Why Doctors Need Marijuana Education ASAP
Doctors need Marijuana education: A total of 37 states legalized medical cannabis, which studies show is an effective pain reliever with various benefits for physical and mental health conditions. What's more, cannabis is relatively safe with minimal side effects for most people. So why are U.S. health providers still writing more than 100 million opioid prescriptions causing over 100,000 overdose deaths annually? And why don't more doctors recommend cannabis over ineffective antidepressants? Unfortunately, even today, physicians are marred by a significant medical marijuana education gap compounded by lingering social stigmas.
Let's examine the medical marijuana landscape and challenge the status quo so more doctors can confidently recommend this healing plant.
Legal Cannabis States and Qualifying Conditions
Currently, 37 states and Washington, D.C. allow the medical use of cannabis products. Additionally, 11 states allow "low THC, high CBD" products in limited situations. Severe or chronic pain is a qualifying condition for medical marijuana in almost all states with a program in place. Depending on the state, patients may qualify for treatment with medical marijuana if they meet specific requirements and have a qualifying condition, such as:
- Alzheimer's disease
- Amyotrophic lateral sclerosis (ALS)
- Crohn's disease
- Epilepsy and seizures
- Multiple sclerosis and muscle spasms
- Severe nausea or vomiting caused by cancer treatment
Informed physicians often prescribe high potency CBD varieties to treat forms of epilepsy that other medications can't control. The most widely known case involved a 5-year-old patient named Charlotte, who suffered nearly 300 seizures a week and had lost the ability to talk, walk, and eat. After taking CBD supplements, her seizures drastically reduced in a few months.
Other doctors utilize high potency THC cannabis to help cancer and HIV/AIDS patients manage the side effects of their treatments. Dronabinol, for example, is FDA-approved to relieve nausea and pain and stimulate appetites while improving mood and reducing anxiety and depression.
How Practitioners Can Help Patients in Medical Marijuana States
Doctors need Marijuana Education: Officially, health care professionals can't prescribe cannabis because the federal government still classifies it as an illicit drug. However, in states where medical marijuana is legal, medical providers can verify that patients suffer from qualifying conditions and write a certification for a medical marijuana card. This allows patients to grow cannabis or buy it from a medical marijuana dispensary.
Finding a physician to provide a medical marijuana certification is the biggest challenge for patients due to states' various rules and conditions. Some states make it simple for doctors and patients to gain access, while others have more restrictions.
Below are some of the best places for medical marijuana in the U.S.
- New Jersey recognizes commonly neglected conditions, like anxiety.
- New York expanded the types of practitioners who can recommend cannabis and currently has 3,685 certified practitioners. New York also recently dropped qualifying conditions for its medical marijuana program and waived the $50 patient application fee.
- Washington, D.C., and Massachusetts allow physicians to recommend treatment for conditions not on their official state lists.
- Oklahoma is considered one of the most lenient states, and 10% of its population, or 376,000 people, have registered with its medical marijuana program since June 2018.
- In Florida, more than 2,000 physicians are certified to recommend medical marijuana.
These states make it much more challenging for doctors and patients to get their medicine.
- Iowa is one of the nation's most restrictive states, with only a handful of licensed providers. Even cancer patients must have severe pain, severe nausea, or wasting syndrome to qualify.
- In Georgia, patients must have a severe or life-threatening disorder and can only receive low-THC cannabis oil.
Under the Mississippi Medical Cannabis Act, only those with debilitating medical conditions such as cancer, Parkinson's, Huntington's, HIV/AIDs, sickle cell, and seizures can legally use medical cannabis.
Medical Cannabis vs. Opioid Prescriptions
According to survey data, 70% of U.S. clinicians believe in using cannabis as medicine. Another study revealed that almost half of physicians (49%) experience frequent inquiries about medical cannabis from patients. Yet most continue prescribing antidepressants and addictive pain medications as their first point of call. Why?
While most states have legalized medical marijuana, few medical schools teach prospective doctors about it. According to a study of physicians published in the Drug and Alcohol Dependence journal:
- More than 35% are not prepared to answer patient questions about using cannabis medically
- Nine out of ten feel they are not adequately educated to prescribe it.
Even in Colorado, which legalized medical marijuana in 2000, many physicians remain reluctant to recommend cannabis to patients. Additionally, in 2014, one of the largest physician groups in Massachusetts adopted a policy forbidding doctors from certifying patients for medical cannabis.
As a result, on average, only roughly 2% of a state's population is registered in a medical cannabis program. Some states, like Oklahoma and Missouri, have much higher rates, while other states, like New York, have just 122,000 registered users or 0.6%.
In comparison, prescription rates for opioids continue to be sky-high:
- Opioid prescriptions totaled 142 million in 2020—almost half of the U.S. population (43%).
- In 3.6% of U.S. counties, doctors dispensed enough opioid prescriptions for every person to have at least one pill.
- More than 115 Americans die each day from an opioid overdose.
- The rate of overdose deaths involving opioids has doubled since 2000.
- Painkillers are the most commonly abused prescription drug, and up to 29% of patients prescribed opioids for chronic pain misuse them.
- In New York, the number of overdose deaths involving opioids increased each year between 2010 and 2017 by 200.2%.
Additionally, antidepressant (SSRI) use is also on the rise:
- 7% of the U.S. population over age 12 took antidepressant medication in the past month.
- People using antidepressants increased by 64% between 1999 and 2014.
- Doctors prescribed more than 20 million antidepressants between October and December 2020.
- Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults (18.1%) every year.
- Over half of all people who take antidepressants have side effects.
Specialists believe that some doctors prescribe antidepressants unnecessarily, such as for milder symptoms.
Closing the Medical Marijuana Prescription Gap
Closing the medical marijuana education gap is critical because it can potentially offer safer alternatives to pain and depression treatment, with fewer side effects and less potential for abuse or overdose:
- In a 2020 study, 95% of people said marijuana gave them rapid, short-term relief from depression symptoms.
- In another study, 44% of medical cannabis users stopped taking a pharmaceutical drug or reduced their reliance.
- Zero people have died of a cannabis overdose in recorded history.
Fortunately, policies are changing around the country to help doctors move away from prescribing opioids in favor of cannabis:
- Colorado, Illinois, and New York now allow health professionals to recommend marijuana instead of addictive pills such as OxyContin, Percocet, and Vicodin.
New Mexico, New Jersey, New York, and Pennsylvania allow people with opioid addiction to qualify for a medical marijuana card.
Overcoming the Lingering Cannabis Stigma
There are several reasons why certain physicians still feel hesitant to recommend marijuana for medical use:
- Discrepancies between federal and state medical marijuana laws mean that doctors risk violating federal law when writing marijuana recommendations, potentially revoking their DEA licenses.
- Some doctors are reluctant to recommend a drug that doesn't specify the form, contents, dosage, and type like a typical drug prescription. As a result, dispensary employees, not the doctors, recommend the type of marijuana and the delivery method.
- Because marijuana is still federally illegal, growing and cultivation standards are mainly unregulated and unstandardized. As a result, some doctors have concerns about product safety, such as pesticides, molds, and other contaminants.
Some doctors still have preconceived notions about the plant's reputation as a recreational drug, with no medical value and addictive potential.
Overcoming the Medical Marijuana Education Gap
Medical marijuana research and marketing have rapidly outpaced physician education. As a result, doctors don't properly understand the benefits, adverse effects, dosing, methods, strains, and how to advise patients:
- Only 9% of medical schools have medical marijuana documented in their curriculum.
- 85% of doctors say they received no education in medical school or residency on medical marijuana.
Conversely, physicians experienced in prescribing cannabis are more convinced of its benefits and less concerned about adverse effects. This illustrates that education on medical marijuana benefits and regulations would be an immense help to physicians and patients. For instance, many don't realize that the first amendment protects doctor recommendations for medical marijuana, so they don't need to fear losing their licenses.
Offering more structured education courses on medical marijuana would provide doctors with basic information so they could answer questions from patients. For example, in New York, doctors must take a 4-hour online course before they can write marijuana recommendations. The course is not nearly extensive enough but explains the use of medical marijuana for each of the conditions covered in the Compassionate Care Act, based on available scientific evidence.
The bottom line
Medical marijuana is legal in most states, but many doctors don't have the proper training or confidence in recommending it to their patients or registering for a medical marijuana license. More education is essential to break the stigma so doctors can begin recommending cannabis, where appropriate, instead of prescribing dangerous and addictive prescription drugs.