Doctors: Marijuana Is Not Medicine – At Least Not Yet
The leading physician opposing the medical marijuana ballot question — which Massachusetts voters approved this month — anticipates that many of his colleagues will join him in declining to recommend the drug to patients, legal or not.
Dr. James Broadhurst, a Shrewsbury physician and an assistant professor of family medicine and community health at University of Massachusetts Medical School in Worcester, said many doctors he knows don't like the idea of recommending a substance that has not been properly studied for medical efficacy and safety, like the other drugs they recommend or prescribe.
"I don't feel there is a responsible role I can play in [recommending] marijuana," Broadhurst said.
With so many different strains containing various compounds and other material, Broadhurst said he doesn't see marijuana as a medicine. An emergency room doctor wouldn't tell a patient in severe pain to smoke opium, he said. The doctor would give the patient morphine, an alkaloid derived from opium.
"When I, as a practicing physician, prescribe a medication to someone, what I'm prescribing is a specific, purified, standardized compound which has been reviewed in an evidence-based way by the FDA."
The Massachusetts Medical Society, which has more than 24,000 members, shares Broadhurst's views. The society has asked its members not to recommend marijuana to patients until the drug is FDA accepted.
Studying the drug is difficult, given its restricted status at the federal level.
The society asked the U.S. Drug Enforcement Agency last month to reclassify marijuana to allow further study, but so far, that hasn't happened.
Caught In The Middle
Broadhurst, who was vocal in his opposition leading up to the election — leading the 'No On Question 3' committee — said he received many phone calls from people who disagreed with him.
"I don't know why people make the assumption that I or any other physician doesn't recognize there's medicinal value in marijuana, but I also don't understand why people aren't just willing to look at the situation and call it what it is, which is a great push in our society to make this stuff legal," he said. "Why are we putting doctors in the middle of this?"
While he feels marijuana may help some patients, he maintains that the law is filled with loopholes that amount to a "wink and a nod" to recreational users, allowing them to get recommendations for less serious conditions.
Exactly how the state will regulate the medical marijuana industry is still unknown. The Department of Public Health (DPH) has four months to write regulations on how 35 not-for-profit marijuana dispensaries will be licensed and regulated, and what steps doctors will have to take to issue certification letters to patients. And there could be delays along the way.
But in the meantime, other area providers are keeping a close watch on that process, though they're keeping their public comments to a minimum.
Worcester-based Reliant Medical Group, an affiliate of Atrius Health and representing 250 doctors, referred comment to its fellow affiliate Southboro Medical Group, which has 60 doctors.
Dr. Robert Jandl, chief medical officer of Southboro Medical Group, said his organization opposed Question 3.
"But now that it has become law, we plan to work with DPH as regulations are developed to make this as safe for our patients as possible," Jandl said in an emailed statement.
Saint Vincent Hospital in Worcester, owned by Vanguard Health Systems, declined to comment.
Dianne Borque, a health care attorney with Boston-based Mintz Levin, said there are many blanks for DPH to fill in before the state's health care industry can better understand how the law will play out.
"The fundamental issue is the disconnect between state law and federal law," Borque said.
Borque said some doctors are nervous about having DEA registrations, which allow them to prescribe narcotics, revoked for violating federal law.
Like Broadhurst, Borque thinks there will be doctors who won't recommend medical marijuana to patients. But others will see clinical value in the drug.
Christian Sederberg, a Colorado attorney who has represented marijuana dispensaries, patients and doctors — and who helped author the Massachusetts ballot question — said doctors shouldn't worry about the DEA revoking their registrations, because they would be recommending marijuana to patients rather than prescribing it, which he said is an important distinction.
"This is First Amendment-protected speech for these doctors," Sederberg said. "It's about educating them, and I certainly understand it's a hot-button issue right and you can be stigmatized for going out there on a limb, but it's more and more accepted all the time."
Correction: The original version of this article incorrectly stated Southboro Medical Group's relationship with Reliant Medical Group. The two are both affiliates of Atrius Health.
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