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You Spoke, We Listened. Psychiatry's Cannabis Survey
Enlightening survey results reveal what psychiatrists think about medical marijuana/cannabis use, how or whether to discuss with their patients, and what biases might get in the way of such conversations.
We asked, you answered. Here are the results of the survey accompanying the Psychiatric TimesTM Special Report: Cannabis Conundrum. Results are based on a survey pool of 416 eNewsletter repondents.
Clinical Management of Cannabis Complications
Special Report Chairs
Thomas R. Kosten, MD, and Christopher D. Verrico, PhD
The Age of Cannabis Has Arrived: Issues for Older Adults
Marc Agronin, MD
Cannabis 2021: What Clinicians Need to Know
Laurence M. Westreich, MD
Cannabis and Psychosis: A Synthesis of Quantitative Reviews
Brian Miller, MD, PhD, MPH
How to Discuss Cannabis With Your Patients
Tony Thrasher, DO, DFAPA
You Spoke, We Listened. Psychiatry's Cannabis Survey
Psychiatric TimesTM Editors
QUESTION 1. Do you discuss medical marijuana/cannabis use for medical/psychiatric issues with your patients?
Reader comments:
I discuss the reasons not to use it.
When it is legal in my state, I will.
I sometimes discuss how the patient is currently using marijuana to self-treat their symptoms.
If a patient brings it up, we discuss the risks/ benefits per available scientific valid studies.
I warn patients marijuana use is similar to alcohol in its addiction potential and that there is too little known about who it at risk for an adverse event.
Patients often bring it up, but we cannot prescribe marijuana use in this state.
We discuss risks of cannabis use, but I do not recommend its use for psychiatric conditions.
Psychiatrists said:
The benefit is only temporary and at this early state. It opens the door to more issues down the line.
We need better evidence.
Cannabis is not useful for all disorders, and use depend on the presenting and underlying symptoms.
Only for severe anorexic conditions.
Good for pain management and perhaps female fertility, although more research is needed.
I have concerns because so many of my patients have cannabis-induced psychiatric issues.
It is right up there for ethanol for anxiety and cocaine and heroin for depression.
What Others Said:
Perhaps CBD but not the others.
If there were to be solid scientific evidence presented, and approval by the FDA, I would consider it. Until then, absolutely not.
Only if the benefits outweigh risks (eg, preferable to using benzodiazepines long term)—only with careful discretion.
There are a few applications, eg, anorexia, terminal illness, seizures, chemo treatment, or comfort care.
Unlikely unless traditional treatment options exhausted; if so, would refer to expert in this area.
If allowed by my organization, I would recommend low THC/CBD ratio for a very select few patients with low psychosis risk.
Only for treating neuropathic pain.
Answers From Your Colleagues
If alcohol can be legal, there is no reason cannabis should be illegal. It may give more opportunity for research.
I think promoting health initiatives for education and treatment are better options than incarceration.
Yes, in general, but safeguards need to be implemented to address potential addictions.
No. The resources for adverse effects (disorders) is not commensurate with the “promotion” of use.
Only if the records of people previously convicted of marijuana possession/use are expunged.
Overall, I think more negative than positive if criminal justice reform and undoing systemic racism could be accomplished another way.
I do not like the idea of states having incentive to encourage cannabis use for the revenues. I am unhappy with the thought psychotic disorders could increase.
A bad thing. We don't need another legal intoxicant.
I believe in making it legal. I see no sense for people going to jail for marijuana.
Legal is okay. Commercializing is terrible!
Decriminalization is a good thing. Promotion of this drug is not.