Cannabis activists, particularly those that have worked in medical cannabis clinics, have heard more and more stories regarding patients experiencing severe discrimination from their physicians due to their use of medical marijuana, even when allowed under state law. Published stories regarding patients being denied transplants have surfaced, and even some signs of hope that such a policy, with no scientific basis, is starting to be reformed. Many patients are now reporting that they are being forced to choose between medical marijuana and pain medication, with doctors threatening to stop prescribing pharmaceutical pain killers if the patients continue using medical cannabis.
Many patients anecdotally have reported using fewer pain killers such as OxyContin due to using medical cannabis. Scientific research now backs up these anecdotal claims. Published in the Journal of Psychoactive Drugs:
There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective. Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates.
Cheryl Smith, Executive Director of the Compassion Center, a Eugene, Oregon, clinic that registers qualified patients with the Oregon Medical Marijuana Program (OMMP), contacted the Oregon Medical Board requesting any information on an official policy regarding pain management and medical marijuana use. Kathleen Haley, Executive Director of the Oregon Medical Board responded:
The Board does not currently have a rule or policy on prescribing opioids to patients with a medical marijuana card. While the Board’s consultants have included the use marijuana among the list of contraindications for long-term opioid use, the Board has not prohibited the concurrent use of these drugs.
Prescribing practices do come to the Board’s attention, and every written complaint is investigated as required by statute. The Board does not discipline physicians solely based on certifying patients for the use of medical marijuana, prescribing opioids to a known medical marijuana patient, or creating treatment plans that include the concurrent use of opioids and medical marijuana. However, if an investigation into a complaint showed inappropriate practices or unprofessional conduct by ay physician, the Board would take action for any violation of the Medical Practice Act that are found.
The Board will will continue its attention to this evolving area of medicine. Any updated policies created by the Board are always available on our website at www.oregon.gov/OMB. We appreciate you interest in this important issue and its impact on the safety of Oregon patients.
According to a recent Center for Disease Control report, opioid overdoses kill nearly 15,000 Americans, almost double the number of deaths caused by heroin and cocaine combined. While the Oregon Medical Board’s current position, isn’t terrible, it could certainly be improved and new research will only conclude that medical marijuana is safer for patients than opioids. After all, we are still waiting on the first overdose from marijuana. It would seem that to “do no harm” would be to include medical marijuana as a possible alternative or supplement to more addictive, intoxicating and lethal drugs, such as OxyContin. Doctors prescribing opioids to medical marijuana patients shouldn’t be facing any discipline from any medical board, but forcing patients to give up a non-toxic substance like cannabis in favor of drugs that kill more people than heroin and cocaine combined should attract scrutiny.