Medical marijuana benefits proven

Surprise. Medical marijuana really helps. What millions of us have known ever since friends with AIDS proved it more than a decade ago is now affirmed. San Francisco Chronicle writers Victoria Colliver and Wyatt Buchanan broke the news today:

The first U.S. clinical trials in more than 20 years on the medical efficacy of marijuana found that pot helps relieve pain and muscle spasms associated with multiple sclerosis and certain neurological conditions, according to a report released Wednesday by a UC research center.

Dr. Igor Grant, a UC San Diego psychiatrist who directs the center, called the report “good evidence” that marijuana would be an effective front-line treatment for neuropathy, a condition that can cause tingling, numbness and pain.

The results of five state-funded scientific clinical trials came 14 years after California voters passed a law approving marijuana for medical use and more than 10 years after the state Legislature passed a law that created the Center for Medicinal Cannabis Research at UC San Diego, which conducted the studies.

California’s Proposition 215, passed in 1996, allows patients with a valid doctor’s recommendation to grow and possess marijuana for personal medical use. It is one of 14 state laws legalizing medical marijuana. But the federal government still says pot is illegal and without medical benefit. Perhaps that may now change.

“This is the first step in approaching the (U.S. Food and Drug Administration), which has invested absolutely nothing in providing scientific data to resolve the debate,” said state Sen. Mark Leno, D-San Francisco, who noted that marijuana showed benefits throughout the AIDS epidemic in helping people afflicted with neuropathy and other ailments.

Dale Gieringer, a Berkeley resident who is executive director of the California branch of the National Organization for the Reform of Marijuana Laws, agreed.

“This is finally the evidence that shows that the (U.S. Drug Enforcement Administration) stance that marijuana does not have medical use is just wrong,” he said. “It’s time for the Obama administration to act.”

The bad news is that funding for research that could further confirm the potential medical benefits of marijuana may soon run out.

The Center for Medicinal Cannabis Research has approved 15 clinical studies, five of which were completed and reported Wednesday, and two are in progress. While researchers said more studies are needed, the future of the center is in doubt.

The center has spent all but $400,000 of the $8.9 million in research funding it started with in 1999. Leno said the state doesn’t have the money to continue funding it.

“It may be close to the end of its life unless there’s foundation money to continue the work,” Leno said.

If we could just combine the savings that could accrue from getting the feds out of the pot-prosecution business and the taxes that would accrue from legalization of medicinal use, a lot of that work could continue. And a lot of suffering could be alleviated.

Doctors making house calls? An old idea whose new time has come

Could house calls make a comeback? It’s already happening. The University of California at San Francisco, for one success-story example, started the UCSF-Mt. Zion Housecalls Program in 1999 with a philanthropic gift. Its original goal was to teach medical students about home care, but with the exploding need for primary care for homebound elders it has evolved into filling that need throughout San Francisco — while still teaching the new generation about house calls.

In an article in the San Francisco Chronicle, staff writer Victoria Colliver details some of the many advantages that such programs have.

June Hagosian’s brain tumor has made it difficult for the 77-year-old San Francisco woman to leave her house in recent years, keeping her mostly confined to her bed.

For someone like Hagosian whose medical needs require frequent doctor visits, that would usually pose a problem. But because of a program run by UCSF, the doctor comes to her. She has had to leave her bright yellow home in the Richmond District to go to the hospital just three times in the past seven years.

“This program has been so wonderful,” Hagosian said during a recent home visit with her physician, Rebecca Conant, director of UCSF’s Housecalls Program. “I wish everyone could have it.”

Conant, who had just 15 patients when she took over the program in 2001, is one of five part-time UCSF physicians who spend all their clinical time outside the office, traveling from home to home visiting frail and elderly patients. Housecalls currently serves nearly 100 San Francisco residents and has an eight-month waiting list.The Housecalls physicians visit patients whose conditions make it so hard for them to go to the doctor’s office that they might otherwise put off seeking medical care. By then, they would be so sick they would need an ambulance and end up in a hospital emergency room. The program takes patients regardless of whether they have insurance or an ability to pay, which separates it from private practices that offer home visits as a convenience but at an added cost.

UCSF’s 10-year-old Housecalls Program is an old idea that has gained new traction. Both the House and Senate versions of the health reform bills contain proposals to examine whether home-based care improves the health of chronically ill patients and saves the government money by reducing hospitalizations and ER visits.”There’s no question there is both a medical need and substantial cost savings to the Medicare program,” said Constance Row, executive director of the American Academy of Home Care Physicians.

The Department of Veterans Affairs’ Home-Based Primary Care program, which has been operating for more than two decades, has showed a 24 percent reduction in costs for those patients, and some studies suggest savings as high as 40 percent, Row said.

UCSF’s Housecalls Programs operates on an annual budget of $300,000, almost all of which is devoted to physician salaries. That’s an average cost of $3,000 per patient, which does not include the cost of hospital care when needed. Medicare spends a national average of $46,412 per patient over the last two years of life, when patients typically have several chronic illnesses, according to researchers from the Dartmouth Institute for Health Policy and Clinical Practice.

But new technology – the ability to X-ray patients using portable machines, conduct blood tests and provide other services using mobile devices – allows doctors to offer a much higher level of care in the comfort of the patient’s home.

Conant, an associate clinical professor at UCSF, said she uses mobile devices to aid in her patient care, but she finds home visits offer other advantages like allowing her to see patients’ physical environments, meet their caregivers and better understand what kind of care they need.

“Not only does that improve medical care, but it’s based in reality,” she said.

The UCSF program is not the only home-based primary care program in the Bay Area. Kaiser Permanente, for example, serves some 370 members in San Francisco as part of its 13-year-old Community Care Program, which is handled by physicians, nurse practitioners and social workers.

Reinstituting and reinforcing in-home care, considering the significantly improved care for patients and the reduced cost to the taxpayer, would seem a no-brainer. But brains are losing out to politics a lot these days.

via UCSF program shows house calls’ time returning.