Thursday, September 6, 2012

"Medical" Marijuana and Prescription Monitoring

Having run state prescription monitoring program reports on a few patients who report use of "medical" (Yes, I'm skeptical.) marijuana I wonder what should prevent the drug's inclusion. If the law requires pharmacies to report dispensing drugs from Schedules II-V, how hard could it be to require marijuana dispensaries to report this Schedule I drug? The same justification holds.

Physicians need to know what other physicians have prescribed, including marijuana. I certainly want that information about what my patients take, just as I want to know who prescribes what other controlled substances for them.

Marijuana should have a legal status similar to that of alcohol and tobacco, neither of which is scheduled despite the obvious danger and harm associated with them. Nobody talks about "medical tobacco." Leave us doctors out of it. But as long as doctors can authorize its use we should see it in monitoring reports along with oxycodone and alprazolam.


  1. Agree completely - especially with the examples that you have given. I think that part of the problem is that in some states after you get the permit to use medical marijuana there are no standardized dispensing practices and the permit that you have to use it does not necessarily mean that anything is being regularly dispensed to you. There is also the problem of dispensing a Schedule I drug - given the definition of that category.

  2. This reminds me of a long time ago when the Thought Broadcast pdoc, Steve Balt, would have patients with medical marijuana. When he would try to coordinate care with the marijuana docs, they either didn't call him back or they would and tell him how shocked they were that he was actually trying to coordinate care with them.

    He would also tell his patients with medical marijuana to discuss their medications with their mj doc if they had any questions about mixing their weed with their medications. His patients would look totally surprised and say they couldn't do that because they only see the doc once a year.

  3. I'm not surprised Jane. Good on Steve for giving it a try. I wouldn't even bother.

  4. Jane, if Steve and I are pdocs, what do you think of calling a psychotherapist a "ptherapist?" (I think just plain "therapist" demeans the profession, aside from being to vague.)

    1. I don't think that's a good idea...because "p" stands for psychotherapist and many people don't know what that is anymore. I called one of my insurance companies for a referral for therapy. The woman on the other line asked, "What kind of therapy? respiratory?..." I replied, "Psychotherapy." There was a long pause on the other end of the line and she asked, "Is that like counseling?"

      And she wasn't the only person to not know what that word means. I've actually learned that I have to tell people that I see a therapist instead of a psychotherapist because they get a confused look on their faces and I have to explain that I get counseling from a therapist.

      I think it's the word "psycho" that throws people.

    2. That's the opposite of what I would expect, but we have to choose whether to cave in to ignorance, or fight it (and stigma). Think of all the people you have and can educate(d)! Psychotherapy is so much more than counseling.

      But maybe we should just use ptherapy (ist) among us cognizants.