If our survey on medical cannabis is any indication, psychiatrists are widely—and deeply—divided on whether and how marijuana should be used in clinical practice. Feelings are running, well . . . high, about whether, when, or in what circumstances this drug might be prescribed for patients with psychiatric disorders.
We invited psychiatrists to complete a survey about medicinal marijuana and didn’t expect nearly 2200 people to complete that survey in a just a few days. We heard from 1138 psychiatrists, 930 of whom practice in the US. We also heard from 109 psychologists, 163 nurse practitioners, and 22 physician assistants. About 30% of the respondents were 51 - 60 years old; 20% were 41 - 50; and 22% were 61 - 71. The minority (40%) live in a state where medical cannabis is legal.
The graphs you see on the following pages summarize survey results.
What is your opinion of medical marijuana?
We got 922 answers and 112 comments: 37% would never prescribe; 40% would consider prescribing in some circumstances; and 11% would consider, but only in pill form. Here’s a sampling of the widely divergent opinions.
“Marijuana should be legal for all and should not require a prescription."
“There is no medical necessity to legalize or prescribe something as addictive or toxic as smoked marijuana.”
“I am offended at the use of the term 'medical.' I am a physician and it is up to physicians to decide what is medical, not politicians. It is recreational or political, not medical until we as a profession say otherwise."
“Marijuana is NOT medicine. It happens to be effective for chemotherapy-related side effects, but not all the time, and not for everyone. Let’s get real. People want ‘medical marijuana’ because they feel less discomfort WHEN THEY ARE HIGH. When people are facing terminal illness, I give them whatever they want. Welldocumented, intractable pain—almost anything they want, with careful monitoring. Short of this, they want the buzz. There is nothing inherently wrong with wanting this. I, however, do not need to support it in my practice.”
“I would not prescribe marijuana because it has no psychiatric indication.”
“I work in a state facility where it is not an option to prescribe marijuana. However, some of my elder patients may benefit from prescribed pills of its synthetic derivatives like Marinol.”
“When I see good double blind studies that demonstrate effective long-term uses in psychiatric conditions, I would consider prescribing regulated medical marijuana.”
“I have a 49 year old patient with rapid deterioration of multiple sclerosis. Marijuana helps her with mood swings and discomfort. If legal, I would prescribe it without hesitation . . . ”
“I would prescribe for terminally ill cancer patients. I consider it to be a toxic, dangerous drug under most circumstances.”
“I would legalize all drugs of abuse as the war on drugs is a failure, wastes money, is a threat to civil liberties, and funds narco-terrorism.”
“Because I am an addiction psychiatrist, I do not prescribe medical marijuana. Like all drugs, it has its place in the medical armamentarium, and I approve of its medical use when appropriate. There should be more funded research and less ‘religious opinion’ so we can know what the proper use of marijuana is. Currently it has become a political football and the medical- correctional industry has a financial stake in not acknowledging the abject failure of the War on Drugs.”
1. Adler JN, Colbert JA. Clinical decisions. Medicinal use of marijuana—polling results. N Engl J Med. 2013;368:e30.