MEDICAL BOARD of CALIFORNIA OFFICIAL POSITION ON MEDICAL MARIJUANA (CANNABIS)

[Guest guest]

Medical Board of California Official Position on Medical Marijuana

(cannabis)

 

 

Medical Marijuana

 

This statement was adopted by the full Medical Board on May 7, 2004.

For more

information, please see our news release dated May 13, 2004:

http://www.medbd.ca.gov/NR_2004_05-13_Marijuana.htm .

 

 

 

On November 5, 1996, the people of California passed Proposition 215.

 

 

 

Through this Initiative Measure, Section 11362.5 was added to the

Health &

Safety Code, and is also known as the Compassionate Use Act of 1996.

The

purposes of the Act include, in part:

 

 

 

" (A) To ensure that seriously ill Californians have the right to

obtain and use

marijuana for medical purposes where the medical use is deemed

appropriate and

has been recommended by a physician who has determined that the

person's health

would benefit from the use of marijuana in the treatment of cancer,

anorexia,

AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or

any other

illness for which marijuana provides relief; and

 

 

 

(B) To ensure that patients and their primary caregivers who obtain

and use

marijuana for medical purposes upon the recommendation of a

physician are not

subject to criminal prosecution or sanction. "

 

 

 

Furthermore, Health & Safety Code

section 11362.5© provides strong protection for physicians who

choose to

participate in the implementation of the Act. - " Notwithstanding any

other

provision of law, no physician in this state shall be punished, or

denied any

right or privilege, for having recommended marijuana to a patient

for medical

purposes. "

 

 

 

The Medical Board of California developed this statement since

medical marijuana

is an emerging treatment modality.

 

 

 

The Medical Board wants to assure physicians who choose to recommend

medical

marijuana to their patients, as part of their regular practice of

medicine, that

they WILL NOT be subject to investigation or disciplinary action by

the MBC if

they arrive at the decision to make this recommendation in

accordance with

accepted standards of medical responsibility. The mere receipt of a

complaint

that the physician is recommending medical marijuana will not

generate an

investigation absent additional information indicating that the

physician is not

adhering to accepted medical standards.

 

 

 

These accepted standards are the same as any reasonable and prudent

physician

would follow when recommending or approving any other medication,

and include

the following:

 

 

 

1. History and good faith examination of the patient.

 

 

 

2. Development of a treatment plan with objectives.

 

 

 

3. Provision of informed consent including discussion of side

effects.

 

 

 

4. Periodic review of the treatment's efficacy.

 

 

 

5. Consultation, as necessary.

 

 

 

6. Proper record keeping that supports the decision to recommend the

use of

medical marijuana.

 

 

 

In other words, if physicians use the same care in recommending

medical

marijuana to patients as they would recommending or approving any

other

medication, they have nothing to fear from the Medical Board.

 

 

 

Here are some important points to consider when recommending medical

marijuana:

 

 

 

1. Although it could trigger federal action, making a recommendation

in writing

to the patient will not trigger action by the Medical Board of

California.

 

 

 

2. A patient need not have failed on all standard medications, in

order for a

physician to recommend or approve the use of medical marijuana.

 

 

 

3. The physician should determine that medical marijuana use is not

masking an

acute or treatable progressive condition, or that such use will lead

to a

worsening of the patient's condition.

 

 

 

The Act names certain medical conditions for which medical marijuana

may be

useful, although physicians are not limited in their recommendations

to those

specific conditions. In all cases, the physician should base his/her

determination on the results of clinical trials, if available,

medical

literature and reports, or on experience of that physician or other

physicians,

or on credible patient reports.

 

 

 

In all cases, the physician must determine that the risk/benefit

ratio of

medical marijuana is as good, or better, than other medications that

could be

used for that individual patient.

 

 

 

A physician who is not the primary treating physician may still

recommend

medical marijuana for a patient's symptoms. However, it is incumbent

upon that

physician to consult with the patient's primary treating physician

or obtain the

appropriate patient records to confirm the patient's underlying

diagnosis and

prior treatment history.

 

 

 

The initial examination for the condition for which medical

marijuana is being

recommended must be in-person.

 

 

 

Recommendations should be limited to the time necessary to

appropriately monitor

the patient. Periodic reviews should occur and be documented at

least annually

or more frequently as warranted.

 

 

 

If a physician recommends or approves the use of medical marijuana

for a minor,

the parents or legal guardians must be fully informed of the risks

and benefits

of such use and must consent to that use.

 

 

 

Physicians may wish to refer to CMA's ON-CALL Document #1315

titled " The

Compassionate Use Act of 1996 " , updated annually for additional

information and

guidance

 

http://www.cmanet.org/bookstore/freeoncall2.cfm/CMAOnCall1315.pdf?

call_number=13\

15 & CFID=745764 & CFTOKEN=27566287 .

 

 

 

Although the Compassionate Use Act allows the use of medical

marijuana by a

patient upon the recommendation or approval of a physician,

California

physicians should bear in mind that marijuana is listed in Schedule

I of the

federal Controlled Substances Act, which means that it has no

accepted medical

use under federal law. However, in Conant v. Walters (9th Cir.2002)

F.3d 629 the

United States Court of Appeals recognized that physicians have a

constitutionally-protected right to discuss medical marijuana as a

treatment

option with their patients and make oral or written recommendation

for medical

marijuana. However, the court cautioned that physicians could exceed

the scope

of this constitutional protection if they conspire with, or aid and

abet, their

patients in obtaining medical marijuana.

 

 

 

 

http://www.medbd.ca.gov/Medical_Marijuana.htm