OR: OHSU Doc Drafts Cannabis Primer For Other Doctors

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Photo Credit: Associated Press

You’ve heard of the Merck Manual of Diagnosis and Therapy? Now comes a short guide for psychiatrists and other doctors to navigate the world of cannabis to help them treat their patients.

Don’t know what BHO is? Vaping? (And is it possible that in 2018 you’ve never heard of a “bowl?”)

This new a primer for doctors, developed by two local doctors, will explain. It’s pretty basic stuff, but that’s what Dr. Jeramy Peters says he was after.

As a resident in psychiatry at Oregon Health & Science University Hospital, Peters figures up to 80 percent of the patients he sees consume cannabis regularly or have in the recent past.

To some doctors, the world of marijuana and terms used to describe the many ways people consume it can be as mystifying as medical jargon to someone trying to understand a treatment plan.

Eager to get a better handle on the topic, Peters and a colleague, Dr. Joseph Chien, reviewed the types of cannabis available today and came up with a quick rundown for physicians.

It explains, for instance, that hash has been largely replaced by butane hash oil and how marijuana-infused edibles include foods like honey sticks.

Here’s a Q&A with Peters (edited for length and clarity).

How did this paper come about?

“We work at the Portland VA on the inpatient psych ward and something I noticed, a lot of patients use cannabis and something we were finding was they were using these different products, whether they be edibles or the dabs, the high concentrated stuff.

“It seemed like they sort of knew more about them than we did so we started our own research, to learn a little bit more and have more of an informed discussion with our patients and it became clear to us that a lot of other providers didn’t know much about this stuff as well. We decided to write an article to help expand everybody’s knowledge.”

What do you hope to help doctors understand?

Typically a lot of doctors stop at ‘Are you using cannabis?’

I think part of our goal here was to have people explore a little farther. What types of cannabis product? How much? What is the potency?

The patients seem really comfortable sharing this information with physicians. I don’t think it’s so much of a taboo anymore, especially with legalization. It’s really helpful for physicians to know.

The way I put it to my patients is, everyone makes their own choices and I am not in the business of telling people what they can or cannot put in their bodies. I want to make help everyone make the safest decision possible and part of that is to know what else is going on with the patients before I prescribe a medication.

It is important to ask patients, even if they haven’t endorsed using in the past. And I really think that a big area of our focus is making sure the pediatric patient is kept safe and part of that is pretty basic: making sure edible products that look like candy are kept out of reach of kids.

Did you find anything that surprised you in your review of research?

The strength of cannabis, the potency of THC percentage by weight. That increase from the 60s and 70s until now was pretty surprising. We are talking in the 60s 1 or 2 percent THC by weight and now the strongest strains in the world are 30 percent plus by weight.

As with all substances our patients are using, it’s super important to keep the dialogue open and honest and nonjudgmental and especially with cannabis it’s really important for physicians and patients to keep an open mind and continue pushing for quality research.

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