MedPharm Iowa held a ribbon cutting at their medical marijuana production facility in Des Moines on Thursday, Nov. 1, 2018.
Kelsey Kremer, firstname.lastname@example.org
‘Helping’ patients may not mean consenting to treatment with medical marijuana, Iowa Medical Society president writes
Recently, the Des Moines Register ran an article entitled, “Many Iowa doctors hesitate to help patients enroll in new medical marijuana program.” That’s absolutely true, but I think the basis for our hesitation is misunderstood. The key word in this discussion is “help.”
Remember the Hippocratic Oath that physicians take during their training: “I will do no harm.” Physicians are not hesitant to help our patients; we dedicate our entire careers helping our patients. But physicians are extremely cautious about treatments that may result in harm to our patients.
Physicians are trained as scientists, which means we approach scientific problems through a multi-step process called the scientific method. In the “medical marijuana” discussion, the one critical step in this process that physicians have found lacking is adequate research. We certainly have plenty of anecdotal observations about the medicinal effects of THC/CBD, two chemical components of marijuana. And those observations have led to plenty of hypotheses about those medicinal effects. But physicians are not easily swayed by observations or hypotheses.
The state of Iowa, through the expansion of medical marijuana law, has in essence set up a laboratory to research the hypotheses around the effectiveness of THC/CBD compounds. Problem is, we’re doing research on real patients, with little physician oversight, in uncontrolled settings, with huge potential for drug interactions, without the usual trappings of drug research, like random patient selection and double-blinding of participants.
Dispensaries have no means to verify health or medication history, which has potentially disastrous implications for patients with certain health issues. And under Iowa’s law, to obtain the drug, patients are only required to check back in with their physicians to certify their condition once per year.
Requiring physicians to certify the patient has one of the nine qualifying conditions is an implied consent for treatment with THC/CBD products — that is consent which is not expressly granted by a physician, but rather implicitly granted by a physician’s actions. Until more research evidence is available to confirm the efficacy of THC/CBD products, physicians will not consent (implicitly or otherwise) to potentially place their patients in harm’s way.
Dr. Michael Romano, MD, MHA, is a family physician and president of the Iowa Medical Society.
Read or Share this story: https://www.desmoinesregister.com/story/opinion/columnists/2018/12/06/why-iowa-doctors-leery-medical-marijuana-cannabis-health-care-dispensaries-pain-epilepsy-cbd-oil-thc/2228286002/