Comments on: Medical Marijuana: What Should Palliative Care Specialists Know? http://www.aahpm.org/apps/blog/?p=1405 Physicians caring for patients with serious illness. Thu, 07 Feb 2013 01:31:00 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: Randy Hillard, MD http://www.aahpm.org/apps/blog/?p=1405&cpage=1#comment-49792 Randy Hillard, MD Mon, 09 Jul 2012 16:19:03 +0000 http://www.aahpm.org/apps/blog/?p=1405#comment-49792 Here is the abstract of a paper that I am prestnting at the American Psychiatric Meeting in October. I was a medical marijuana patien last year when I was getting radiation and chemotherapy for stage 4 stomach cancer. It is the only thing that got me through. So, yes, I think that we should be brave and endorse this concept. In 2008, a referendum authorizing legal use of marijuana for medical purposes was passed 63% to 37% in Michigan. This law permitted authorization of an exemption from state anti-marijuana laws for patients who were certified by a physician as suffering from: (a) cancer, glaucoma, or positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), hepatitis C, amyotrophic lateral sclerosis, Crohn's disease, agitation of Alzheimer's disease, or nail patella. (b) a chronic or debilitating disease or medical condition or its treatment that produces one of more of the following: (i) cachexia or wasting syndrome; (ii) severe and chronic pain; (iii) severe nausea; (iv) seizures, including but not limited to those caused by epilepsy; or (v) severe or persistent muscle spasms, including but not limited to, those which are characteristic of multiple sclerosis; or In practice, a limited number of physicians have taken a very broad approach to certification, particularly with respect to "pain", and "nausea." As of 12/2011, 126,912 patient registrations had been issued in Michigan, which has a population of about 10,000,000, or to over 1.25% of the population. In 2011, the new state attorney general has concluded that while medical marijuana possession is legal, its sales through dispensaries is illegal. Marijuana remains illegal under federal law. Increasingly, patients seeking mental health treatment are being seen initially already having been prescribed medical marijuana or have it prescribed during mental health treatment. Multiple interactions between cannabis and psychotropic medication have been documented. In addition, there is a large body of evidence indication that cannabis use may be associated with onset of psychosis and other psychiatric conditions and that it can exacerbate existing conditions. On the other hand, there is a large body of evidence indicating that medical marijuana is beneficial in a variety of medical conditions and that it may be superior to other available treatments for some patients. There is also a body of largely anecdotal evidence suggesting that cannabis may be beneficial for some psychiatric conditions, including anorexia nervosa, obsessive compulsive disorder and chronic insomnia. This workshop will discuss the official positions of the APA, AMA and other organizations on medical marijuana. It will also explore the implications for psychiatric practice of medical marijuana laws and the plusses and minuses of medical marijuana law as implemented in Michigan. Ample time will be provided for participants to share their clinical experiences, to ask questions, and to make comments. Here is the abstract of a paper that I am prestnting at the American Psychiatric Meeting in October. I was a medical marijuana patien last year when I was getting radiation and chemotherapy for stage 4 stomach cancer. It is the only thing that got me through. So, yes, I think that we should be brave and endorse this concept.

In 2008, a referendum authorizing legal use of marijuana for medical purposes was passed 63% to 37% in Michigan. This law permitted authorization of an exemption from state anti-marijuana laws for patients who were certified by a physician as suffering from: (a) cancer, glaucoma, or positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, agitation of Alzheimer’s disease, or nail patella.
(b) a chronic or debilitating disease or medical condition or its treatment that produces one of more of the following:
(i) cachexia or wasting syndrome;
(ii) severe and chronic pain;
(iii) severe nausea;
(iv) seizures, including but not limited to those caused by epilepsy; or
(v) severe or persistent muscle spasms, including but not limited to, those which are characteristic of multiple sclerosis; or

In practice, a limited number of physicians have taken a very broad approach to certification, particularly with respect to “pain”, and “nausea.” As of 12/2011, 126,912 patient registrations had been issued in Michigan, which has a population of about 10,000,000, or to over 1.25% of the population. In 2011, the new state attorney general has concluded that while medical marijuana possession is legal, its sales through dispensaries is illegal. Marijuana remains illegal under federal law.

Increasingly, patients seeking mental health treatment are being seen initially already having been prescribed medical marijuana or have it prescribed during mental health treatment. Multiple interactions between cannabis and psychotropic medication have been documented. In addition, there is a large body of evidence indication that cannabis use may be associated with onset of psychosis and other psychiatric conditions and that it can exacerbate existing conditions.

On the other hand, there is a large body of evidence indicating that medical marijuana is beneficial in a variety of medical conditions and that it may be superior to other available treatments for some patients. There is also a body of largely anecdotal evidence suggesting that cannabis may be beneficial for some psychiatric conditions, including anorexia nervosa, obsessive compulsive disorder and chronic insomnia.

This workshop will discuss the official positions of the APA, AMA and other organizations on medical marijuana. It will also explore the implications for psychiatric practice of medical marijuana laws and the plusses and minuses of medical marijuana law as implemented in Michigan. Ample time will be provided for participants to share their clinical experiences, to ask questions, and to make comments.

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