Your cancer patient asks for a prescription for medical marijuana which was just legalized in your state. You 1) happily hand over the paperwork needed and recommend a reputable dispensary 2) balk and recommend an alternate medical solution 3) flat out refuse and suggest the patient leave your practice.
It’s a tough decision, as state’s line up to approve cannabis for medical and even recreational use, because the Federal government still considers it a crime. What is the best approach for your practice, and for your patient?
Legal Issues of Prescribing Marijuana
Currently 20 states and the District of Columbia have legalized medical marijuana. If you work in an approved area and choose to help patients try medical marijuana you don’t actually write a prescription. In most states, the doctor provides the local Department of Public Health with a written certification of potential patient benefit. This will let the patient obtain a state issued registration card and they can then go to a dispensary. This structure is common and is based on the 2002 federal appeals court ruling Conant v. Walters.
Each physician should check their own state guidelines before proceeding. If you’re not a private practice physician check with your group or hospital to make sure you’re not in violation of any guidelines.
Do Doctors Want It?
A Sermo Poll conducted in November 2012 asked our U.S. physicians, “Would you prescribe marijuana for medicine purposes if/when legalized in your state?” Physicians answered …
- 61% No
- 39% Yes
This contrasts strongly with a New England Journal of Medicine global poll that was published in May 2013. There 76% of votes were in favor of medical marijuana. The poll had 1,446 votes from 72 countries and 56 states and provinces in North America.
Marijuana is still categorized as a Schedule 1 substance, the highest level assigned by the Drug Enforcement Agency. It’s in the same group as LSD, heroin and “ecstasy.” To compare, cocaine is not considered as dangerous and is listed as a Schedule 2 substance.
To qualify for Schedule 1 the drugs must meet three criteria.
- high potential for abuse
- no currently acceptable medical use
- lack of accepted safety for use under medical supervision
There have been many studies that support benefits to medical marijuana. Addiction rates are also lower than other common drugs. According to a CNN report with Sanjay Gupta who recently produced a documentary called “Weeds,” the addiction rates are …
- 9% marijuana
- 20% cocaine
- 30% tobacco
We also found addiction rates for alcohol to be 10% to 15% for the general population.
Do you think medical marijuana deserves its Schedule 1 status? As states have been legalizing marijuana, will the DEA and the Federal government reach a tipping point where it acquiesces to state laws? Do you think medical marijuana should be legalized? If your state has already legalized have you noticed any changes in patient care?
If you’re an M.D. or a D.O. feel free to join the healthy debate on this subject inside Sermo.