Medical marijuana should be applied for certain treatments in Barbados with great speed, but authorities must accompany its introduction with all the precautions applied to any registered pharmaceutical.
This call has come from no greater a Barbadian authority, based on a combination of medical knowledge and experience, than Dr Ermine Belle who for 16 years served as Senior Consultant Psychiatrist at the Psychiatric Hospital in Black Rock, and for a number of years chaired the National Mental Health Commission.
“Psychiatrists have seen the bad and the ugly of marijuana usage. We’ve been in the frontline of treating the negative effects and the outcomes of marijuana usage,” she said in arguing that such professionals are well-suited to pronounce on this controversial issue in Barbados.
“We can’t disregard, however, and close our minds to the fact that medical science and research have shown that there are definite benefits to marijuana usage in many chronic physical conditions.”
Dr Belle spoke at a University of the West Indies, Cave Hill, Faculty of Medicine-sponsored discussion on the topic last month about existing evidence that medical marijuana works as a curative drug for certain illnesses, when properly applied.
She referred to research findings highlighting cases for marijuana use in depression and anxiety, medical conditions “which are more in my area”.
She said information on medical marijuana being successfully used to treat epilepsy is widespread, and pointed to “the many people who have moved to Colorado to use marijuana because of the fact that their children are epileptic and they need to do an intervention to help them improve”.
Additionally, Dr Belle said, “the treatment of chronic pain and various disorders” is also fairly well documented and moderately well established.
“We have Multiple Sclerosis which is also being treated by medical marijuana, and many other conditions. Glaucoma treatment, I think, has been fairly well highlighted, and documented.”
“How can we ignore facts?” she asked. “Let us be realistic, medical marijuana is not a myth. It is here to stay.”
“As a physician and a psychiatrist, I’m sure that everyone would presume that my stance on medical marijuana would be a resounding ‘no’,” she mused, indicating her support for marijuana being applied as a medicine was because the evidence is becoming overwhelming.
“Like many of my colleagues internationally and, hopefully, here in Barbados, we are willing to see the bigger picture.”
Dr Belle cited a survey of 1 500 American doctors by the Internet-based medical organization, WebMD, that found them agreeing on a need for patients’ access to medical marijuana, with 69 per cent saying marijuana can help with certain ailments and the management of certain conditions; 67 per cent stating that marijuana should be a medical option for patients; and 56 per cent supporting legalization.
“Doctors voting highest in this survey were the oncologists and hematologists, and those treating epilepsy. They have had probably the most experience in managing medical marijuana to date,” she observed.
“We have reached the point of the serendipity moment to realize that we have a lot of work to do, a lot of research to undergo, and we have to move forward and be fair, and also be certain that we do no harm in bringing these new regulations and perspectives into our medical management.”
Dr Belle’s position comes against a backdrop where marijuana possession or use, even for medical purposes, remains totally illegal in Barbados.
“So how do we psychiatrists and other concerned physicians proceed?” she asked. Without answering the question of legalization of the drug, Dr Belle suggested a two-pronged approach.
“We must still continue treatment of those who succumb to the ravages of substance abuse, and specific to this discussion, the fight against marijuana abuse.
“We now have to look at the good that can be realized by the use of medical marijuana. I will not err on the side of promoting indiscriminate use of marijuana. Every effort has to be made to achieve harm reduction.”
She called for more information on the drug and its proper use to be made easily available.
“Education about marijuana must continue vigorously to give, especially our vulnerable young people, the opportunity to make the choice not to use marijuana if they so desire, especially if they come from a family with a predisposition through their genetic make-up to develop psychological or psychiatric impairment as a result of this usage
“Likewise every effort must be made to enhance the research on the way to refine and establish quantities used to achieve adequate efficacy, ensure efficiency in the products analysed, so that all who need them can access the drug in an equitable fashion.”
She stressed that research must be given priority. “We really have to concentrate on making sure that the research and the management of the development of protocols and other standardization is done in a timely fashion.”
In spite of her enthusiasm for legal application of medical marijuana, Dr Belle made it clear that many questions remain to be addressed.
“So how do we go about reconciling the fact that we have witnessed the psychoses, major depressions, anxiety-related disorders associated with marijuana usage?” she asked, and answered, “We have to become a lot more pragmatic. And we also have to remember our basic Hippocratic Oath, which says first do no harm.”
The good doctor threw out more questions to the Barbados medical fraternity that may be rooting for access to medical marijuana for patients.
“How do we stop the behavior of some to cause damage to others, the drug pushers?
“How do we address going forward the myriad of 1:41:42 psycho-social factors?
“How do we manage to look at those psycho-social factors underlying the issues of substance abuse in general?”
“We must continue to work in this regard but we must also embrace new medical treatment advances,” she said.
“Like other drugs used for treatment, these regulations and controls will be absolutely necessary.
“We have to move forward with faith and not with fear.”