Marinol approved for military members?

Discussion in 'Military Medicine' started by marinol, Jan 3, 2009.

  1. marinol

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    Marinol, synthetic THC, is approved at the federal level. Medical Marijuana has only been approved at the State Level. That would make it illegal at the Federal Level.

    So does that mean that Marinol is approved for military members? Meaning, will not "pop" on a urinalysis if they have a valid prescription for Marinol?

    Federally approved is Federally approved...but is there a catch?
     
  2. cbrons

    cbrons Ratatoskr! *Roar*
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    what a waste of money. Some guy on state aid got this stuff at our pharmacy. Cost the state $1800. Worthless... I hate to point out the 800 lb elephant in the room but why can't the guy just be allowed to smoke it for pennies?
     
  3. IgD

    IgD The Lorax
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    I would suspect that if a service member had a condition where marinol was indicated (cancer, etc) he would be unfit for duty and released via the disability system.
     
  4. DogFaceMedic

    DogFaceMedic Member
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    I think the 800lb Gorilla is that people want to get stoned.

    I doubt Mary Jane's safety profile: "Cerebellar infarction in adolescent males associated with acute marijuana use." Pediatrics Apr 2004, 113(4), e365-70.
     
  5. DogFaceMedic

    DogFaceMedic Member
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    Dude...Bummer.
     
  6. marinol

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    All personal feeling aside...

    If Marinol is approved federally, wouldn't that mean that it's approved for military too? You don't have to have Cancer or AIDS to get a prescription for Marinol, there are others reasons to be prescribed Marinol. But if you're prescribed by a civilian doctor, how can the military tell you you're wrong in taking it, even though it's legal?
     
  7. BigNavyPedsGuy

    BigNavyPedsGuy Junior Member
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    What if I asked for marinol. . . . we have a history. You'd hook a brother up right? i mean we PMed and everything.
     
  8. rotatores

    rotatores Senior Member
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    You're sad! Enough said.
     
  9. marinol

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    You guys can't just answer a question.

    But by you not answering, I got my answer. Bottom line, it's federally approved, so there's nothing that the federal government can do if someone is prescribed.

    You don't like it, but nothing you can do about it...
     
  10. colbgw02

    colbgw02 Delightfully Tacky
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    hahahaha. this post amuses me to no end. in the military, you're talking about an agency that has the right to send men and women to fight and die, and if they don't then they throw them in jail or - in extreme cases - execute them. and you seem to think that they can't keep someone from toking some weed? laughable.
     
  11. IgD

    IgD The Lorax
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    Here is what I found:

    MARINOL Capsules is indicated for the treatment of:
    1. anorexia associated with weight loss in patients with AIDS;
    2. nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments.

    To the original poster, do you have a specific situation in mind where a service member would need treatment with Marinol?
     
  12. rotatores

    rotatores Senior Member
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    I'm guessing you are either a young pre-med or med student...no physician is going to prescribe this for a little N/V or VGE.

    My advice...get a life and quit smoking that crap! You're not going to out smart the system.
     
  13. Gastrapathy

    Gastrapathy no longer apathetic
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    I'll answer your question. First of all, you haven't outsmarted anyone, so stop patting yourself on the back. I presume that you are an AD member hoping to use this forum for medical/legal advice to avoid trouble for THC use.

    If you were referred to a civilian provider from sick call or your assigned Tricare PCM and that provider ordered a controlled medication, you probably would not get in trouble (this is no guarantee, you seem like the sort of person that people would want to find a way to punish). If, however, you go to a doctor on your own, you can, and should, get separated for drug use. Furthermore, if you show up waving a rx, you'll piss people off and they will come at you all the harder.

    If you really need to smoke pot, get out and then smoke it. If you actually have a chronic condition that you think would benefit from marinol (sure), use the military health system to request a medical board.
     
  14. BigNavyPedsGuy

    BigNavyPedsGuy Junior Member
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    Can someone write me a prescription for some cocaine? I think I have an arrhytmia. I also have ADHD and need some adderall.

    OH, and anybody got a dime bag?

    There's nothing you can do about it, because somewhere, someone write presecriptions for these.
     
  15. DogFaceMedic

    DogFaceMedic Member
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    I always take advice on drug-dealing from the local barrack's lawyer.

    I suppose some cowardly commanders/supervisors might buckle when confronted by a private with an Rx. I did have a soldier once who claimed he took diet pills from Mexico and didn't know it had meth in it. The SGM backed him up, b/c she was fat, and he got off. That loop hole has since been closed. (Fortunately, the soldier got wiser and found help before he sank lower.)
     
  16. DogFaceMedic

    DogFaceMedic Member
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    Are dime bags FDA approved for weight loss?
     
  17. DogFaceMedic

    DogFaceMedic Member
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    Quite right.
    Private/sailor/airman Marinol: Any use of outside medical care without informing your boss, is considered misuse of government property, which is what you are.

    If abusing MJ and have to stop immediately, there is the potential of anxiety withdrawal s/sx's and necessitate the use and abuse of benzos.
     
  18. notdeadyet

    notdeadyet Still in California
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    Picking up benzos while quitting pot seems kind of like starting to smoke cigarettes to stop from biting your nails.
     
  19. cbrons

    cbrons Ratatoskr! *Roar*
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    all I'm saying is the drug costs thousands of dollars. If the doctor wants them to have it, it makes much more sense financially to just get the grass for them to smoke it versus paying (lets be honest, in most cases medicaid pays) nearly $2000 for a one month supply.
     
  20. 45408

    45408 aw buddy
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    Wow, what a buzzkill. I just wanted some Doritos, man.
     
  21. NavyFP

    NavyFP Senior Member
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    No, you don't smoke it......... you put it in the brownies. :D
     
  22. notdeadyet

    notdeadyet Still in California
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    Actually, a lot of folks who use medicinal marijuana do so via tea. A lot of folks just smoke it, but it's not the only method and every physician I've spoken to strongly recommends that folks not begin smoking marijuana for the prescribed THC. A lot of prescriptions are literally written out for little old ladies who wouldn't think of smoking. There are other ways of getting the effect.
    Again, it's not necessary to smoke it. The downside of the tea route is that you apparently use a lot more marijuana than you would smoking it for the same therapeutic effect, but the cost would still be a whole lot less than what Marinol apparently runs.

    I'm from California and for arthritis, glaucoma, AIDS, cancer patients, many physicians have no problems writing marijuana prescriptions. For all the reefer madness talk, I haven't heard any stories of little old ladies ODing on pot. In fact, I'd never heard of Marinol before because for those with a legitimate need, going to a cannabis club with prescription in hand seems to work a lot better out here.
     
  23. cbrons

    cbrons Ratatoskr! *Roar*
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    well I thought the U.S. Gov't grows the stuff anyway. You mean there is no way to tell how much you're getting from a certain amount? So its untrue that some cancer patients are allowed to smoke it?
     
  24. Jolie South

    Jolie South is invoking Domo. . .
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    The amount of THC varies from plant to plant, so you can't predict how much the patient is actually getting when they smoke.
     
  25. notdeadyet

    notdeadyet Still in California
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    From my understanding (and this is outside my area of expertise) is that the THC in marijuana varies radically from strain to strain, but much less so from plant to plant. The idea is that if you have a bunch of plants from the same strain of seed, the THC content will be roughly in the same neighborhood.

    This is why when folks buy and smoke marijuana from one supply to the next, they can get very different highs, because it can come from different strains. But if someone buys a few bags from the same supply, it doesn't alter radically from one to the next.

    I've also heard that the clubs advertise the THC strength of one strain to the next so that the patient can choose a strain that suits them. Since patients dose marijuana to effect, I'm not sure it is a big deal. Take until the pain goes away, take more when the pain comes back. Not rocket science.
     
  26. notdeadyet

    notdeadyet Still in California
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    Prescriptions for medical marijuana are only allowed in certain states. California being one. I have no idea what the others are.

    As for "smoking" it, it varies by physician and (moreso) the patient's condition. For non-smoking arthritis sufferers that could be using it for 30 years, teaching them how to smoke probably isn't a bright idea. For end-stage cancer patients literally in hospice, I don't think too many doctors are going to care about the health implications of someone smoking joints.
     
  27. cbrons

    cbrons Ratatoskr! *Roar*
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    How do you get a "prescription" for medical marijuana when its a DEA schedule 1 controlled substance? Aren't all these uses technically experimental?
     
  28. notdeadyet

    notdeadyet Still in California
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    In California, physicians "recommend" the patient use marijuana for cancer, anorexia, AIDS, glaucoma, arthritis, migraines, etc. With that doctor's note, the patient can go to a cannabis club and fulfill the "prescription".

    Prop 215 authorized this practice in California in '96. There's been some case law since supporting California's doctors rights to do this. A federal appeals court found that the DEA can't go after doctors for recommending marijuana to patients.
     
  29. HarryJAnslinger

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    :thumbdown:thumbdown

    As a provider you have a responsibility to counsel and care for your patients, students, and subordinates. Here you come off as nothing more than a self-righteous brute more intent on causing pain in pursuit of morally absolutist judgment than a provider looking to assist. If you do not agree with the recreational use of unauthorized drugs or a person's attempt to use such drugs via deception...that is fine. As a provider, however, you must suppress such emotions and seek only to provide the best information possible. You failed miserably in this respect; and as a result, I am ashamed that much more to be a part of the Armed Forces.
     
  30. i want out

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    another troll? or same one forgot his marinol password after dosing up?
     
  31. orbitsurgMD

    orbitsurgMD Senior Member
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    Get a clue, newbie.

    He isn't your doctor. You aren't his patient. This is an internet BB, not a medical school or residency program. He isn't advising you about anything. He isn't your "provider." No one posting here has any obligation to seem sympathetic to you, or to treat you like a student, or to show any kind of restraint in their personal opinions. He stated some facts about the powers of the military medical department over the care of active duty members. Obviously you don't like that idea.

    You said:
    You gloss nicely over the fact that in most places "recreational use of unauthorized drugs" is a crime. In the military, if you really are in the military, which I doubt, most people with intact situational awareness don't need to be reminded that the customs of casual lawbreaking common in the civilian world are treated differently. If I thought one of my aircrew or maintenance staff was obtaining Marinol or any other drug which use had no place in our operational environment, I would down that member and go to the CO and tell him why. It would have been my duty to do so.

    But I doubt you would know any of that. You seem like a self righteous poster looking to scold anyone who doesn't support your point of view.
     
    #31 orbitsurgMD, Mar 1, 2009
    Last edited: Mar 1, 2009
  32. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
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    An interesting choice of handle:

    http://en.wikipedia.org/wiki/Harry_J._Anslinger

    Harry Jacob Anslinger (May 20, 1892 – November 14, 1975) held office as the Assistant Prohibition Commissioner in the Bureau of Prohibition, before being appointed as the first Commissioner of the Treasury Department's Federal Bureau of Narcotics (FBN) on August 12, 1930.
    He held office an unprecedented 32 years in his role (rivaled only by J. Edgar Hoover), holding office until 1962. He then held office two years as US Representative to the United Nations Narcotics Commission. The responsibilities once held by Harry J. Anslinger are now largely under the jurisdiction of the U.S. Office of National Drug Control Policy. Anslinger died at the age of 83 of heart failure in Hollidaysburg, Pennsylvania. Today he is most remembered for his campaign against marijuana, but in his work he probably spent much more time on work against illegal trading of heroin, opium and cocaine[1]. He has been the target of much criticism, though it is alleged that the use of illicit drugs in the United States during his last decade as head of Federal Bureau of Narcotics was lower than it is today.
     
  33. Perrotfish

    Perrotfish Has an MD in Horribleness
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    vv
    He gave you the best information possible. He explained very clearly and concisely why this half assed plan to get a marinol perscription to get high is a poor idea, and how milimed has the capibility to both keep you from carrying it out and to punish you for even trying. To me, that's excellent , usable information.
     
  34. jwin74

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    @Tired: I've got bars on my collar too buddy. 13 years Army, two years Navy MSC, commanded twice as an O-3 and O-4. You may be a physician by profession, but you're paid by the taxpayer to provide health expertise. Fortunately, most folks I have worked with recognize that there are medical experts, and there are leadership experts, and for good reason the two worlds don't overlap much. (Apologies to some great IDCs and 18D medics who are the exception.) Any CO who gets a doctor offering legal advice like "recommend pre-trial confinement" should take it with a grain of salt. I dealt with more than a few self-righteous windbags in the medical corps, and they're one level up from civilian in my book. Your interest in "smashing" a servicemember says it all.

    @Marinol: Here's the reality: come to work drunk, high, or otherwise be incompetent and a CO will not like it. Get ****ty on your own time and it's don't ask don't tell. That said, the military has a special concept of what "your own time" is, since you may be on call or standby. Other than these situations, what you do on leave or pass, as long as it wears off before you come to work, is morally and ethically your own business.

    This should not be construed as legal advice, but obviously FDA approved synthetic THC is a potential way around the current unconstitutional prohibition laws. Marinol is FDA approved as a Schedule III drug under the CSA, which means it's less regulated than Adderall or Codeine. Don't assume that everyone is as intolerant as the people who answered here. It is a good question that you came here to ask, and it is a shame that you got such a negative response.

    At the time of your urinalysis, you will be asked if you are taking any prescription drugs. If you used Marinol recently, your urine probably will test positive for THC metabolites. So, four possible results are:

    Hot test, Marinol disclosed: They might tell you to stop, but you can probably stay in the service. As a CO I would support you.
    Hot test, no Marinol disclosed: You will come under scrutiny for failing to disclose the prescription, but you might be allowed to stay.
    Negative, Marinol disclosed: If you have a bigoted doctor or CO involved they might tell you to stop, or they might not even notice because a negative test gets no attention.
    Negative, no Marinol disclosed: No problem.

    The first case is interesting legally and to my knowledge has not been tested.
     
    #34 jwin74, Feb 9, 2011
    Last edited: Feb 9, 2011
  35. J-Rad

    Physician Moderator Emeritus 15+ Year Member

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    I'm sure in the nearly two years that has transpired since Marinol made his three posts on this site (in this thread) he/she has been checking in every day to awaiting your illuminating response. And I'm sure your righteous indignation that some physicians might have the audacity to not appreciate (the attempt at) being used to provide information on how to beat a piss test will bring those lowly posters back to cry in the reflection of your shiny bars.

    :thumbup:
     
  36. Gastrapathy

    Gastrapathy no longer apathetic
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    Random resurrection for 500 Alex
     
  37. BrickHouseMD

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    So much anger! (apparently nearly 2 years worth)
     
  38. jwin74

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  39. J-Rad

    Physician Moderator Emeritus 15+ Year Member

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    Really? This opinion is starkly different than what is written above? I'm glad you've set us all straight.
    Look, welcome to the board and thank you for your service-sincerely. But try not to come in, lack attention to detail, fail to comprehend what really was written in the thread you resurrect from the boneyard or you new "so-there" reference and proceed to try to piss on the other long standing members here while shaking your feathers. You might find some friends and colleagues here in that case. Currently-not so much.
     
  40. jwin74

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    Hmm. That legal memo from a state JAG pretty much echoed my uneducated guess on the issues. There is no stark difference. What details did I miss? Someone asked for advice and "Tired" took offense because the question involves a drug he doesn't like. I pissed on him because his attitude reflects discredit on himself and the military medical profession. He might think it's ok to be an ******* in a public forum* because he's hiding behind an anonymous internet alias, but he still needs to be called out for it. Last time I checked, regulating drugs is the business of the FDA and Marinol is a Schedule III drug. There are infantry units in Afghanistan with a large fraction of the guys on Schedule II drugs. Is he gonna **** them up too?

    Is "I take great joy in smashing guys like you" more tolerable because he's been a member of an internet group for a long time? If I find an officer who is more interested in smashing servicemembers than in doing his job, I'll do everything I can to get rid of him. The fact that the person claims to be a physician makes it even worse. I'm all for making friends, but calling wrong wrong is more important.

    *Like I said, this is the first Google hit. It doesn't reflect the general tone of the website, but in this case it's a pretty poor reflection of our profession.
     
  41. colbgw02

    colbgw02 Delightfully Tacky
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    Dude, this is almost entirely about you bumping a completely random thread that hasn't seen any traffic in nearly two years. There's an unofficial statute of limitations on these types of things. You might as well show up at work tomorrow and become suddenly indignant about the Iran-Contra affair. But hey, if righting past wrongs in online forums concerning abandoned topics is your thing, far be it from me to stop you. In fact, you better get started; it's a big internet out there.
     
  42. Gastrapathy

    Gastrapathy no longer apathetic
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    So, wise mid-grade officer (lets call you a hinge in aviator parlance), why were you googling marinol and military?

    It was highly likely that the OP (you?) was looking for a way to get away with abusing marijuana, synthetic or otherwise and to use the medical department as a way to get away with it. Thats why he got that response. If his query was "I'm dying of metastatic cancer and would like some marinol to stimulate my appetite, is that possible?" Aside from maybe telling him it doesn't work, the tone of the responses would have been vastly different.

    There are countless catfights in the archives of this forum. This one is tame.
     
  43. IgD

    IgD The Lorax
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  44. AF M4

    AF M4 Junior Member
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    Gastrapathy - he's right you know, this is the first thing that comes up when you Google "marinol military".

    Know what the second thing is? This link to something called the California Cannabis Research Medical Group.

    http://www.ccrmg.org/journal/05spr/opinion.html

    I particularly liked the response to the PTSD soldier's question about using marinol in the military: "Medically, cannabis is the treatment of choice for PTSD but definitely would spell the end of your military career."

    So apparently IgD has been holding out on us what with not mentioning what the real optimal treatment for PTSD is.:eyebrow:
     
  45. Gastrapathy

    Gastrapathy no longer apathetic
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    I believed him. My only question was why Major Hinge was googling that in the first place.

    Nice link. Personally, I think scotch is the treatment of choice for many acronym-based maladies (PTSD, AHLTA, DHMRSI, etc).
     
  46. IgD

    IgD The Lorax
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    I see quite a number of patients who use marijuana. Some use it as a form of self-treatment for anxiety but almost all of them feel that the consequences outweigh the benefits. I have seen a few patients who told me marijuana is the only thing that helps their Chron's disease however. You are GI Gastrapathy right what do you think of that?
     
  47. DogFaceMedic

    DogFaceMedic Member
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    One of the more entertaining aspects of this forum is the repeated efforts to ask advice on how to beat a UDS. I detect the infamous "barracks lawyers" who is an E3-4 offering legal advice to gullible enlistees. The underlying mythology is that marijuana is not harmful because it helps treat their "anxiety" - aka withdrawal symptoms.

    I had a few cases of "spice" induced seizures -- treated effectively with benzos. Has anyone else had experience with this latest trend?
     
  48. jabreal00

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    The only people I'll ever prescribe Marinol are those with end-stage cancer or those who have significant metabolic diseases with wasting. Otherwise it's just not indicated. Anyone who is young and relatively healthy getting Marinol would raise red-flags. Oh and gastroenteritis is not an indication and would also raise red-flags for underlying substance abuse.
     
  49. jabreal00

    7+ Year Member

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    I am also GI. I would never endorse or approve of Marijuana for inflammatory bowel disease as any kind of palliation. I would never prescribe Marinol, benzos, or opiates for Crohn's or UC either. It's just a recipe for dependence and can also mask real clinical pathology. It's typically the well meaning but ill-informed PCM that puts someone on opiates, benzos, or Marinol for IBD abdominal pain.
     
  50. psychbender

    psychbender Cynical Member
    Physician 10+ Year Member

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    One of the trauma surgeons at my hospital loves to put our recent casualties on it for appetite stimulation. I was off the first day he came on service to our SICU; the next day when I returned, half my patients were suddenly on it.
     

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