Doctors wary of medical marijuana program

Posted July 10, 2010, at 12:33 a.m.

BANGOR, Maine — Marijuana dispensaries are a hot topic, but Maine doctors remain lukewarm about the key role they play in the state’s emerging medical marijuana program.

Many physicians are skeptical about the benefits of treating medical conditions with marijuana, and others are unclear about the implications of recommending a drug that remains illegal for nonmedical use. Physician skepticism and ambivalence may prolong patients’ inability to legally obtain a drug they say brings them significant relief.

Dr. John Woytowicz of Augusta says marijuana’s effectiveness in relieving pain, nausea and muscle spasms is well-established. For the past decade, Woytowicz has provided the documentation his patients have needed to legally possess small amounts of marijuana under Maine’s previous law. But that law didn’t help patients obtain marijuana, leaving them either to grow their own or purchase it from illicit dealers.

“The dispensaries are a great feature,” Woytowicz said Thursday. “People are going to feel much more comfortable because they don’t have to do anything illegal.”

But patients can purchase from the dispensaries only if they sign up with the state’s program, and that includes getting a doctor’s certification. Woytowicz said many doctors are hesitant to participate in the program.

Some have concerns about the possibility of running afoul of federal law if they prescribe the use of a drug that not only does not have the endorsement of the Food and Drug Administration but that also remains illegal under federal statutes, he said. Other doctors doubt the effectiveness of marijuana over mainstream pharmaceuticals, or fear that their practices will be overrun by drug-seekers if it becomes known they’re willing to certify patients for the program.

But if doctors cultivate good relationships with their patients, use good clinical judgment and keep careful documentation, he said, marijuana can provide an important alternative to prescription drugs.

Dr. David McDermott, president of the Maine Medical Association and director of emergency services at Mayo Regional Hospital in Dover Foxcroft, said many physicians do not understand how the new medical marijuana program works or what their obligations are.

The medical association, which neither endorses nor opposes the use of marijuana, has held several physician education programs around the state that have been well-attended. But that doesn’t mean doctors will decide to get on board, McDermott said.

“The law does not obligate physicians to prescribe marijuana for their patients,” he said.

In Bangor, Dr. Erik Steele, chief medical officer for Eastern Maine Healthcare Systems, said he is unaware of any decision about the organization’s member hospitals, physician practices or individual doctors participating or not participating in the medical marijuana program.

“I know the debate is going on, but I know of no decision that has been made,” he said.

Steele, a practicing emergency room physician, said some patients recently have asked him to certify them for the marijuana program. “I’m struggling with it,” he said. “I’m not sure it’s a good thing.”

For patients nearing the end of life who find that marijuana relieves their pain and nausea, he said, he would be more comfortable.

But for chronic disorders, he said, “I would probably rather you used other treatment.”

Steele predicted it would take at least a year for most Maine physicians to make an informed decision about whether to participate in the new program.

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