Doctors Warn About Prescribing Medical Marijuana

Doctors Warn About Prescribing Medical Marijuana

Many adults with chronic pain use medical marijuana to relieve their symptoms, but marijuana is not a good treatment option for teens who suffer from pain, according to researchers at the Mayo Clinic.

“The consequences may be very, very severe, particularly for adolescents who may get rid of their pain — or not — at the expense of the rest of their life,” says J. Michael Bostwick, MD, a Mayo Clinic psychiatrist who co-authored a commentary in the July issue of the journal Mayo Clinic Proceedings.

Bostwick says there have been few studies on the pros and cons of adolescents using medical marijuana. While medical marijuana may help improve appetite and relieve pain, its adverse effects can include fatigue, impaired concentration and slower reaction times.

marijuana-smoking1-293x300The researchers described the cases of three high school students at the Mayo Clinic’s pediatric pain clinic who said they used marijuana regularly. Pain worsened for all three teens despite their marijuana use. None attended school full time, and they reported impaired functioning and difficulty being socially active.

Marijuana use before age 16 has been linked to psychosis and smoking marijuana more than once a week has been connected to persistent cognitive damage in adolescents. About 1 in 10 marijuana users become addicted and people under 25 are more susceptible to addiction, according to Bostwick.

“If you’re a pain patient, and you’re using this drug or others, narcotics as well, one of the side effects is to be ‘out of it’ when the goal of a pain rehab program is actually to get you into it,” Bostwick says. “The whole point is function restoration, not further functional decline.”

“If you will not work on your life until your pain is gone, then you’re probably going to be stuck for a very long time, because the kinds of chronic pain that show up in pain clinics tend to not ever completely go away. They tend to be managed. People have to learn to get on with their lives even despite the pain.”

Bostwick recommends that physicians screen their teenage pain patients for marijuana use, and offer them alternative treatments, such as biofeedback, acupuncture and physical therapy.

That view was echoed in a recent commentary by Gerald Aronoff, MD, past president of the American Academy of Pain Medicine, who is wary of prescribing medical marijuana to any pain patient — whether a teenager or adult.

“Even if marijuana were 100% legal, I would still have qualms about its use in patients with chronic pain,” Aronoff wrote in Pain Medicine News.

“This is especially true in settings that require their complete attention, alertness, and mental acuity, as is always true while driving and frequently true at the workplace. The use of marijuana by patients in these situations also may put the prescriber and his or her medical practice at increased risk for adverse outcomes.”

In his own practice, Aronoff says he requires a urine or oral drug screen for all new pain patients, and then conducts tests randomly. If marijuana is detected, he refuses to write any new prescriptions for the patient for controlled substances, including opioid analgesics.

“From a risk-management perspective, it is foolhardy to continue writing opioids for patients known to be using/abusing marijuana or other substances deemed to be illegal,” said Aronoff.

“In the event that the patient in question has a work accident or motor vehicle accident in which there is an injury or death, the clinician writing the prescription for the controlled substances with full knowledge that the patient was abusing an illicit drug capable of causing mental status changes, judgment, and perceptual problems would be in a position that is difficult to defend. The physician could potentially be held liable.”

Not all doctors feel that way. A recent survey by the New England Journal of Medicine (NEJM) found that most physicians would be willing to prescribe medical marijuana to ease the pain of an older woman suffering from advanced breast cancer.

The online survey, published in the May 30 edition of the NEJM, found that 76 percent of the 1,446 doctors who responded would give the woman a prescription for medical marijuana.

Voters in Washington and Colorado voted last year to decriminalize marijuana. Medical marijuana is legal in 18 states and the District of Columbia.

Authored by: Pat Anson, Editor

There are 14 comments for this article
  1. Lynda B. at 7:22 pm

    I think medical Marijuana should be approved in all states. Ireally is a good pain relever

  2. La.la at 4:28 pm

    I agree with all the comments who talk and replyt this quote “If you will not work on your life until your pain is gone…”

    We are the same people, just free … In our minds, in our souls, and our bodies…. So we can do whatever we want, but HIGH IS MUCH BETTER!

    Kiss

  3. Kathy K at 7:04 am

    As a 20 year sufferer of Fibromyalgia and Ostioarthritis I have taken all of the prescription drugs the doctors wanted me to. I got to a point where my mind was no longer my own. I over dosed on the meds I was on and almost died.
    At that point I decided to detox and smoke and eat Medical Marijuana.
    I’m now Licensed to do so and I am not pain free but I do manage my pain much better and sleep better, have a lot less nausea. Marijuana helped me to quit smoking cigarettes. It took me 3 years to clear the pharmaceuticals out of my body and brain. I was still able to go to work every day and put in a full day for 24 yrs. I live a good holistic life. I don’t go through my day feeling like I’m addicted and got to have a fix. My body lets me know when it’s time to medicate. If I eat too much or smoke too much (which I don’t) then I pop a vitamin C or take a nap.
    Doctors really need to get it together and listen to their patients. OXY’S KILL….I see my family and friends die from cigarettes and alcohol which is so much worse for us than Marijuana. My fear now is that the government is charging such an outrageous amount for our medicine that someone that has to have a higher prescription to cook with it won’t be able to afford their prescription.
    We are suppose to be living in a free country ….Marijuana is a weed… I say the government should release offenders…let the weed be a weed….and let us decide for ourselves whether or not Marijuana is our medicine and we should be able to grow our own medicine in our own gardens with the rest of our vegetables and herbs without the government sticking their hands in our pockets.

  4. Krymsun at 6:30 pm

    Which approach will help keep marijuana out of the hands of minors, prohibition or legal regulation?

  5. Esoteric Knowledge at 3:24 pm

    It’s really disturbing that these doctors are lying to the public. Sure you shouldn’t be balancing on a wire while intoxicated, but marijuana does not cause psychosis or cognitive damage. The hidden prejudice is the motivation of these doctors: “If you will not work on your life until your pain is gone…” The threat is individuals relaxing and while relaxing, they will think. The doctors try to paint this discriminated class as lazy and stupid, just like many feared minority classes before. The individuals who put this out to the press are bolstering a system that violates the rights of the population; which does not allow marijuana users employment; which does not allow the same rights, respect and medical care as non users, as the doctor has admitted; so they must use lies and poor excuses to hide their discriminating, prejudice, irrational, criminal and immoral activities. The only one exhibiting poor judgment and perceptual problems is Gerald Aronoff, MD.

  6. Dennis Kinch at 2:42 pm

    Here we go again. Can you even hear yourself? The stigma of the “killer weed” goes on and so do the agenda ridden, so-called experts. The vast majority of people in pain say that pot helps their pain. You quote the ways in which it does, then bring up ridiculous reasons it’s bad. Grow up! The Nixon, J. Edgar days are gone. Someday soon marijuana will be legal everywhere and our grandchildren will laugh at our ignorance and puritanism, all in the name of saving us from ourselves.

    Everyone wants to preserve our painful lives and give us longevity but again I say, “I would rather live happy and productive and have a decent quality of life, then die from some side effect, rather than live another ten years in bed, riddled with pain. Get over yourself! You’re not helping. Why don’t you try researching the numbers with the agenda of helping people in pain. You will be amazed at how large the vast majority is. Remember freedom? We are so far behind the rest of the world, in medicine and freedom, and these reports only push us backwards.

    Hey, why don’t you do some research with the agenda of getting the thousands of people out of prison, some sentenced to life because of the outdated pot laws. You’re trying to do what your bosses will like, not what people in pain would like. For that, it takes guts. If I die from pot or opioids or getting hit by a bus tomorrow, I will consider myself a necessary casualty in the fight for getting pain medicines to the people who need it. That is my agenda.

    By the way, I don’t use marijuana, but I would die defending those in pain their right to make that choice.

  7. Annie at 12:17 pm

    Any medicine that is abused can be a bad thing. I have chronic pain and would love the option of medical marijuana. Not for use all day and night, but for use when I have a bad flare and the pain is so bad I cannot sleep and have a hard time functioning on a basic level. I take opioids and am prescribed enough to take multiple times everyday but I don’t do that. It doesn’t make sense to do that to your body and it makes the meds ineffective. I also don’t want a DUI in case I ever got into a car wreck. Medical marijuana is like other things – to be used responsibly.

  8. pete at 10:29 am

    Although what they say are lies, with their many assurances, it will become the truth.

    There is no 1 ‘marijuana’ devoted growers helping patients control pain symptons have developed strains of marijuana that have no THC the part that creates the high, injested orally through a tincture or oil, Without lethargy or impared concentration

  9. Maddie at 10:06 am

    As someone who lives in constant pain and is only slightly out of the age range investigated I will say that in the past it has helped me WAY more than my Vicodin/Tramadol cocktail ever has. Reports like this make me sad to see how invested big pharma is in their own personal gain rather than the well-being of others. Medical marijuana is not for everyone, it is not a cure-all, it is however some individuals best shot at living their lives the best they can.

  10. Carolyn mayo at 6:56 am

    One word…dosage! You do not need to be wasted to benefit from Cannabis! I am a professional living with terminal cancer, along with all the side effects. You only need a drop of oil to CURE many cancers, seizures, shaking from neuro problems,and… too many to mention! One hit of this medicine is enough to create miracles! Get on with your life, said like a true pain sufferer…NOT! You cannot put this wonder in the gutter! People will overdose and abuse their pharmaceuticals in the same way! So get off your HI HORSE…AMA…you will not win this one..>>>Alternative medicine is the way of the future! Get ready WallStreet…dump your Pharmaceutical shares…I’ve worked for 20 yrs to promote natural remedies! So go talk to your overdosers of PHARMACEUTICALS are guilty of the same.

  11. jonathan woodruff at 6:38 am

    medial marijuana is not for children nor everyone.. ,but to say adult’s can not tell me an adult it doesnt cure my pain & i’ve been free of opiods for years srry .but it is for some ,but not everyone …….

  12. ted at 4:10 am

    this is bs, im 20 and not addicted, smoke basically every day and have a pretty good reaction time

  13. Shana N. at 10:49 pm

    “Get on with their lives”….SMH! That comment really irritates me.

  14. Deb Gotto at 9:20 pm

    They would rather keep poisoning us with big drug company drugs. Stupid with all the studies of the positive things that come from marijuana and its derivatives. Another case of a way to big government that allows alcohol which does major damage to individuals and families but makes it a felony to use marijuana.