Marijuana continues to be probably the most highly abused drug in America. The arguments for and against the legalization of marijuana continue steadily to escalate. This piece is not meant 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 in many cases are up against the dilemma of whether or not to prescribe controlled substances to patients who drug test positive for marijuana. This is particularly 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 with no accepted medical use within the U.S. The fact remains that all state laws have Federal oversight, as stated in the Supremacy Clause of the Constitution. “The Supremacy Clause is a clause within Article VI of the U.S. Constitution which dictates that federal law is the supreme law of the land. Beneath the doctrine of preemption, that will be on the basis of the Supremacy Clause, federal law preempts state law, even when the laws conflict.”(1)
Whenever a physician becomes aware that a patient is using marijuana, alternate types of therapy must certanly be implemented besides prescribing controlled substances. How long will the 250mg CBD Gummies Jar last me? Physicians also needs to take steps to refer the in-patient for treatment and cessation if any illegal drug use is revealed, including marijuana. Physicians also needs to remember that the marijuana produced today is significantly more potent compared to the past and using high potency marijuana in conjunction with controlled substances is not safe for patients.
Is there anything as FDA approved medical marijuana? You can find two FDA approved drugs in the U.S. containing a synthetic analogue of THC (tetrahydrocannabinol), that will be the principal chemical (cannabinoid) accountable for marijuana’s psychoactive effects. A manufactured version of THC is included in 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 contain the psychoactive properties of traditional marijuana and doesn’t produce a high. If this drug receives FDA approval, it would make history being the initial approved drug containing CBD in the U.S.
Additionally, DEA has issued a unique registration to a research 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 is not federally approved being an accepted medical treatment in the U.S. Patients who smoke or ingest marijuana need to keep yourself updated they are breaking Federal law and could possibly be prosecuted under Federal statutes. Furthermore, physicians must certanly be testing for marijuana use and if detected, they ought to not prescribe controlled substances, regardless of their diagnosis and the patient’s symptoms, as per current Federal statutes.