Why Are Doctors So Hesitant To Talk About Marijuana?

By Kelly Burch 04/11/18

A clash between state and federal laws has left doctors in an awkward position when it comes to medical marijuana.

Image: 
doctor holding a tray of medical marijuana

A majority of states in the country now have a medical marijuana program, but doctors across the nation remain hesitant to discuss medical marijuana with their patients, in part because of a federal policy that limits research on cannabis and thus leaves medical professionals with little scientific data available to help them make informed recommendations to their patients. 

"We have the federal government and the state governments driving a hundred miles an hour in the opposite direction when they should be coming together to obtain more scientific data," Dr. Orrin Devinsky, director at New York University's Comprehensive Epilepsy Center, told NPR.

Devinsky is researching using cannabidiol to treat epilepsy, but has been frustrated by competing messages from the federal government and the states. "It's like saying in 1960, 'We're not going to the moon because no one agrees how to get there,’” he said. 

Concerns that doctors have about the federal marijuana policy—which classifies the drug as Schedule I, with no accepted medical use—have grown under the Trump administration, which has taken a hardline stance on cannabis.

In March, Health and Human Services Secretary Alex Azar said, “There really is no such thing as medical marijuana.”

However, 29 states have decided that there is medical merit to the plant, and that people who need it to treat medical conditions should be exempted from federal prohibitions.

Still, although some patients attest that using medical marijuana has improved their lives and helped them avoid arguably more dangerous drugs like opioids, actual scientific data remains elusive. 

One reason for this is that all marijuana that is studied using federal funds must come from one provider at the University of Mississippi. Researchers say that this pot is less potent than what many people buy in dispensaries, making it difficult to study its real-life medical potential. 

"It's public policy before science," said Chinazo Cunningham, a primary care doctor at the Albert Einstein College of Medicine and a lead investigator on research exploring marijuana as a treatment for pain. "The federal government's policies really make it much more difficult.”

Although Cunningham’s study received a $3.8 million federal grant, she is not allowed to give marijuana to patients directly. Because of this, the study can’t be truly random (the highest scientific standard), since the patients who use medical marijuana are self-selected. 

"It's a Catch-22," she said. "We're going to be looking at all of these issues—age, disease, level of pain—but when we're done, there's the danger that people are going to say, 'Oh, it's anecdotal' or that it's inherently flawed because it's not a randomized trial."

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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