More states allow it, but many doctors unprepared to prescribe medical marijuana

While many states have legalized medical marijuana, few medical schools are teaching future doctors anything about the subject.

In fact, nine out of 10 doctors say they are unprepared to prescribe medical marijuana and just over 35% say they are not prepared to answer patient questions about the drug, according to a study published in the journal Drug and Alcohol Dependence.

Medical marijuana is now legal in 29 states and the District of Columbia, but researchers at Washington University School of Medicine in St. Louis found the topic is rarely addressed in medical schools.

“Medical education needs to catch up to marijuana legislation,” said senior author and psychiatry professor Laura Jean Bierut, M.D., in an announcement about the study.

Physicians need to know the benefits and drawbacks of medical marijuana so they know whether to recommend it as a treatment for patients, she said. Given the country’s opioid crisis, doctors must look for other alternatives to treat patients’ pain.

As part of the study, researchers surveyed 101 medical school deans and more than 250 residents and fellows at the university and Barnes-Jewish Hospital in St. Louis, and examined a curriculum database maintained by the Association of American Medical Colleges.

The majority of deans (66.7%) reported their graduates are not at all prepared to prescribe marijuana, and 25% said graduates were not prepared to answer questions about the drug. The majority of residents and fellows (89.5%) said they were not prepared to prescribe medical marijuana.  

Only 9% of medical schools have medical marijuana documented in their curriculum and 85% of doctors surveyed said they received no education in medical school or residency on medical marijuana.

“As a future physician, it worries me,” said co-author Anastasia B. Evanoff, a third-year medical student, in the announcement. “We need to know how to answer questions about medical marijuana’s risks and benefits, but there is a fundamental mismatch between state laws involving marijuana and the education physicians-in-training receive at medical schools throughout the country.” She compared it to the increased training in medical schools about the use of opioids, including the risks and benefits to patients.

And more senior doctors, who have moved beyond residency, also lack knowledge. There are no guidelines to help them treat patients and they were also not taught about the once-illegal drug in medical school. Some see medical marijuana as an alternative to narcotics, including the opioid painkillers that have created an epidemic in the country, to the extent that drug overdoses are the leading cause of injury death in the U.S.