Hitting a Nerve

When patients ask about medical marijuana


 

References

How often do your patients ask about medical marijuana? I suppose it depends on where you live, but here in Arizona, it’s legal. So they ask about using it for migraines, epilepsy, diabetic neuropathy pain, and others. I hear the question from many patients.

How do I answer it? It gets tricky. I have mixed feelings about it, with anecdotal evidence from patients who have tried it, medical journals, and the usual overhyped stories in the lay press. It’s often hard for doctors to see the answer clearly and even more so for patients.

Dr. Allan M. Block

I suspect a lot of the interest comes from the commonly held belief that if it comes from "natural" sources, it has to be better for you than "chemicals." Never mind that what my dog leaves in the backyard is also "natural" or that THC is a chemical. Pretty much everything in the human body (and universe in general) is technically a chemical.

So I tell them I don’t know for sure. At best, it may help them. At worst, it’s an expensive placebo that could lead to other health issues. I explain the treatments I have to offer and that nothing is 100% successful or completely free of side effects – even "natural" products.

I’ve learned that those who’ve decided to use it won’t be dissuaded by my arguments or any amount of equivocal data, so I try to keep an open mind.

I let them make their own decision and document it carefully. If they want to go find a medical dispensary, that’s their call in the end, not mine. I also tell them that, if it doesn’t work, I’ll still be here to do my best to help them. I don’t take offense at their decision, ever.

At our best, doctors are only advisers. We can’t make anyone do anything they don’t want to.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Recommended Reading

VIDEO: Does obesity’s effect on RA support different treatment goals?
MDedge Internal Medicine
Long-acting–opioid prescribing rate highest in Maine
MDedge Internal Medicine
Telecare intervention lessens chronic joint pain
MDedge Internal Medicine
WHO recommends HIV pre-exposure prophylaxis as a prevention option
MDedge Internal Medicine
WHO recommends HIV pre-exposure prophylaxis as a prevention option
MDedge Internal Medicine
FDA approves opioid tablet designed to deter abuse if crushed
MDedge Internal Medicine
Most kneecap pain can be managed conservatively
MDedge Internal Medicine
VIDEO: Dr. Fauci: What you need to know about chikungunya
MDedge Internal Medicine
The Medical Roundtable: Chronic Low Back Pain
MDedge Internal Medicine
Acetaminophen no better than placebo for acute low back pain
MDedge Internal Medicine