Q&A with Medical Society president on medical marijuana
We wanted to have a very limited and narrow scope for this legislation because we believe that therapeutic cannabis is an unproven therapy. Studies have not been done to confirm that this would be a useful intervention or to say it would not be a useful intervention. We thought for some people with life-threatening illnesses that were not responding to treatment that this might be something worth considering. We're very concerned about the risk of diversion and the message we send to the children and adolescents of New Hampshire about cannabis. We wanted to make sure we did not send a message that it is a safe product to be used in a recreational way.
We played a very active role in getting the scope narrowed; the biggest example is post-traumatic stress disorder, where there is some evidence that cannabis can be disruptive to appropriate treatment.
They are not. When I write a prescription, I've made a diagnosis, I look at FDA-approved therapies and I prescribe a medication that is approved by the Food and Drug Administration. This allows the doctor to certify that (the patient) has that condition. The patient then takes that certification to a dispensary, which can dispense to a person who has a certifying diagnosis.
It is somewhat concerning; there is lot of question of how it will play out in practice, We in the medical society are going to work with the Board of Medicine and work with the Drug Enforcement Administration to understand what is legally appropriate, but also what is morally and ethically appropriate for our providers within the scope of the law and actually do the right thing for our patients.Can a doctor be a conscientious objector and say, "No, I'm not doing that.'"
I think they could. In the same way that some doctors choose not to prescribe birth control, some doctors could decide not to certify certain diagnoses.Will continuing education be recommended or required for physicians about what to do when someone comes in looking for a diagnosis that will allow use of medical marijuana.There is nothing required in the legislation, but the Medical Society is going to work very aggressively to make sure we have information out to the physicians of the state. It is a critically important issue that physicians do it right, and we want to make sure they have the right information to make the best decisions when they are with their patients.
Smoking marijuana is clearly bad for people's lungs. If I had a patient certified for a diagnosis, I would recommend against smoking it unless they had no other way of getting it into their system.
There is a medicine that is a purified form of THC — it is called Marinol — to help stimulate appetite in people with wasting disorders like HIV/Aids. It is something that we've been able to prescribe for a number of years. We have argued that (Marinol) probably would have been a better route than to legalize an unproven therapy, but there was political will in the state that it was going to pass. If (medical marijuana) was going to be a therapeutic option in the state, we wanted to minimize the risk to people.
No. We were very upfront that we didn't think moving forward with therapeutic cannabis was the right thing, but we followed up with, "If you are going forward, these are the things that we think will make your bill better." We did not keep silent on things we cared about.
That certainly is a risk, and I think the Legislature decided this is a risk we're going to have. I do hospice and home calls (for terminally ill patients) and we have excellent medications to treat their pain and to keep them comfortable in the last days, weeks or months of their lives when they have a terminal illness. I don't believe we need an additional therapy of marijuana. I'm open to having more research on this, but don't think we should be having research done on patients in New Hampshire in an uncontrolled fashion.
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