Why your doctor won’t talk about medical marijuana.

Have you tried to talk to your doctor about medical marijuana? Were you surprised about their reluctance to discuss it with you even though you live in a medical marijuana friendly state. Did you feel that you weren’t receiving the best treatment options when you have read so much about the benefits cannabis can provide?

The medical marijuana community has fought for years to bring its benefits back into the conversation of patient care. The once taboo topic can now be part of a treatment plan for many who are suffering from symptoms that traditional medicine has not been able to provide relief. It is a huge win for advocates and we have come a long way with changes to policies happening throughout the world. However, even though your state may be medical marijuana friendly, there is still a major obstacle that must be overcome to truly allow patients to receive the best medical care possible. Many of you reading this may have already encountered this barrier.

Fear of DEA repercussions

Due to marijuana being listed as a Schedule I narcotic many physicians are under the impression that they are not allowed to discuss marijuana with you. They believe, and rightfully so, that their license from the Drug Enforcement Administration (DEA) to prescribe all medications will be revoked. A source in Michigan, a recently legalized state, told me how the DEA spent the last year “preparing” physicians for legalization by conducting trainings. These informational sessions made sure to communicate the message that the physician’s license could be in jeopardy if they recommended marijuana to their patients.

However, this is not true. The 9th district court ruled in the case of Conant v Walters (2002) that physicians have a first amendment right to discuss marijuana with you. Of course, they can’t write a prescription, it is still a federally illegal substance, but they can make a “recommendation for the use of medical marijuana based on a sincere medical judgment.” That means your doctor, regardless of the state you live in, can have an open conversation with you about medical marijuana if they genuinely feel it has a medical benefit for you.

Restrictions on your combination of prescriptions

In some instances, medical marijuana is not discussed due to how it will restrict your access to other medications. An example of this is seen in cancer treatment. Oncologists have been one of the leading specialists who recommend marijuana to help with the devastating side effects of chemotherapy. Medical marijuana not only helps with the nausea associated with chemotherapy but can also help increase appetite and lift a patient’s spirits up so they can endure the treatment process. In addition to medication to eliminate the cancer there is also a need for numerous pain medications.

Once again, the Schedule I classification comes into play. Pain medications may be restricted if marijuana is listed on the patient’s record. This is despite the fact that there are numerous studies indicating that marijuana is appearing to be an effective exit drug for opioid dependence. It enhances the effectiveness of opioids, allows patients to lessen the amount of opioids or even discontinue use.

The restrictions on what can be prescribed in the treatment plan, with marijuana included, has turned into a dangerous exchange between patient and care team. I recently had a discussion with a physician assistant at a prominent hospital. They described an environment where marijuana is being used by numerous cancer patients but rarely documented in their charts. As they put it, it’s a “don’t ask, don’t tell” type of policy. Conversations are quickly stopped when the patient mentions marijuana because the care team doesn’t want to restrict necessary pain medication in the future. They feel this is best for the patient. I disagree. When you are battling something as serious as cancer every part of your health should be openly discussed with your care team so you have the best chance at recovery.

Compassionate patient care includes all treatment options.

Lack of available information

Finally, if you live in a marijuana friendly state, your doctor may approve of medical marijuana but they just don’t have the information to be able to make recommendations. Did you know that only 13% of medical schools offer courses regarding the Endocannabinoid System? In addition, Only 9% have medical marijuana documented in their curriculum. This lack of information about the largest receptor system in the body is the root cause of a physician’s apprehension. Physicians-in-training are not prepared to discuss and recommend medical marijuana.

Right now, physicians are learning most of what they know from patients and independent research. Without available courses in medical school, and continuing medical education, they don’t have the available information they need to make an educated recommendation. Medical Marijuana 411 is working hard to change this and offer cannabis training for physicians, nurses and other care providers.

As a patient, you should feel comfortable discussing all alternatives that can help your health and well-being. Know that your doctor can discuss medical marijuana with you, regardless of which state you live in. However, also know that until the Endocannabinoid System, and medical marijuana, are part of medical education your doctor may be more uncomfortable with the topic than you are for suggesting it.

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