus threaten to become epidemic in human populations. GSK’s Influenza A (H5N1) Virus Monovalent Vaccine, Adjuvanted, has also received regulatory approval  in Europe and Canada under the brand names, Pumarix™ and Arepanrix™ H5N1, respectively. Though it is not available for commercial use, the vaccine will be added to the national stockpile and distributed by public health officials if such an epidemic were ever to arise.

“This vaccine could be used in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of disease across the globe,” said Karen Midthun, M.D., director of the FDA’s Center for Biologics Evaluation and Research. “Vaccines are critical to protecting public health by helping to counter the transmission of influenza disease during a pandemic.”

The evaluation of safety compared approximately 3,400 adults 18 years of age and older who received the vaccine to about 1,100 adults who received placebo in a multi-center study (a type of study that can be ethically performed when the risk of the preventable disease is expected to be near 0 during the time of trial). The most common side effect reported during the clinical studies among the vaccine recipients was injection site pain. Muscle aches, headache, fatigue and injection site redness and swelling were also common, but no serious side effects were observed. To determine the effectiveness of the vaccine, the immune response was evaluated in about 2,000 of the vaccinated adults. The results of the study established that approximately 91% of individuals between the ages of 18 and 64 years and 74% of individuals 65 years and older who received the two-dose regimen developed sufficient levels of antibodies that would prevent infection by the disease.

According to the Centers for Disease Control and Prevention (CDC), the H5N1 influenza has relatively rare. The CDC has reported that more than 600 human H5N1 cases have been reported to the World Health Organization from 15 countries in Asia, Africa, the Pacific, Europe and the Near East since November 2003.  Approximately 60 percent of individuals with documented H5N1 disease have died. Evidence has shown that the virus is highly pathogenic by causing a deadly pneumonia. In addition, there are several studies that have shown that H5N1 can be easily transmitted to humans from avian species through respiratory droplets.

The new vaccine, approved for use in people over the age of 18 who are at increased risk of exposure to the virus, is the first US-approved H5N1 vaccine that contains an adjuvant to boost the body’s natural immune response to the virus, and despite ongoing debate over the safety of such adjuvants, the new vaccine is “the first to show it can confer protection in the event of a pandemic,” Reuters reported.

This vaccine will save lives, many lives, in case of an avian flu epidemic. 

If you need to search for scientific information and evidence about vaccines try the Science-based Vaccine Search Engine.

Key citations:

Why we vaccinate: to prevent meningococcal disease

Meningitis-baby-watch

Update of 24 September 2013 article to address outbreak at Princeton University.

Meningococcal disease usually refers to a group of diseases caused by the bacteria, Neisseria meningitidis, typically known as meningococcus. The most common illness arising from the bacterial infection is meningococcal meningitis (or just meningitis, even though there are non-bacterial forms meningitis, unrelated to this form). In meningococcal meningitis, the lining of the brain and spinal cord have become infected with these bacteria. These bacteria also have a causative role in other serious infections, such as bacteremia or septicemia, which are blood-borne infections.

Meningococcus bacteria are easily spread through the exchange of respiratory and throat secretions. The bacteria can pass quickly from one individual to another in close quarters, for example, schools and dormitories. Although the disease can be very serious, it can be treated with antibiotics that prevent the more severe forms of the illness and can reduce the spread of infection from person to person. 

If meningococcus isn’t treated quickly (or prevented by vaccines), the disease can be disabling or even fatal. And if the infection spreads to the blood, the consequences can be quite severe, requiring hospitalization. Meningococcal disease cannot be treated at home with over the counter or woo-based remedies. In fact, the symptoms of the early stages of the infection can mimic less dangerous infections, and require a physician’s diagnostic tools to rule out other less-serious infections. Continue reading “Why we vaccinate: to prevent meningococcal disease”

Marijuana and cancer – Sanjay Gupta’s anecdotes are not science

Editor’s note–this article has been updated and included into a multi-part series on marijuana and medicine. Check it out there. 

Unless you were hiking in the Amazon River jungles, with no access to the internet or American TV, you probably have heard that CNN’s chief medical correspondent, Dr. Sanjay Gupta, changed his mind about marijuana (or “weed” as he keeps saying). Of course, this has become big news, because he’s such a “respected doctor” (why is that? Because he’s on TV?), and because a few years ago he was vociferously anti-cannabis.

I have no doubt that Dr. Gupta’s “conversion” to being pro-weed is genuine (and that his previous stance of anti-weed was similarly authentic), but we need to weed out what is real and what’s just smoke about his comments. His first major point about cannabis* was that the United States Drug Enforcement Agency (DEA) considers marijuana to be a Schedule 1 drug, which is defined as “drugs with no currently accepted medical use and a high potential for abuse.”

Dr. Gupta thinks this classification is ridiculous, and on the surface, many people, even those who are not devoted pot smokers, would probably agree. However, this is a political discussion, at least in the USA, and it is hardly a medical/scientific one. The chances of any political party having the fortitude to correct this classification is about as close to 0 as you can get, without actually stating that there is a 0 chance. But if Gupta wants to make a big deal of this, or that he’s so self-centered that he thinks he’ll change the mind of politicians, more power to him. But for me as a skeptic, it is not the most important thing he says.

In his article, he mentions a young girl who “started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.” This is simply an anecdote of no quality whatsoever. Did he thoroughly investigate her case to determine if the number of seizures actually went down? Do we know that cannabis has anything to do with the change? Is this nothing more than a Post hoc ergo propter hoc fallacy, that just because she consumed cannabis and the seizures decreased does not mean anything about cannabis’ causative properties with regards to this type of seizure. And then, Dr. Gupta continues with the anecdotes by stating, “I have seen more patients like Charlotte first hand, spent time with them and come to the realization that it is irresponsible not to provide the best care we can as a medical community, care that could involve marijuana.” Why do these TV doctors (like Dr. Oz) think that their anecdotes are better than anyone else’s.

Anecdotes are useless because they aren’t controlled, because they are subject to all levels of bias, and because these stories aren’t peer-reviewed. In other words, anecdotes have no value in science-based medicine. Anecdotes do have value in formulating testable scientific hypotheses, but assuming that anecdote=data, and more anecdotes=more data is simply pseudoscientific. I don’t care what Sanjay Gupta writes or says publicly, but providing these stories as “evidence” that marijuana has a medical benefit is essential like telling me that he observed homeopathy (which is just water) working. It’s laughable.

Continue reading “Marijuana and cancer – Sanjay Gupta’s anecdotes are not science”

Herbal supplements–unproven, unregulated, unsafe

One of the more ironic memes on the internet is how pharmaceutical companies make so much money (and they do), with the false conclusion that somehow all that money means that they’re not really interested in providing drugs that are safe and efficacious. Then, those same memes will claim that “natural supplements” are healthier and better, while they ignore the profit motive of supplement pushers (henceforth called Big Herbal).

The National Center for Complementary and Alternative Medicine (NCCAM), an abomination that pushes fraudulent science, reported that in 2007, US adults spent $33.9 billion on visits to complementary and alternative medicine (CAM) providers and for purchases of CAM products, classes, and materials. About $14.8 billion of that spending was on non-vitamin, non-mineral, natural products, such as fish oil, glucosamine (no evidence of effectiveness), and Echinacea (no evidence of effectiveness). What is surprising is that this $14.8 billion is about ⅓ of what is spent on prescription drugs. Finally, about $4.4 billion was spent on herbal supplements, which are supplements that use botanical products based on some historical or current belief that the products have some ability to treat some disease or symptom. Of course, sometimes these beliefs are myths, or even errors, like when a Swiss CAM products company misunderstood someone and believed that Native Americans used Echninacea for treating colds. They didn’t. Continue reading “Herbal supplements–unproven, unregulated, unsafe”