Pot continues to be the most highly mistreated drug in america. The arguments for and contrary to the legalization of pot continue to escalate. This piece is not designed to set the stage for a legalization debate about pot. Instead, I need caution practitioners whoever patients under their care test positive for pot. Pot use is still a no-no by Federal law and patients who self-medicate or abuse pot should not be prescribed controlled substances.
Unfortunately, many medical professionals are often up against the dilemma of whether or not to order controlled substances to patients who drug test positive for pot. This is particularly the case in states that have modified state laws to legalize pot. These changes in state law do not change the Federal guidelines that medical professionals must follow. As a former career DEA agent, I remind medical professionals that pot is still an illegal Schedule I controlled substance with no accepted medical utilization in the You. S. The fact remains that all state laws have Federal oversight, as stated in the Supremacy Term of the Metabolic rate. RoyalCBD “The Supremacy Term is a term within Article VI of the You. S. Metabolic rate which dictates that federal law is the better law of the land. Under the doctrine of preemption, which is based on the Supremacy Term, federal law preempts state law, even when the laws conflict. “(1)
When a physician becomes aware that a patient is using pot, alternate methods of therapy should be implemented other than prescribing controlled substances. Medical professionals should also make a plan to refer the person for treatment and cessation if any illegal drug use is revealed, including pot. Medical professionals should also keep in mind that the pot produced today is much stronger than the past and using high capability pot in conjunction with controlled substances is not safe for patients.
Is there such a thing as FDA approved medical pot? There are two FDA approved drugs in the You. S. containing a man made analogue of THC (tetrahydrocannabinol), which is the key chemical (cannabinoid) responsible for marijuana’s psychoactive effects. A man made version of THC is involved in the FDA approved drugs Marinol (Schedule III) and Cesamet (Schedule II) which are prescribed to treat nausea for cancer patients going through chemotherapy. Marinol is also prescribed to stimulate the appetite of cancer and anorexia patients (2). The FDA is currently supervising studies being conducted on Epidiolex (3), a drug manufactured by GW Pharmaceutical drugs and developed to reduce convulsive seizures in children. The drug contains cannabinoids from pot, referred to as cannabidiol or CBD, which does not secure the psychoactive properties of traditional pot and does not produce a high. If this drug receives FDA approval, it would make history being the first approved drug containing CBD in the You. S.
Additionally, DEA has issued a special registration to a research research laboratory at the University of Mississippi to grow various strains of pot for clinical studies (4). This research will continue, but as of this writing, ingesting or smoking botanical pot or the cannabis plant itself is not federally approved as an accepted medical treatment in the You. S. Patients who smoke or enjoy pot need to be aware that they are breaking Federal law and might be prosecuted under Federal statutes. Furthermore, medical professionals should be testing for pot use and if detected, they should not order controlled substances, regardless of their analysis and the patient’s symptoms, per current Federal statutes.