
This article originally appeared in the August 2018 print issue of Cannabis Business Times. To subscribe, click here.
Everyone with serious cannabis industry experience has spoken with patients, friends and relatives about cannabis’s effectiveness as medicine. Patients tend to be the most familiar with its effectiveness in controlling disease symptoms, including pain, and in controlling various diseases themselves. We all find ourselves with a chance to educate when an outsider asks, “It’s not only for pain, but it actually treats the disease?”
Some of us may dive into technical details and explain that THC and CBD are partial agonists for the endocannabinoid system’s CB1 and CB2 receptors, among other things. We also may discuss cannabinoid-induced apoptosis (cellular suicide activated by the presence or removal of a stimulus) among malignant cells. In response, we often receive blank stares.
Obviously, it would be nice if patients had these conversations with doctors before turning to cannabis-industry members. Doctors’ ignorance of the endocannabinoid system and reticence to engage with our industry keeps them from jumping in. We’ve talked to a few, who fell into the following categories.
- Prehistoric medical training: Many medical school professors, and the doctors those professors trained, completed their respective educations before the early ’90s, prior to the discovery of the human endocannabinoid system. Those doctors typically do not know that the endocannabinoid system exists.
- Conventional medicine: Many doctors live quite well working within established medical practice care standards (defined treatment protocols for each disease state) and insurance-driven drug formularies (lists of drug products covered by each source of insurance). In addition, federal resistance in Congress, the Food and Drug Administration (FDA), the National Institute on Drug Abuse (NIDA) and the Drug Enforcement Administration (DEA) has effectively prohibited the randomized, double-blind, placebo- controlled clinical research that has otherwise served the medical community reasonably well. Thus, many doctors find it unreasonable to risk their licenses to practice by involving themselves or their patients in unproven medicine.
For the doctors who fall into those buckets, medical marijuana is, at best, an unproven novelty. There are, however, three other groups to consider. Each of these three groups accepts the thought that marijuana may be extremely effective in treating various disease states:
- Yes, but not in my practice: This first group understands at least some of the science behind medical marijuana, but is not willing to accept any risk from cannabis involvement. This group refers its patients to doctors with recognized medical marijuana expertise.
- Cannabis mills: The next group of doctors receives payment for registering patients with their respective state regulators. Nothing more, nothing less. Some are principled, and some are not.
- The few good ones: Finally, there are a few doctors who are both knowledgeable and involved. Even when they start with little or no awareness of medical marijuana, given a patient with an unresolved need, these doctors follow their professional responsibilities wherever they may lead. Most professions have some great professionals; medicine is no different.
Can We Help the Situation?
Doctors have spent long hours and long years with biology and chemistry texts and in laboratories, all focused on human health. As a group, our focus is typically elsewhere. Some of the issues for these doctors might originate from how we present ourselves to them, like being heavily focused on the recreational market or on our businesses’ bottom lines.
If we wanted to make a serious attempt to engage doctors, how might we do this, and what might be in it for us?
To read the full article in Cannabis Business Times' August 2018 issue, click here.
Top photo: Mitch | Adobe Stock