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D.C. Doctors Not High on Medical Marijuana

Though physicians will be able to recommend the drug, doctors have concerns about side effects and federal law.

Editor's Note: This story has been updated with comments from the Marijuana Policy Project.

As early as this summer, qualifying patients in Washington will be able to receive a recommendation from a physician to make legal purchases of medical marijuana at local dispensaries. But, even if District patients are willing to buy medical marijuana, some District physicians say they are not so willing to prescribe the drug.

D.C. neurologist Marc Schlosberg said he does not plan on recommending medical marijuana because of medical marijuana's illegality under federal law, and the drug's effects, or lack thereof.

"One concern is it's not a safe way to deliver the drug because people would smoke it, and that means they're breathing smoke into their lungs," Schlosberg said. "It being illegal [under federal law] is a concern, because even if we do recommend it legally I think there will be scrutiny from the DEA for any prescription you write. Even if I recommend it for approved purposes, I think I could get into trouble."

Under federal law, the distribution, cultivation or possession of medical marijuana is still illegal. The federal government classifies marijuana as a Schedule I drug, which means it is a substance that has a high potential for abuse, with no accepted medical use.

But Morgan Fox, spokesman for the Marijuana Policy Project, said doctors have no reason to be hesitant to recommend marijuana for treating the short list of treatments approved by City Council.

"The side effects of marijuana are demonstrably weaker and far safer than many of the drugs prescribed by doctors every day," he said in an email.

"In addition, it is perfectly legal for doctors to recommend marijuana in DC regardless of its status according to federal law. This has already been established in legal precedent, and physicians in states where medical marijuana is legal have been recommending it to patients without fear of federal prosecution for over a decade," Fox said.

Washington ophthalmologist Andrew Adelson said he doesn't see himself recommending medical marijuana to patients either because of its effects on the central nervous system and the amount of times a patient would have to smoke the drug to get the desired medical effects.

"It affects your central nervous system so it impairs your ability to think, so the side effects outweigh the benefits. We have other forms of treatment that don't affect your ability to think," Adelson said. "To get the medical effect of marijuana, you have to smoke it, and you would have to smoke it every three hours about five times a day. And for my patients who aren't young — as most people with glaucoma are older — that's not something they usually want to do."

Adelson said instead of recommending medical marijuana, he will continue to use other treatments that are more effective, such as eye drops, laser surgery and operating room surgery.

Qualifying patients must be District residents who are diagnosed with medical conditions that include HIV/AIDS, cancer, glaucoma and multiple sclerosis.

"The doctors I have spoken to about this have told me they would not have any problem recommending marijuana for serious illnesses, but like good physicians, they would like to see more research," Fox said. "Hopefully, being able to witness the benefits of marijuana firsthand in the nation's capitol will convince skeptical lawmakers and obstructionist federal agencies to stop interfering with that research."

Edward Shanbacker, executive vice president of the Medical Society of the District of Columbia, said from discussions with local physicians, he thinks the number of physicians who think medical marijuana is appropriate for patients is very, very small.

"There are 9,000 licensed physicians in the District of Columbia, and somewhere in that cohort of 9,000 there may be somebody who supports marijuana for medical use," Shanbacker said.

He said there are two aspects that may be affecting physicians' decisions: legal and clinical.

"These physicians are literally on the front yard of the Department of Justice, so there's the aspect of being in violation of federal law. And, if there are physicians who think clinical marijuana is appropriate in the District, they are waiting for government entities to weigh in first," Shanbacker said.

Kevin Sterling April 23, 2012 at 11:35 AM
It is good that ignoramuses like Dr. Schlosberg won't recommend medicines of which they have no understanding. Smoking is not required to gain the benefits of cannabis, whether for medicinal need or just for enjoyment. Any potential health hazards due to smoking are not the hazards of cannabis, but of smoking. Vaporization is proven safe,  less expensive, and preferred by a margin of 7:1 in peer reviewed research published in 2007. http://www.cmcr.ucsd.edu/index.php?option=com_content&view=article&id=149:vaporization-as-a-qsmokelessq-cannabis-delivery-system&catid=41:research-studies&Itemid=135
Kevin Sterling April 23, 2012 at 11:52 AM
It's also reasonable for doctors to be concerned about whether they would be in compliance with Federal law, but like those States that worry about the absurd proposition that State employees might be prosecuted for the mundane day to day administration of medicinal cannabis patient protection laws this concern has been put to bed by the Federal Appellate Courts. This particular concern was put to rest in Conant v. Walters. (9th Cir 2002) 309 F.3d 629, (cert denied Oct. 14, 2003). Physicians have a First Amendment right to discuss medical marijuana with their patients, but not to help them obtain cannabis for medical use. http://www.chrisconrad.com/expert.witness/conant.htm Dr. Shanbacker is either incompetently unaware or knowingly misrepresenting support for medicinal cannabis in the medical community. If the former he should inform himself; if the latter he should be run out of town on a rail. The more accurate statement of fact is "“There are 9,000 licensed physicians in the District of Columbia, and somewhere in that cohort of 9,000 there are going to be physicians who will kowtow to the medically ignorant representatives of Federal law enforcement.” Drs. Schlosberg and Shanbacker being prime examples of such brown nosing sycophants. Is there any particular reason why Ms. Courtney only represents one side of the issue in her pathetic attempt at journalism above?
Kevin_Hunt April 23, 2012 at 03:58 PM
The American Medical Association has reported that "Results of short term controlled trials indicate that smoked cannabis reduces neuropathic pain, improves appetite and caloric intake especially in patients with reduced muscle mass,and may relieve spasticity and pain in patients with multiple sclerosis." Source: REPORT 3 OF THE COUNCIL ON SCIENCE AND PUBLIC HEALTH (I-09) Use of Cannabis for Medicinal Purposes (Resolutions 910, I-08;921, I-08;and 229, A-09) (Reference Committee K)
Therapeutic index April 25, 2012 at 02:17 AM
Dr Tashkin has shown that even smoking cannabis has no negative side effects in over 2000 patients (one of the largest smoking trials to date). Doctors who superimpose Tobacco's side effects onto to cannabis need more continuing education credits (CEC). They are the exact dead and dying doctors health care reform will wipe from practice. Too lazy to stay current but high on their "brilliantly outdated" information. Its 100 fold safer than alcohol. Why is a vicodin commission doctor even in the discussion? http://www.lung.med.ucla.edu/faculty/tashkin.htm
JH April 25, 2012 at 08:25 PM
More people high on drugs ---- just what this City needs. Doctors know there are other ways to deal with true medical requirements. The entire "make it legal" idea is wacky. More children and families will be destroyed and the doctors know it.
Kevin_Hunt April 26, 2012 at 03:51 AM
JH, how can you explain that in Portugal and the Holland, where marijuana is practically legal, the use rates for adults, teens, and children are less than they are in the U.S? Explain how doctors find other ways to deal with "true medical requirements". This statement is too nonspecific. Why is legalization "wacky"? Provide evidence that 75 years of marijuana prohibition has achieved any of its stated goals. Also, please provide scientific evidence that families are destroyed by marijuana, which is less harmful than alcohol. Thanks.
Kim A. Brolutti April 26, 2012 at 05:26 AM
I estimate that in two years thins will turn around.Have been dealing with this situation with Kaiser-perm working with a social worker we have been attempting to present abstracts, medical research and other information.She and I believe in or hearts that things will chang with our (so wonderful) doctors,Guess it will take them that long to read this new research. Wing GOR US DYING I WIsh they could get it togetrher.It is taking to long for us dying patients not to mention prevent cancer and cure types of cancer from this wonderful cannabis plant. I can't wait for this irony of how these naive, politically motivated absurdities they say now.the are not looking at medicine, just the possible legalities.It is really been and getting upsetting and makings us criminals for using a medication that has proven for thousands of years to be effective.THESE DOCTORS ARE BEING CLOSED MINDED and I am getting pissed .

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