Patients increasingly ask doctors for guidance in using cannabis. This article, originally published in the American Journal of Endocannabinoid Medicine (AJEM) on July 12, 2023 and reprinted here by permission, discusses the current rules, regulations, and considerations for doctors when discussing or recommending cannabis to patients and removing the barriers for physicians to communicate openly with their patients about cannabis.1,2
As a cannabis lawyer, I am often asked, “When will cannabis finally be legalized?” My typical response is, “Cannabis is already legal.” Even from the standpoint of a lawyer advising cannabis companies daily, however, it can be tricky to keep up. The rules regarding cannabis vary considerably from state to state and from product to product.2,3 To complicate matters further, we have 2 parallel cannabis legal regimes in the forms of “marijuana” and “hemp,” each of which is governed by entirely different rules. Marijuana remains illegal at the federal level, whereas hemp is lawful.4
Despite the thicket of overlapping, confusing, and conflicting state and federal laws regarding cannabis, an adult consumer can easily and legally purchase a wide array of cannabis products—from cannabidiol (CBD) cosmetic creams to delta-9-tetrahydrocannabinol (THC) gummies to high-potency cannabis flower—online and in shops in almost every city in the country. The only difference is that cannabis consumers in North Carolina (where medical marijuana remains illegal) purchase “hemp” THC gummies, whereas consumers in California (where adult-use marijuana is lawful) purchase “marijuana” THC gummies.5 Although this provides legal fodder for lawyers, the reality is that these 2 products are similar, and usually identical, in their physical characteristics. The cannabis market is open for business throughout the United States.
The recent and widespread availability of a vast array of cannabis goods poses a unique challenge to physicians, whose patients are consuming these products at an accelerating rate. Patients often seek advice and recommendations from a trusted source intimately familiar with their medical history.1,6 In addition to keeping up with a rapidly evolving market and the numerous scientific studies regarding cannabis compounds that inform their health recommendations, physicians must also navigate both federal and state regulations and understand the legal distinction between “marijuana” and “hemp” to best advise their patients and stay within the bounds of the law. To add to their responsibility, medical providers must respond to patients’ requests for “quality” products. The task can be daunting in an atmosphere of rapid change, novel discoveries, and creative product development.6
Although the cannabis legal landscape is complex and evolving, there are some general principles physicians should consider when considering how to address patient questions about cannabis.
Increase Physician Patient Communication
First, removing the barriers for physicians to have an open line of communication with their patients about cannabis is essential. Physicians must create an atmosphere where patients can be open and honest about their cannabis use. Many patients already use cannabis products but may not disclose this information to their health care providers because they are concerned about their physicians’ reactions. By establishing an open line of communication, physicians can ensure their patients are using cannabis safely and effectively, and they can also identify potential adverse effects or drug interactions.1,6
Once the conversation is started, physicians need to be knowledgeable about the latest research on cannabis and its medical uses. Physicians should also be prepared to discuss the potential risks and benefits of cannabis use with their patients and make recommendations based on their patients’ medical histories and conditions.
https://cannabusiness.law/cannabis-and-patient-care-in-a-rapidly-changing-environment/
