When a patient seeks a doctor for pain relief, a person may take narcotics. Opiates can be part of a treatment plan for a long time, especially if they have chronic pain and no surgical solution. Opiates can have serious side effects. Marijuana treatment can provide significant relief, which can reduce the need for high doses of opiates or, in some cases, provide relief when opiates are ineffective. Opiates are not the best option for peripheral neuropathies. They are not good at modulating pain, whereas medical marijuana does an excellent job creating these problems.
Medical marijuana does not preclude the need for interventional pain relief.
For a herniated disc or focal problem where a pain relief injection can help, medical marijuana is not the answer. When patients take medications for chronic pain with their doctor, a pain contract is usually signed. The “contract” generally states that as long as the patient is in her care, they will not use illegal drugs. Unfortunately, marijuana is still banned at the federal level, even though it is now legal. Most maryland medical marijuana dispensary doctors who specialize in pain relief screen their patients for medications. So if the patient has a contract, gets tested, and tests positive for THC (the active ingredient in marijuana), is it appropriate for the pain reliever to stop treatment?
It is a simple answer as to whether the pain reliever has the authority to interrupt a patient’s treatment, but it is not a simple answer as to whether it is appropriate. If the pain settlement states that the physician has the right to discontinue the patient’s treatment if the drug test is positive for non-prescribed medications, this is difficult to disprove. If the patient is allowed to correct her exception by stopping marijuana use and retesting after a few weeks, this is again the physician’s prerogative. From an ethical point of view, things are not that simple. Patients deserve effective pain relief, and more people try not to over-treat them. Medical marijuana is effective for various chronic pain conditions and many other conditions, including severe nausea/vomiting and cancer.
The presence of marijuana remains illegal at the federal level and falls under illegal law, which puts pain relievers in a challenging situation. If they test patients for THC and then don’t rule outpatients who test positive, is there a bias against other banned substances? Some pain relievers do not consider marijuana illegal due to its medicinal value, so they do not test it for its presence. If the patient informs the doctor about marijuana use, the problem becomes the same.
At the end
The fact is, there really is no single right or wrong answer that a doctor can follow. Recommendations must be individualized. As the federal government’s views on marijuana change, these ethical issues will be up for debate.