Go­ing to pot?

Rec­om­mend­ing mar­i­juana should be doc­tor’s choice

Northwest Arkansas Democrat-Gazette - - EDITORIAL PAGE -

Arkansas con­tin­ues its march to­ward be­com­ing a place where mar­i­juana is no longer treated, at least ex­clu­sively, as an il­licit drug. Whether that’s good or not so good de­pends on whom you ask.

The drug re­mains on the fed­eral list of con­trolled sub­stances, along with ec­stasy, LSD, heroin, co­caine and all those ex­ten­sively tested and re­searched medicines only doc­tors are al­lowed to pre­scribe and phar­ma­cies are au­tho­rized to dole out.

But state by state, those who would like to use, cul­ti­vate or sell mar­i­juana are ben­e­fit­ing from a shift in at­ti­tudes. The drug, more or less, is go­ing through a re­brand­ing. Wash­ing­ton, Ore­gon, Cal­i­for­nia, Ne­vada, Colorado, Mas­sachusetts and Maine have laws al­low­ing re­cre­ational use of the drug. An­other 20 have passed laws al­low­ing mar­i­juana’s use in one form or an­other for med­i­cal pur­poses.

Arkansas is among the lat­ter group. Vot­ers last Novem­ber ap­proved Is­sue No. 6, which de­fined 17 med­i­cal con­di­tions for which med­i­cal mar­i­juana can be used. Ac­cord­ing to that mea­sure, be­fore a per­son could get a med­i­cal mar­i­juana card from the Arkansas Depart­ment of Health, a doc­tor had to con­firm the pa­tient has one of those con­di­tions and de­clare in writ­ing that “the po­ten­tial ben­e­fits of the med­i­cal use of mar­i­juana would likely out­weigh the health risks for the qual­i­fy­ing pa­tient.”

There’s still un­der­stand­able un­easi­ness in the med­i­cal com­mu­nity about what role doc­tors should play in the state’s new pot in­dus­try. Ev­i­dence of that arose in the Gen­eral As­sem­bly’s leg­isla­tive ses­sion a few months ago. State Rep. Doug House, con­cerned doc­tors would be un­com­fort­able deter­min­ing what the po­ten­tial ef­fects of mar­i­juana might be for their pa­tients, in­tro­duced a bill to elim­i­nate the re­quired dec­la­ra­tion about po­ten­tial ben­e­fits and risks. That’s now law and the only re­quire­ment for doc­tors is to ver­ify

a pa­tient has one of the qual­i­fy­ing con­di­tions. In a re­cent North­west Arkansas

Demo­crat-Gazette story, some physi­cians still ex­pressed hes­i­ta­tion, and who can blame them? Arkansas’ voter-cre­ated med­i­cal mar­i­juana sys­tem, when com­pared to pre­scrib­ing fed­er­ally ap­proved phar­ma­ceu­ti­cals to a pa­tient, has about as much pre­ci­sion as us­ing a globe to give a mo­torist di­rec­tions to get from Dick­son Street to Ra­zor­back Sta­dium in Fayet­teville.

Doc­tors give pa­tients pre­scrip­tions that are lim­ited by both time and dosage, re­quir­ing their re­turn for ad­di­tional eval­u­a­tion to mon­i­tor the medicine’s ef­fects. With med­i­cal mar­i­juana, the doc­tor’s role ends once he de­clares the pa­tient has a qual­i­fy­ing con­di­tion. And there will be no as­sur­ance, as there is with FDA-ap­proved drugs, that mar­i­juana sold one day has the same po­tency as a batch sold a week later. Or that one de­liv­ery sys­tem for mar­i­juana will have the same ben­e­fits as an­other. Pa­tients can spin the reefer roulette wheel.

We’re not ar­gu­ing against med­i­cal mar­i­juana. The pub­lic made that de­ci­sion, and so be it. But no one should equate the pre­ci­sion of the doc­tor/phar­ma­cist/drug man­u­fac­turer/FDA sys­tem to the, shall we say, laid-back busi­ness of over-the­counter pot dis­pen­saries.

Ad­vo­cates for med­i­cal mar­i­juana hope fam­ily doc­tors will get on board. One called it a “tragedy” if they won’t help pa­tients get mar­i­juana.

But physi­cians should not feel pres­sured to par­tic­i­pate if they don’t want to be­come part of a po­lit­i­cal, not med­i­cal, cre­ation. There will be doc­tors who em­brace a role in get­ting their pa­tients mar­i­juana. One de­scribed it as “le­git­i­mate health care.” Other physi­cians should not feel obliged to rec­om­mend some­thing they’re un­com­fort­able with when they feel an obli­ga­tion for the care of their pa­tients just as strongly as a doc­tor who will sup­port med­i­cal mar­i­juana.

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