Ohio's medical marijuana law begins today. And, I'm telling you right now, I will not prescribe it. Why? Well, the short answer is that that the regulations in Ohio haven't been figured out yet. So, don't even think about it in Ohio until approximately September 2018. Plus, the Ohio statue does NOT permit Smoking of medical marijuana, only "edibles, patches, oils, tinctures, and plant material." (Columbus Dispatch)
Setting that aside, my long answer to this question begins with me saying that I believe that I'm part of a large group of physicians in Ohio who are uncomfortable prescribing medical marijuana. I know that physicians are trying to be influenced by "famous" doctors like Sanjay Gupta in essays like "Why I Changed My Mind On Weed." Pressure is also coming from "famous" politicians and "famous" celebrities (influenced by pro-medical marijuana advocates) who are trying to put pressure on physicians to write for medical marijuana. I still have my doubts. Here are Four Reasons I am hesitant to prescribe medical marijuana in Ohio:
1. Ohio's Pill Mill Past: This state has been down this path before. In the past, it bowed to the political desires of the people in forcing physicians to act compassionate about patient's pain. Remember "Pain as the 5th Vital Sign?" Where did that get us? The state government having to crack down on "Ohio's Pill Mills" (meaning pain pill facilities), and now nationally, the US Surgeon General addressing the patient's Opioid Epidemic. Will Ohio have a "Pot Mill" future?
2. Failure From Other States: Some other states have been through this before, and we have a lot to learn. Pro-marijuana advocates point to the successes, but I point to an article entitled, "Why Montana Is Going Backward on Medical Marijuana." Are other states having similar experiences?
3. How Can I Get Sued? Medical liability is always a huge question on policy changes like this. Physicians are traditionally hesitant to prescribe any new medication, even when it has been tested and has received FDA approval. As we all know, medical marijuana has not had a lot of testing, and many physicians are skeptical because of the lack of current science and research that is presently out there. "But Mike, it has to be legal to do research," many will e-mail and tweet me. I understand this argument. But, physicians are not the only ones worried about medical marijuana liability. Ohio's Trumbull County, and Ohio cities like Parma & Avon Lake are so worried about liability that they are among a group of Ohio's municipalities who are putting a temporary moratorium on Ohio's medical marijuana law. How will employers in Ohio deal with the medical marijuana law?
4. Unintended Consequences: I invite you to check out the essay entitled, "The Unintended Consequences of Medical Marijuana," by Emily Gibson, MD. Her words sum it up better than I can: "[Medical Marijuana] just makes people so much less alive and engaged with the world. They are anesthetized to all the opportunities and challenges of life. You can see it in their eyes and hear it in their voices." What are other unintended consequences of medical marijuana?
So, over the next year or so, the press in Ohio will be covering this story in its usual sensational style, and writing stories about patients who could potentially benefit from medical marijuana. They will also say that, these potential patients will not be able to get medical marijuana yet, because the legislature is too slow, and the physicians are dragging their feet. Ohio's Medical Marijuana is really "be careful what you wish for." If not regulated correctly, and expectations are set too high, who will be harmed? It will be The Patient, and Ohio just can not let that happen...
Addendum: Thanks to WFMJ-TV in Youngstown, Ohio for interviewing me on September 15, 2016 for the story: "Salem Doctor Uncomfortable Prescribing Medical Marijuana"