Marijuana remains the most highly abused drug in America. The arguments for and from the legalization of marijuana continue to escalate. This piece is not intended to set the stage for a legalization debate about marijuana. Instead, I’d like caution practitioners whose patients under their care test positive for marijuana. Marijuana use remains forbidden by Federal law and patients who self-medicate or abuse marijuana shouldn’t be prescribed controlled substances.
Unfortunately, many physicians in many cases are confronted with the dilemma of whether or not to prescribe controlled substances to patients who drug test positive for marijuana. This is particularly the case in states that have modified state laws to legalize marijuana. These changes in state law don’t change the Federal guidelines that physicians must follow. As a former career DEA agent, I remind physicians that marijuana remains an illegal Schedule I controlled substance with no accepted medical use in the U.S. The actual fact remains that state laws have Federal oversight, as mentioned in the Supremacy Clause of the Constitution. “The Supremacy Clause is really a clause within Article VI of the U.S. Constitution which dictates that federal law may be the supreme law of the land. Beneath the doctrine of preemption, which can be on the basis of the Supremacy Clause, federal law preempts state law, even once the laws conflict.”(1)
When a physician becomes aware that a patient is using marijuana, alternate ways of therapy should really be implemented apart from prescribing controlled substances. Are CBD gummies suitable for kids? Physicians also needs to take steps to refer the in-patient for treatment and cessation if any illegal drug use is revealed, including marijuana. Physicians also needs to remember that the marijuana produced today is a lot more potent than the past and using high potency marijuana together with controlled substances is not safe for patients.
Can there be such a thing as FDA approved medical marijuana? You can find two FDA approved drugs in the U.S. containing a manufactured analogue of THC (tetrahydrocannabinol), which can be the principal chemical (cannabinoid) in charge of marijuana’s psychoactive effects. A synthetic version of THC is within the FDA approved drugs Marinol (Schedule III) and Cesamet (Schedule II) which are prescribed to take care of nausea for cancer patients undergoing chemotherapy. Marinol can be prescribed to stimulate the appetite of cancer and anorexia patients (2). The FDA happens to be overseeing trials being conducted on Epidiolex (3), a drug manufactured by GW Pharmaceuticals and developed to cut back convulsive seizures in children. The drug contains cannabinoids from marijuana, called cannabidiol or CBD, which doesn’t support the psychoactive properties of traditional marijuana and doesn’t make a high. If this drug receives FDA approval, it would make history being the very first approved drug containing CBD in the U.S.
Additionally, DEA has issued a particular registration to a study laboratory at the University of Mississippi to cultivate 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 U.S. Patients who smoke or ingest marijuana need to keep yourself updated that they are breaking Federal law and could be prosecuted under Federal statutes. Furthermore, physicians should really be testing for marijuana use and if detected, they need to not prescribe controlled substances, regardless of these diagnosis and the patient’s symptoms, as per current Federal statutes.