In the past decade several US states have enacted laws legalizing marijuana use to various degrees. Whilst these changes are very welcome federal laws at this time still classifies marijuana as an illegal substance. There are still many individuals doing jail time for various violations of marijuana statutes today. There are marijuana offenders in both federal and state prisons across the country today. In my medical practice I have used the legal marijuana derivative Marinol to treat various ailments but I have not yet formally recommended smoking weed, use of oils or edibles for any patient.
My Experience With Medical Marijuana
I however have many of my patients though have made their own decisions that marijuana or should I use the word cannabis served some of their health needs better. These individuals and have elected to self medicate. In such cases I have learned to get out of their way. Research shows that daily cannabis use can cause lung diseases such as COPD. There is also a high likelihood that lung cancer could be a long term outcome for some daily users . At this time though there is no good research to support such a claim. For young people though cannabis can lead to low IQs in those who use daily in their teen years.
I still remember one patient who came to my office after the Maryland State Legislature legalized marijuana. The gentleman wanted a marijuana prescription even before there were dispensaries available in Maryland. Unfortunately His diagnosis and prior treatment history did not meet Maryland State Criteria. The state Maryland has reserved that option for individuals who have tried other forms of therapy unsuccessfully. The lack of dispensaries in our state meant such a person would need to travel to go to Washington DC for acquire marijuana legally. Today though there are up to 71 licensed dispensaries all over the state in several different stages of licensure. There are also several online stores that provide marijuana derivatives from the hemp plant.
In my practice I have encountered several patients who insisted that smoking marijuana alleviates various ailments. Several individuals have mentioned that smoking weed was better for different types of pain symptoms than most opioid analgesics. In one case when one patient had to choose between stopping marijuana use so he can continue receiving prescriptions for opioid analgesia the individual chose to self-medicate with marijuana instead.
Our Federal Agencies and Marijuana Legislation
Cannabis today is slowly moving into the realm of everyday medical care. The increase in Tetrahydrocannabinol (THC) product on the markets is pushing the FDA to take a closer look at Cannabis. This week the FDA invited academic and industry experts to provide input on recreational and medical use of Marijuana
Whatever the FDA decides the use of Marijuana in our society is moving in the direction of broader acceptance. The former Speaker of the House, a vociferous opponent of Marijuana legislation said his views have evolved. John Boehner said his new stance was the result his interactions with many individuals who use marijuana for health needs. I would like to applaud Boehner on his open-minded appraisal of the benefits of cannabis. I must however also say his evolution was also associated with his membership on the board of Acreage Holdings. This publicly traded company in New York State specializes in the distribution of Cannabis across 11 states.
At this time it is not really clear how much of John Boehner’s newly discovered love of Cannabis is the age old love of the green back as opposed to a real appreciation of the benefits of this popular centuries old herb.
Different Cannabis Species
The evolution of Marijuana laws across various states as usual is lagging federal legislation. This has created some problems for this industry. Today most local Marijuana businesses are still cash only businesses. This unique situation has spurred a whole new industry involved in the protection and transportation of the proceeds of these businesses. These security firms specialize in moving funds to financial services providers for Marijuana businesses. All these transactions are occurring outside the traditional banking channels since most banks refuse to serve this billion dollar industry. There is a bill proposed by Congressman Ed Perlmutter(D), “The Safe Banking Act” to address this. This bill has unfortunately stalled in The House of Representatives.
Projections and The Way Forward For Physicians
Many in the industry believe that by the end of 2019 Marijuana banking would be moving into the mainstream federally. This may be too optimistic since others believe this would require a federal legalization bill which may be more complicated.
Whatever happens on the federal level, those interested in Marijuana for health reasons will need to follow a few rules;
- Be aware of your local laws governing the use of marijuana and its products.
- Have an open and honest conversation with your physician. If your physician is not well informed and this is important to you consider looking for a new one
- Always consider the use of other medicines and products that have been studied more extensively
- Use the same caution with marijuana use as you would alcohol and opioid analgesics.
- Avoid driving or operating heavy machinery whilst using this drug.
- Be aware that the euphoria associated with the use of THC products may make it difficult for you to honestly determine if this drug is helping you as expected or just making you feel good.
On this note I would like to say that whatever happens with Federal Legislation all doctors must view Marijuana products as one of the many drugs available to us and our patients. We will therefore need to educate ourselves to enable us help our patients better.
Dr. Leonard Sowah is an internal medicine physician in Baltimore, Maryland
The Botany of Desire, by Michael Pollan
Educational Resource for Physicians and other Healthcare Professionals
The Health Effects of Cannabis and Cannabinoids
For licensed dispensaries close to you try https://www.leafly.com
Feature photo: Modified from Ganja by Desmond Alexander is a free stock photo