How Do Doctors Feel About Marijuana? [REVEALED]
On August 11, 2016, the DEA elected to keep marijuana’s Schedule I classification which has kept it illegal on a federal level since the Controlled Substance Act was introduced in 1971. At that time, almost half a century ago, weed was classified as being ‘addictive’ with no ‘accepted medical value’. While it was possibly forgivable to place marijuana in the same category as heroin back then due to complete ignorance about the plant, it makes no sense to do so now.
There have been countless studies which prove that weed is less addictive than coffee and cigarettes, and that it DOES have an accepted medical value. As well as being legal for recreational use in eight states plus D.C, cannabis is legal for medicinal purposes in 20 more states. Several more states will take the notion of legal medicinal marijuana to the ballot box within a couple of years.
In the states where cannabis is legal for medicinal use, you need an MMJ card (medicinal marijuana card). To get this card, you have to speak with a physician who will ask you a series of questions about your medical condition and decide whether to approve you for the MMJ card. While some doctors are fairly relaxed about it, others are vehemently against weed, and not always because of its perceived dangers.
The Case for Medical Marijuana – A Physician’s Take
Nathaniel P. Morris is a mental health specialist and routinely speaks to patients about substance abuse. He admits that alcohol is the first substance he worries about and points out that drunk patients often end up in an ER after crashing their car, choking on their vomit or falling into a coma. The NIH says that 1.2 million people go to the ER annually due to an alcohol-related condition. The Centers for Disease Control says that 88,000 people die from alcohol-related conditions annually.
Other substances that concern Morris include cocaine, methamphetamine, opioids such as morphine and IV drug use. According to Morris, marijuana is so far down the list of substances that concern him, and other healthcare providers, that it effectively registers as an afterthought. Mainly because there are no overdoses to worry about, nor are there weed-related brain abscesses or even cannabis-induced heart failures. In the medical field, weed is typically placed on a par with caffeine or tobacco.
Morris is aghast that weed is a Schedule I drug, when even methamphetamine is Schedule II and some prescription opioids are as low as Schedule IV. While he acknowledges that more research is necessary, the doctor argues that a huge 2015 systemic review shows the medical benefits of marijuana. To keep it on the controlled substances list when people are doubled over in agony because of alcohol, dying from opioids or becoming violent from crystal meth, is bizarre in his opinion.
For physicians like Morris, who believe marijuana should be used in medicine, it is a case of it being far safer than most prescription drugs on the market. When you have close to 100 people dying from an opioid overdose per day, perhaps he has a point.
It is also true that an increasing number of doctors are in favor of widespread marijuana legalization. The Doctors for Cannabis Regulation (DFCR) was founded in 2016 and has broken from the American Medical Association’s (AMA) official stance on weed. According to the DFCR, the continued criminalization of cannabis is causing more harm than good with pointless arrests along with racial and economic disparity regarding those caught and punished for possession of weed.
Physicians Against Marijuana – Lack of Knowledge is a Problem
In states such as Maine, where weed has been legal for medicinal use for over two decades, you would expect doctors to know why they are prescribing weed. In reality, a significant number of physicians still feel ‘in the dark’ about the plant. Doctor Jean Antonucci operates out of Farmington and admits that she is unable to answer most patient questions. She says that, when patients ask her if weed can help reduce chemotherapy nausea or glaucoma, she is unable to provide a definitive answer.
According to Mikhail Kogan, a medical director at George Washington University’s Center for Integrative Medicine, cannabis should not be smoked medically. He says that it is hard to absorb enough of the drug through the lungs and if you try to eat it, gastric acid interferes. Kogan believes weed should be placed under the tongue or even provided rectally for greater effectiveness.
Jeff Blackmer of the Canadian Medical Association admits that the lack of peer-reviewed research into the efficacy of medical marijuana is the primary reason why a large percentage of doctors are still reluctant to prescribe it. Blackmer added that most physicians hate being perceived as the ‘gatekeepers’ of cannabis.
In a study* published in the Journal of Clinical Oncology in 2018, half of surveyed oncologists recommended weed to patients in the last year. However, about 50% of these oncologists admitted to lacking sufficient knowledge on marijuana to make the recommendation. The survey also discovered that oncologists were unsure as to the cancer symptoms that weed can treat. One-third said it was more effective than typical pain treatments, one-third disagreed, and one-third said they had no idea!
It is wrong to say there is no research backing up cannabis’ efficacy in treating cancer symptoms. A 2017 review* published in The National Academies of Sciences Engineering Medicine looked at marijuana use on cancer patients since 1999. It concluded that there was “substantial evidence that cannabis is an effective treatment for chronic pain in adults.” The review also said that marijuana works to control vomiting and nausea in chemotherapy patients.
To be fair, you have to sympathize with physicians. A lack of double-blind clinical research trials has hindered scientific research into weed. There are also hundreds of cannabis strains, so you can’t always tell what strain a patient will receive at the dispensary. The legalization of weed in states such as California should help solve that issue along with a few others. For example, a few years ago, it was common for flowers to be mislabeled, or for the THC content of an oil to be different to what it says on the label. In 2018, dispensaries are monitored on a state level so these problems have all but disappeared.
Lack of knowledge is a huge obstacle as only nine percent of medical schools teach students about medical marijuana. One-quarter of medical school graduates admitted they would be unable to answer questions on the subject. To prescribe medical marijuana in states where it is legal, licensed doctors need to complete a course which varies in duration and difficulty from state to state.
In New York, you have to register with the State Department of Health and complete a four-hour course approved by the Commissioner. In Michigan and other states, the course takes as little as an hour.
As well as the growing body of scientific literature which is almost impossible to keep up with, there is the small matter of contradictory laws within states. Although marijuana is legal in several states, it is still illegal on a federal level. Therefore, physicians can technically be prosecuted for prescribing a Schedule I controlled substance. As a result, doctors who only want what’s best for patients may err on the side of caution and refuse to recommend marijuana. Sadly, there are individuals with less altruistic motives for keeping weed out of the reach of patients.
Physicians Against Marijuana – The Profit Motive
Numerous physicians have been criticized for overprescribing marijuana because it is ‘easy money’ for them. Back when weed was still only legal for medicinal use in California, Doctor Frank Lucido gained a reputation for writing cannabis recommendations in what was a ‘quick and easy’ process. Doctor Samuel Dismond III of San Francisco also admitted to approving patients for marijuana use and set aside one day a week specifically for the purpose.
However, this is nothing compared to the antics of Big Pharma. In 2016, Insys Therapeutics of Arizona was found guilty of bribing doctors to prescribe a fentanyl spray named Subsys. Six of the company’s executives were arrested and charged with racketeering. Fentanyl has killed thousands of people and was notoriously responsible for the deaths of 74 people in three days in Chicago in 2015.
Indeed, Big Pharma has a long history of bribing doctors to prescribe specific drugs. Aside from offering free drugs, these organizations would pay for Caribbean vacations for physicians. This is what Pfizer did with 5,000 doctors to ensure they prescribed a painkiller named Bextra, which was so dangerous it was taken off the market in 2005 because of its propensity to increase the risk of heart conditions! GSK was charged with employing 700 people, including sex workers, to convince physicians in China to prescribe more of its drugs.
Whether we want to acknowledge it or not, doctors are people too and if a major pharmaceutical company is willing to pay thousands of dollars just for them to prescribe more drugs, it is hard to turn down, especially for those in struggling practices. Studies have shown that even a $20 meal was enough to convince physicians to prescribe more Big Pharma drugs. For such doctors, there is no chance they will prescribe medical marijuana when they can recommend an opioid and make some cash in the bargain.
Final Thoughts on How Physicians View Marijuana
Suffice to say, opinion is still mixed amongst doctors, although one study*, published in the journal, Drug and Alcohol Dependence in 2018, showed that up to 90% of physicians were not prepared to prescribe an MMJ card. This is mainly down to a lack of knowledge about weed. In 2018, doctors have a greater understanding of how opioids damage the organ systems and can lead to addiction.
Therefore, they have no excuse for writing prescriptions. When it comes to medical marijuana, we can understand why a medical professional would refuse to prescribe it as there are too many unknowns. What we can’t understand is why a physician would refuse to prescribe weed yet happily write a prescription for a deadly opioid such as fentanyl.
Sources
blogs.scientificamerican.com/guest-blog/a-doctor-s-take-on-pot/
pubs.niaaa.nih.gov/publications/NEDS&NIS-DRM9/NEDS&NIS-DRM9.pdf
cdc.gov/alcohol/fact-sheets/alcohol-use.htm
washingtonpost.com/news/wonk/wp/2016/04/15/more-and-more-doctors-want-to-make-marijuana-legal/?noredirect=on&utm_term=.eb1340afc5e7
pbs.org/newshour/health/doctors-feel-completely-dark-medical-marijuana
wired.com/story/lots-of-doctors-recommend-weed-without-understanding-it/
macleans.ca/society/health/why-doctors-dont-want-to-be-the-gatekeepers-of-medical-marijuana/
theguardian.com/society/2016/jul/28/medical-marijuana-doctors-california-pot-legalization
drugandalcoholdependence.com/*
nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx*
bmj.com/content/355/bmj.i6742
massroots.com/news/pharmaceutical-executives-arrested-for-bribing-doctors-to-over-prescribe-opioids/