In the 21st century, cannabis has seen inroads as a medicine for a variety of illnesses. Though more research is available to reinforce the medicinal potential of cannabis, physicians in the United States remain largely in the dark about marijuana and its medical uses.
People are more curious than ever about marijuana as medicine, so it may come as a shock for many to find that their doctor is unlikely to know anything about the plant or its therapeutic benefits.
A June 3, 2019 op-ed by Stanford University School of Medicine resident physician Dr. Nathaniel Morris, published by the Journal of the American Medical Association (JAMA) documented a growing disparity of medical marijuana awareness between American doctors and their patients. Based on recent statistical evidence and his anecdotal experience as a physician, Morris concluded that most doctors are woefully uneducated on the biochemical effects, legality, and current clinical research associated with marijuana, especially in comparison to the ever-growing pool of American patients who use medical cannabis.
Among the research cited by Morris was a 2016 survey that found 85% of physician participants reported having no marijuana education in medical school, and a 2017 study which found that 38% of a pool of 51 resident physicians didn't know that marijuana is still a Schedule I drug under the Federal Controlled Substances Act, meaning that the government considers the drug to have no medicinal benefits and a high potential for abuse.
Current research has identified cannabis as an effective treatment for post-traumatic stress disorder (PTSD), fibromyalgia, arthritis, and even cancer. The pathway to treatment is often through the endocannabinoid system (ECS) — the body's receptors, lipids, and enzymes that interact with cannabis compounds and help maintain internal balance and regulate several bodily functions. There's also no shortage of research to back up the theory that many illnesses may arise from cannabinoid deficiencies and thus are treatable with marijuana.
According to Dr. Bonni Goldstein, Medical Director of Canna-Centers, a medical marijuana evaluation service in Lawndale, California, and a medical adviser to Weedmaps, dysfunction of the endocannabinoid system is “scientifically proven as the root cause of many illnesses,” which in turn makes access to cannabis medicine “a right that should not be politicized.”
Goldstein also noted that when doctors say there is not enough research to support the prescription of medical marijuana, most of them are unaware of the abundance of research on medical cannabis, especially for common ailments. Many studies are easily accessible on Google Scholar and PubMed.
“Unfortunately, most doctors know nothing about cannabis as medicine or about the endocannabinoid system. There is no formal education about these topics in the majority of medical school or residency programs,” Goldstein told Weedmaps News in a report about disclosing cannabis use to doctors from June 23, 2019. “Only about 9% of medical schools even mention cannabis as medicine in their curriculum. And the reality is that we as doctors are taught that cannabis is a drug of abuse.”
The statistic Goldstein cited comes from a 2017 survey of 101 U.S. medical school curriculum deans, 258 residents and fellows, and the Association of American Medical Colleges (AAMC) Curriculum Inventory database, found a “fundamental mismatch between state-level legalization of medical marijuana and the lack of preparation of physicians-in-training to prescribe it.”
In other words, medical schools continue to lag behind both public perception and state-level legislation in medical cannabis advances. As a result, patients are left to rely on a pool of underinformed physicians who may be averse to cannabis, particularly after decades of systemic bias in the medical community.
Gradually, however, physicians and pharmacists are learning more about cannabis as medicine. According to a survey in a study from the University of Pittsburgh School of Pharmacy, 62% of U.S. pharmacy school respondents reported that they include medical marijuana in their doctorate of pharmacy curriculum. The study, which was published in the January 2019 issue of the journal Currents in Pharmacy Teaching and Learning, also found that 23% of the participants who hadn't incorporated cannabis in their curriculum had plans to do so in the next 12 months.
As patients continue to seek information on medical cannabis, Goldstein recommended that patients who are interested in using medical cannabis first ask their physicians how they feel about medical cannabis. Goldstein also recommended consulting, where possible, a cannabis specialist who can give more specific advice about cannabinoids, product, and dosing.
“If you are asking your physician for medical cannabis advice, you will likely be disappointed as, again, most don't know anything,” Goldstein said. Until federal regulations and medical education undergo significant changes in how they handle medical marijuana, Goldstein said that consulting a cannabis specialist will be more beneficial than doctor visits alone, because different cannabinoids, dosing, and preparations can be discussed in detail, increasing your chances of having a positive result.
Feature image: Most physicians aren't trained to address the medical uses of cannabis. Dr. Bonni Goldstein suggests that consulting a cannabis specialist who can address dosing, preparations, and cannabis composition will be more beneficial than doctor visits alone.