Physicians want robust studies on medical marijuana use
January 4, 2016 12:00 AM
Eric Risberg/Associated Press
In this photo taken May 13, 2009, marijuana grown for medical purposes is shown inside a greenhouse at a farm in Potter Valley, Calif.
By Steve Twedt / Pittsburgh Post-Gazette
Pittsburgh may be ready to decriminalize marijuana for recreational use, but a new survey suggests local physicians hold widely varying views when it comes to their willingness to prescribe marijuana for medical use, even if it were legal.
Of the 97 physicians responding to a recent Allegheny County Medical Society survey about half said they would prescribe and half said they wouldn’t, although some who opposed noted that prescribing marijuana would not apply to their specialty.
“More research is required,” one unidentified physician wrote in comments attached to the survey.
“It is utterly ridiculous to do anything other than legalizing and regulating it like we do alcohol and cigarettes,” said another who supports legalizing medical marijuana use.
“We don’t need any more active addicts in society,” observed a third, who nevertheless added they’d be willing to prescribe if randomized clinical trials showed marijuana’s benefits for specific medical conditions.
John Krah, executive director at the county medical society, a professional association of physicians, said the results show “that physicians would like to be compassionate for the patient who believes that using this will help them.
“But I think it also shows there are concerns that there are not a lot of scientific studies they consider to be at a level that we evaluate other drugs.”
Taking a stand on medical marijuana use might be easier if every discussion that mentions “marijuana” didn’t carry heavy political, social and cultural baggage.
Anguished parents testify to its powers to disrupt their child’s unrelenting seizures; the U.S. Drug Enforcement Administration groups it with heroin and LSD as Schedule I drugs “with no currently accepted medical use and a high potential for abuse.”
“Whenever you’re dealing with drug misuse, you bring in people’s value systems,” said William Johnjulio, the Allegheny Health Network’s system chair for family medicine and a medical society board member. Some will oppose on moral grounds, he said, while a successful corporate executive may think it’s no big deal.
What’s lacking, say many physicians, is solid scientific evidence of both its benefits and its risks.
Although 23 states and the District of Columbia have medical marijuana and cannabis programs, the laws are not consistent from state to state, Dr. Johnjulio said, “so there isn’t a standard that physicians can look at across the country.”
Adele Towers, associate professor of medicine and psychiatry at the University of Pittsburgh, thinks “the vast majority” of pain specialists and oncologists would support legalizing medicinal use of marijuana “if studies would support its use.” But she said the U.S. has lagged behind Israel, Canada and other countries in studying the risks and benefits of marijuana and its byproducts for conditions such as cancer or multiple sclerosis.
So patients who believe marijuana will help them may resort to getting it by any means they can. Dr. Towers said she knows of elderly patients with chronic pain who tell her they buy marijuana on the street and smoke 1-2 joints daily to relieve their symptoms.
“Smoking marijuana is not healthy,” she said, nor is consuming edibles of unknown strength.
Instead, she said, the drug needs to be handled and monitored in a regulated manner, with controls over its strength, dosage and administration. To get there, though, she said studies need to be fast-tracked.
Members of the Pennsylvania Medical Society in October voted to ask the state to fund research on medical marijuana use, a vote that frustrated Dr. Towers. “We need to make it a national priority,” she said. “There are so many people in pain. If we have to wait for studies, we may be waiting another 10 or 15 years.”
Some of the most emotionally compelling arguments for legalization are made by parents of children who suffer dozens of seizures daily that marijuana seems to abate. But even the American Epilepsy Society has acknowledged that “we do not know if marijuana is a safe and effective treatment” and has called for “robust scientific evidence” to make the case.
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