Robert Celt
New Member
As more states legalize medical marijuana, doctors increasingly find themselves serving as gatekeepers for a drug that they may not understand, and perhaps don't condone, with clinical and legal considerations to boot.
By the fall of 2015, 23 states and the District of Columbia, had approved the use of marijuana for medical purposes, according to the National Conference of State Legislatures. While the specifics of state laws vary, typically they rely on a doctor's involvement to refer the patient, called a certification, because the Schedule 1 substance can't be prescribed.
This scenario presents a series of quandaries for doctors and patients alike. "People start popping up with these state forms to fill out," says Scott Hammer, MD, a family physician in Milford, Delaware, which opened its first dispensary in June 2015. Some of the requests are clearly for recreational purposes, he says. But other patients have conditions that might benefit from marijuana, such as the man with metastatic cancer who was coping with a myriad of related symptoms, such as pain and nausea. "I looked at him and said, 'Regardless of my personal feelings, I'm just not [personally] ready to fill these forms out yet,'" recounts Hammer, citing the drug's Schedule 1 status among other concerns.
Debate persists among doctors and researchers regarding which symptoms marijuana can ease, and to what degree, with proponents pointing out that badly-needed research has been squelched by the drug's illegal status.
Doctors worry about running afoul of law enforcement in some way, whether it's federal drug officials or a police officer investigating a traffic accident. Guidance from professional organizations is primarily limited to calls for more research.
Meanwhile, primary care doctors like Hammer, who are reluctant to sign any certifications, acknowledge that patients can obtain the paperwork through another doctor, potentially leaving their regular physician in the dark.
But if patients don't inform their primary care provider, they can't be monitored for any potential issues arising from marijuana use, such as interactions with other drugs or emerging addiction concerns, says Kevin Hill, MD, an assistant professor of psychiatry at Harvard Medical School. "That's a dangerous scenario," he says. "Whether or not they [doctors] want to write for medical marijuana certification, they need to have their eyes open to this issue."
Another dilemma: a patient admits marijuana use during an office visit. "Then there is a decision point," Hill says, because doctors shouldn't be part of a treatment plan that they don't agree with. "Ultimately the physician is left with the choice of whether or not they want to manage it, or sort of sign off on it begrudgingly, or transfer the patient to another clinician."
News Moderator: Robert Celt 420 MAGAZINE ®
Full Article: Medical Marijuana: The Challenge For Physicians
Author: Charlotte Huff
Contact: Medical Economics
Photo Credit: None found
Website: Medical Economics
By the fall of 2015, 23 states and the District of Columbia, had approved the use of marijuana for medical purposes, according to the National Conference of State Legislatures. While the specifics of state laws vary, typically they rely on a doctor's involvement to refer the patient, called a certification, because the Schedule 1 substance can't be prescribed.
This scenario presents a series of quandaries for doctors and patients alike. "People start popping up with these state forms to fill out," says Scott Hammer, MD, a family physician in Milford, Delaware, which opened its first dispensary in June 2015. Some of the requests are clearly for recreational purposes, he says. But other patients have conditions that might benefit from marijuana, such as the man with metastatic cancer who was coping with a myriad of related symptoms, such as pain and nausea. "I looked at him and said, 'Regardless of my personal feelings, I'm just not [personally] ready to fill these forms out yet,'" recounts Hammer, citing the drug's Schedule 1 status among other concerns.
Debate persists among doctors and researchers regarding which symptoms marijuana can ease, and to what degree, with proponents pointing out that badly-needed research has been squelched by the drug's illegal status.
Doctors worry about running afoul of law enforcement in some way, whether it's federal drug officials or a police officer investigating a traffic accident. Guidance from professional organizations is primarily limited to calls for more research.
Meanwhile, primary care doctors like Hammer, who are reluctant to sign any certifications, acknowledge that patients can obtain the paperwork through another doctor, potentially leaving their regular physician in the dark.
But if patients don't inform their primary care provider, they can't be monitored for any potential issues arising from marijuana use, such as interactions with other drugs or emerging addiction concerns, says Kevin Hill, MD, an assistant professor of psychiatry at Harvard Medical School. "That's a dangerous scenario," he says. "Whether or not they [doctors] want to write for medical marijuana certification, they need to have their eyes open to this issue."
Another dilemma: a patient admits marijuana use during an office visit. "Then there is a decision point," Hill says, because doctors shouldn't be part of a treatment plan that they don't agree with. "Ultimately the physician is left with the choice of whether or not they want to manage it, or sort of sign off on it begrudgingly, or transfer the patient to another clinician."
News Moderator: Robert Celt 420 MAGAZINE ®
Full Article: Medical Marijuana: The Challenge For Physicians
Author: Charlotte Huff
Contact: Medical Economics
Photo Credit: None found
Website: Medical Economics
