Questions About Marijuana? MMS Collaboration Helps Providers Find Answers

By Tom Flanagan and Lucy Berrington

“Can marijuana reduce my pain?” “Is it true this could relieve my IBS?” “How should I take it? What exactly should I take?” “I’m using marijuana recreationally — could it affect my treatment?”

In states where medical marijuana has been legalized — like Massachusetts — physicians and other health care providers may struggle to answer patients’ questions. And with recreational pot shops expected to open in the Commonwealth next year, those questions may become broader in scope and more frequent. Physicians may be wary of the disconnect between federal and state marijuana laws, and of marijuana’s uncertain effects on health and development. They may be concerned about the risk of prescribing a contraindicated treatment to a patient taking medical marijuana, and the implications of patients self-medicating with the recreational drug.

The Comprehensive Cannabis Curriculum, available from the MMS, is designed to give physicians and other providers a robust training on the medical, legal, and social issues relating to marijuana use. “The course addresses a huge knowledge deficit clinicians have regarding risks and benefits of marijuana and other cannabinoids. This is just what doctors need to be able to have constructive conversations with their patients,” says Dr. Alan Ehrlich, assistant clinical professor in family medicine at UMass Worcester and deputy editor at DynaMed, who reviewed the program.

“I think most physicians want to understand medical marijuana in terms of those conditions for which there is evidence (preferably good) of efficacy, and those for which the evidence is weak or merely placebo,” says Kathryn A. Hughes, MD, acute care surgeon at Falmouth Hospital. “We also want to know if there is any dosing information, and the mechanics of certification and dispensing.”

The curriculum is a collaboration between the Massachusetts Medical Society and Stephen Corn, MD, and Meredith Fisher-Corn, MD, of the medical education website TheAnswerPage.com. “Whether or not physicians have any intention of recommending medical cannabis for patient care, they now all need to be well educated on the endocannabinoid system and medical cannabis, because their patients will be seeking their expert advice and guidance for this legal medication,” says Dr. Corn.

In 17 modules, the program covers the endocannabinoid system, medical cannabis dosing and contraindications, and metabolism and drug interactions. Studies addressing the physiologic, cognitive, and mental health effects of cannabis are reviewed in detail, as is the medical use of cannabis for 10 disease states: ALS, cancer, epilepsy, HIV/AIDS, Huntington’s Disease, IBS, multiple sclerosis and spasticity, neuropathic pain, and Parkinson’s Disease.

“The chapters have been written by leading experts and the presentation is very balanced with an emphasis on the best available evidence,” says Dr. Ehrlich. The course was also reviewed by the MMS Committee on Sponsored Programs. The curriculum does not represent a recommendation by the MMS for or against the use of cannabinoid medications, says Dr. Henry Dorkin, president of the Society.

TheAnswerPage has been offering peer-reviewed medical educational content since 1998, focusing on medical cannabis, pain, and opioids. Drs. Corn and Fisher-Corn, received the 2017 Special Award for Major Contributions to the Reintroduction of Cannabis as Medicine from the International Association for Cannabinoid Medicines.

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