Barriers to enrollment in the Minnesota medical cannabis program (and other updates)

Charles Reznikoff, MD

Charlie.reznikoff@hcmed.org

JAMA June 23/30 2015 p2456

An important, and skeptical, article was published in a premier medical

journal one week prior to the Minnesota “go live”

Dramatic recent increase in acceptance of marijuana and

increase in use…but stable adolescent use!

262 doctors from four institution (and 3 counties) asked three

questions and invited to comment

I would have a difficult time giving patients both medical marijuana and narcotics. I already am trying hard to get patients off narcotics for chronic pain issues due to dependence etc. I feel marijuana will have the same issues as we are currently having with narcotic use

I believe this will open a huge "can of worms“ with treating chronic pain. If there is convincing evidence of benefit I would be willing to be educated. Otherwise I am not for this.

This indication makes me nervous to register as at this point do not feel comfortable with the burden it would place on me.

Qualifying conditions need to be more black and white.

i think it will introduce conflict

the big roadblock currently is the lack of data available

I think it will open thefloodgates of people desiring these drugs and will be difficult to sort the

appropriate ones.

Physician concerns

• Practicing medicine outside the evidence base norms

• Unconventional production, regulation, dispensing

• Recreating the opioid-for-pain epidemic

• Challenging conversations, demanding patients

• Paperwork and red tap

• Time and energy to learn something new

• Personal opinions about marijuana

Conclusions:

Responsible and thoughtful doctors are resistant to medical cannabis

because of the evidence and process

Some doctors are resistant to medical cannabis because of lack of education/science about cannabis

Some doctors perceive medical cannabis as a hassle, or possibly

time consuming

Some docs fear conflicts with patients seeking medical cannabis

The opioid epidemic looms over medical cannabis on both sides of

the issue….

Thank you!Questions?