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.