Medical marijuana poses dilemma for docs

Medical marijuana is now legal in 23 states and counting, but physician attitudes toward the idea of pot as medicine remain mixed.

In a recent column for the Indy Star, Richard Feldman, M.D., director of medical education and family medicine residency at Franciscan St. Francis Health in Indianapolis, described his personal dilemma. "I struggle with the issue of legalization of marijuana," he wrote, "knowing what I know as a physician, but understanding the problems associated with its continued status as an illegal drug."

Meanwhile, patients appear to be welcoming of marijuana as a treatment option for a number of maladies. According to a June survey conducted by Cambridge-based patient network PatientsLikeMe, 74 percent of respondents said medical marijuana was the best treatment for their malady, the Boston Business Journal reported.

The survey, which garnered 219 responses out of 1,288 invitations, is one of the first to gauge how people using medical marijuana feel about the drug. Respondents were using smoked, edible or vaporized marijuana to treat multiple sclerosis, fibromyalgia, depression, pain, muscle stiffness, insomnia and anxiety. Most patients (86 percent) reported no or mild side effects and few were concerned with long-term side effects such as lung damage. More than a quarter (26 percent), however, said they were somewhat or very concerned with the legal problems associated with the drug, which is still illegal at the federal level.

For doctor's offices authorized by individual states to approve medical marijuana for patients, business has been good. MMJ Physician Practice in Salem, Massachusetts, for example, has certified more than 200 patients for the drug since opening in December. Owner David Rideout, M.D., a retired emergency physician, told the Salem News he strategically set up his practice near the site of the state's first dispensary, which opened last month. He currently evaluates about 20 patients for certification--a one-hour process--per week and expects the increase in traffic to continue.

While Rideout said his decades of seeing patients in emergency departments equip him to take a sound history of many walk-in patients without typically consulting their primary care physicians, the Massachusetts Medical Society (MMS) has reiterated its concerns about a practice whose sole purpose is to offer one form of treatment. A practice that only certifies medical marijuana patients "erodes, if not skirts entirely" the ongoing relationship provision, Richard Gulla, a spokesman for the MMS, told the newspaper, and "has the potential for abuse."

To learn more:
- read the article from the Salem News
- see the story from the Boston Business Journal
- see the column from the Indy Star