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Perspective
June 3, 2019

Educating Physicians About Marijuana

Author Affiliations
  • 1Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
JAMA Intern Med. Published online June 3, 2019. doi:10.1001/jamainternmed.2019.1529

I had always heard it was difficult, if not impossible, to die from marijuana use. We hardly learned about marijuana during medical school, and I don’t remember many questions about marijuana on our licensing examinations that went beyond redness of the eyes. Why focus on marijuana when physicians must worry about medical emergencies such as cardiac arrests, sepsis, pulmonary embolisms, opioid overdoses, and alcohol withdrawal?

Just a few years later, marijuana seems ubiquitous. Ten US states have legalized recreational marijuana use among adults, and 33 states have legalized medical marijuana use. A majority of Americans live in states that allow for some degree of marijuana use. In California, where medical and recreational marijuana use is legal under state law, I drive to work past billboards advertising home delivery services for marijuana. Within blocks of my apartment, 3 dispensaries offer marijuana buds, vape pens, oils, cookies, brownies, and gummies with varying degrees of tetrahydrocannabinol (THC) and cannabidiol. Marijuana has become an inescapable part of my medical training, and most of my learning has come from patients.

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    2 Comments for this article
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    Education vs proselytization about marijuana
    John Coleman, MS, MA, PhD | Assistant Administrator for Operations (Retired), US Drug Enforcement Administration
    Dr. Morris gives a fair but disturbing account of the knowledge base among the medical profession as to the harms of marijuana. That more than a third of a site survey of resident physicians believed marijuana is FDA-approved (and, presumably, OK to prescribe for medical use) is very troubling for a public that depends on the knowledge and skill of their physicians for good health. The paucity of reputable research that Dr. Morris mentions is disappearing quickly as more and more articles are published by serious authors and journals on the dangers and risks associated with the use of marijuana. Regrettably, Dr. Morris failed to mention the burgeoning research on teratological effects of cannabis use and the alarming increases in the rates of certain birth defects in states where marijuana use has been "legalized" for recreation and medical use. Until recently, much, if not most, "research" in this field was biased by authors proselytizing about the virtues and benefits of marijuana. Citing each other as experts and publishing questionable and generally unreplicable findings, it's no wonder such confusion still exists about the serious side effects of marijuana. With the burgeoning of the commercial marijuana industry in the US, and the emergence of large capitalized sources, we may begin to see a rapid increase in the needed research that Dr. Morris suggests is essential. It is unacceptable in this day and age that physicians be expected to acquire their knowledge of this drug on the unverified appraisals of its users. Those appraisals more often than not will reflect the intoxicating or psychic effects of the drug rather than its therapeutic benefits, if any.
    CONFLICT OF INTEREST: None Reported
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    National Council of State Board of Registered Nursing July 2018 Pre Licensure and APN curriculum Guidelines for Medical Marajuan
    Deborah Bolton, BSN,MSN | Deborah L.Bolton and Associates
    The professional publication July 2, 2018 Journal of Nursing Regulation , Vol. 9.Issue 2, has recognized the very issues put forth in the article, supporting literature review, and previous comment to make recommendations the development and implementation of evidenced-based curriculums. It is a start and I hope the medical and pharmacology academic communities move forward.
    CONFLICT OF INTEREST: None Reported
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