Marijuana use and health care

Marijuana continues to be the most widely abused drug in the United States. The arguments for and against the legalization of marijuana continue to grow. This article is not intended to set the stage for a debate on the legalization of marijuana. Instead, I want caution from professionals whose patients in their care test positive for marijuana. The use of marijuana is still prohibited by federal law, and patients who self-medicate or abuse marijuana should not receive controlled Edibles.

Unfortunately, many physicians are often faced with the dilemma of prescribing or not controlling substances to patients who test positive for marijuana. This is particularly the case in states that have amended state laws to legalize marijuana. These changes in state law do not change the federal guidelines that doctors must follow. As a former career DEA agent, I remind doctors that marijuana remains a Schedule I illegal controlled substance with no accepted medical use in the US The fact is, all state laws have federal oversight, such as it is established in the Clause of Supremacy of the Constitution. “The Supremacy Clause is a clause within Article VI of the United States Constitution that dictates that federal law is the supreme law of the country. Under the doctrine of preference, which is based on the Supremacy Clause, the law federal prevails over state law, even when the conflict of laws. ” (one)

When a doctor realizes that a patient is using marijuana, alternative methods of therapy should be implemented in addition to prescribing controlled substances. Doctors must also take steps to refer the patient for treatment and to quit smoking if any illegal drug use, including marijuana, is revealed. Doctors should also keep in mind that the marijuana produced today is much more potent than the past, and that the use of high potency in conjunction with controlled substances is not safe for patients.

Is there FDA approved medical marijuana? There are two FDA-approved drugs in the US that contain a synthetic analog of THC (tetrahydrocannabinol), which is the main chemical (cannabinoid) responsible for the psychoactive effects of marijuana. A synthetic version of THC is contained in the FDA-approved medications Marinol (Annex III) and Cesamet (Annex II) that are prescribed to treat nausea in cancer patients receiving chemotherapy. Marinol is also prescribed to stimulate the appetite of patients with cancer and anorexia (2). Currently, the FDA is monitoring trials with Epidiolex (3), a drug made by GW Pharmaceuticals and developed to reduce seizures in children. The drug contains marijuana cannabinoids, known as cannabidiol, or CBD, which does not contain the psychoactive properties of traditional marijuana and does not produce a halt. If this drug receives FDA approval, its history would be the first approved CBD-containing drug in the U.S.

Additionally, the DEA has issued a special registry for a research laboratory at the University of Mississippi to grow various strains of marijuana for clinical trials (4). This research will continue, but as of this writing, ingesting or smoking botanical marijuana or the cannabis plant itself is not federally approved as an accepted medical treatment in the US Patients who smoke or ingest marijuana should be aware that they are violating federal law and could be prosecuted under federal statutes. Additionally, physicians must conduct tests for marijuana use and, if detected, must not prescribe controlled substances, regardless of the patient’s diagnosis and symptoms, according to applicable federal statutes.