Marijuana continues to be probably the most highly abused drug in America. The arguments for and from the legalization of marijuana continue steadily to escalate. This piece isn’t designed to set the stage for a legalization debate about marijuana. Instead, I’d like caution practitioners whose patients under their care test positive for marijuana. Marijuana use continues to be forbidden by Federal law and patients who self-medicate or abuse marijuana shouldn’t be prescribed controlled substances.
Unfortunately, many physicians tend to be faced with the dilemma of whether or not to prescribe controlled substances to patients who drug test positive for marijuana. This is specially the case in states that have modified state laws to legalize marijuana. These changes in state law don’t change the Federal guidelines that physicians must follow. As a former career DEA agent, I remind physicians that marijuana continues to be an illegal Schedule I controlled substance without accepted medical use in the U.S. The very fact remains that most state laws have Federal oversight, as previously mentioned in the Supremacy Clause of the Constitution. “The Supremacy Clause is really a clause within Article VI of the U.S. Constitution which dictates that federal law is the supreme law of the land. Under the doctrine of preemption, that is based on the Supremacy Clause, federal law preempts state law, even when the laws conflict.”(1)
Each time a physician becomes aware a patient is using marijuana, alternate ways of therapy must be implemented besides prescribing controlled substances. Physicians should also take steps to refer the patient for treatment and cessation if any illegal drug use is revealed, including marijuana. How do 250mg CBD Gummies compare against 500mg, 750mg and 1000mg CBD Gummies? Physicians should also keep in mind that the marijuana produced today is much more potent compared to the past and using high potency marijuana along with controlled substances isn’t safe for patients.
Will there be anything as FDA approved medical marijuana? There are two FDA approved drugs in the U.S. containing an artificial analogue of THC (tetrahydrocannabinol), that is the principal chemical (cannabinoid) responsible for marijuana’s psychoactive effects. An artificial version of THC is within the FDA approved drugs Marinol (Schedule III) and Cesamet (Schedule II) which are prescribed to treat nausea for cancer patients undergoing chemotherapy. Marinol is also prescribed to stimulate the appetite of cancer and anorexia patients (2). The FDA happens to be overseeing trials being conducted on Epidiolex (3), a drug manufactured by GW Pharmaceuticals and developed to lessen convulsive seizures in children. The drug contains cannabinoids from marijuana, referred to as cannabidiol or CBD, which doesn’t support the psychoactive properties of traditional marijuana and doesn’t make a high. If this drug receives FDA approval, it would make history being the very first approved drug containing CBD in the U.S.
Additionally, DEA has issued a particular registration to an investigation laboratory at the University of Mississippi to cultivate various strains of marijuana for clinical trials (4). This research will continue, but as of this writing, ingesting or smoking botanical marijuana or the cannabis plant itself isn’t federally approved being an accepted medical treatment in the U.S. Patients who smoke or ingest marijuana need to keep yourself informed that they’re breaking Federal law and could possibly be prosecuted under Federal statutes. Furthermore, physicians must be testing for marijuana use and if detected, they ought to not prescribe controlled substances, regardless of their diagnosis and the patient’s symptoms, according to current Federal statutes.