Medical Economics published an article by a medical doctor who discussed the stigma attached to medical marijuana prescription writing.
Cannabis doctors are afraid of the stigma attached to writing medical marijuana prescriptions.
Dr De says she responded to an advertisement for a medical position in a very attractive location. The type of work was described as “alternative medicine” in a “relaxed environment”. She thought, “Why not?” It was something different, and sounded great. To her surprise the recruiter did not want to give her much information when she enquired about the position via email.
Eventually the recruiter called her up, and explained this marvelous job was at a medical marijuana clinic.
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Doctors don’t see cannabis as medicine
A great many doctors have a problem seeing cannabis as medication, and still see doctors who prescribe medical marijuana as second-class citizens. Most doctors are afraid they will encourage, or supply recreational users with drugs through patients abusing medical cards in order to obtain drugs for friends. Many doctors are also afraid patients will lie to them about ailments just to obtain medical marijuana cards.
The problem is that there are some nagging studies on long-term marijuana use demonstrating negative effects on the brain. The risk of losing their medical licenses is also obviously a big issue for any doctor. This was recently the case in Colorado where four doctors were suspended after they were accused of over-recommending high plant counts for medical marijuana patients.
A doctor could just not document a case correctly, or by chance prescribe marijuana to an addict, and there could be some very serious consequences, which most doctors are just not prepared to risk.
Medical cannabis is perceived in the same light as opioid mills
As for the cash-only practices some of these doctors run, it smells a bit like the opioid mills for which ‘feel good’ doctors are doing time in state prisons.
In the same breath, Dr. De described her first encounter with medical marijuana more than 10 years ago. It was just called marijuana at the time, and because the patient was a child, no doctor would give him a card. His parents decided to take the risk anyway, and treated him with small quantities of medical marijuana.
The unconventional treatment was only an option after a regimen of five prescription medications for epilepsy with varying degrees of negative side effects were tried. One such side effect led to constant blood samples being taken to make sure his liver wasn’t failing. The boy’s list of medication looked similar to that of a cancer patient. The brain doping effect of the anti-seizures medication didn’t work as the seizures continued, but stopped as soon as he tried marijuana, says Dr. De.
She says that all the doctors at the clinic looked the other way, writing a report saying it was the patient’s family who wished to continue the marijuana regimen. Meanwhile the doctors were all wanting to say: “Patient, PLEASE continue MJ regimen.”
She and her colleagues were not keen to embark on a sixth anti-epileptic drug class discovery trial with him when something else was obviously already working.
How can doctors know if patients are faking?
The dilemma a doctor faces is obvious: How do they distinguish between patients with such severe symptoms that can cause damage to their brain, and the imposters or the fakes? Children with epilepsy are obvious, and Mrs. Smith is not faking her bone pain after her metastatic breast cancer.
Yet, most doctors are just not prepared to deal with the stigma attached to handing out medical marijuana cards to 25-year-olds who are physically perfectly able, or to get fooled by them.
Dr. De says more research into the area will help a great deal, and if the FDA could approve marijuana for specific conditions, the shame attached to prescribing it might be eased.
Even though the agency states on their website that patients with neuropathic pain, chemotherapy-induced nausea, cancer, multiple sclerosis and certain seizure disorders could benefit from the substance, only two synthetic compounds have been approved for chemotherapy-induced nausea and vomiting.
The process of approving a medicine could take many years, and might be dependent on the DEA changing marijuana’s classification from a strictest controlled substance to a less severe substance.
Cannabis is currently a ‘fringe’ treatment
The stigma attached to cannabis is still outweighing the knowledge of its medicinal use. It is not as though marijuana should be made available to all for recreational use, but there are most certainly medical cases where doctors would have liked to help if they had the reassurance from the FDA says Dr. De.
Her opinion is that although medicinal cannabis is currently a “fringe” therapy, once it is more acceptable to mainstream society, it will probably emerge as common practice in treating a variety of conditions.