There remains a some controversy over the use of marijuana to treat some medical conditions, despite legalization several years ago. Some people may wonder if those who seek to be treated with medical marijuana are really just “pot-heads” or aging “hippies” looking for a way to be “legal” when using an illegal drug. Others may continue to think the use of marijuana, medical or otherwise, is a gateway to the use of other illegal drugs, like heroin or cocaine. Still others may be open to the concept of medical marijuana use, but want to avoid the “stink” of a medical marijuana cigarette. As a doctor who has evaluated hundreds, if not thousands, of patients for medical marijuana use, I face this daily.
In my experience, most of the people seeking medical marijuana certification evaluation have a legitimate need. Perhaps 10% of patients have been rejected for not having a certifiable need. Arizona law establishes a limited number of conditions that will qualify a patient for medical marijuana, and most of those conditions have clear criteria for making a diagnosis. These conditions are HIV/AIDS, a worsening of Alzheimer’s disease, Crohn’s, Cancer, Glaucoma, Hepatitis C, Lou Gehrig’s Disease (ALS) and PTSD. These conditions are not diagnosed by a primary care doctor and certainly are not diagnosed in a medical marijuana evaluation center. Most of these require lab tests or medical procedures to make a diagnosis. These are serious conditions requiring careful medical care, so persons with these conditions are not going to be evaluated for medical marijuana “just to be legal.”
Arizona law also allows persons with certain chronic or debilitating conditions to obtain and use medical marijuana. These are: cachexia or wasting (unintentional loss of 10% of body weight in the past six months), severe and chronic pain, severe nausea, seizures (such as in persons with epilepsy), and severe or persistent muscle spasms (such as in persons with multiple sclerosis).
According to the Arizona Department of Health Services, the most common reason for someone to seek medical marijuana is a condition of severe and chronic pain, with nearly 3 out of 4 cards based on this debilitating condition. From my experience, most of these people will have a complaint of low back pain, although other common complaints include migraine headache, fibromyalgia, arthritis, and knee or shoulder pain.
These patients seek medical marijuana in order to have an alternative to the prescription medications used to treat pain: hydrocodone, oxycontin, morphine, methadone and other opioid drugs. Use of these medications frequently have serious side effects, ranging from constipation and a feeling of being in a mental fog, to addiction or even death from overdose. Curiously, the risk of death or other complications from the use of opioid drugs has recently led to the development of “Guidelines” from the state which limit a patient’s access to these drugs. Unfortunately, some patients will seek to replace the opioid drugs with heroin, so in these cases it the prescription drug, not medical marijuana, that is the gateway drug to illicit drug use.
Medical marijuana does not have to be smoked in order to be beneficial. In fact, as a doctor I usually advice my patients against smoking cigarettes or marijuana. The active ingredients in medical marijuana are available in many other forms, such as edibles, oils, lotions, vapors and tinctures (a few drops on the tongue is all that is needed).
Is medical marijuana right for you? Perhaps it is worth considering.