Psychiatric Times.

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CLINICAL Q&A

Medical Marijuana: Regulations Surrounding Its Use

By Marie-Josée Lynch, MD, and Tony P. George, MD | September 14, 2012

Dr Lynch is a PGY-4 Resident in Psychiatry at the University of Toronto. Dr George is Professor and Chair in Addiction Psychiatry at the University of Toronto, and Clinical Director of the Schizophrenia Program at the Centre for Addiction and Mental Health in Toronto. Dr George reports that in the past 2 years, he has received grant support from Pfizer; has been a speaker for Astra Zeneca, Eli Lilly, and Pfizer; and served as a consultant to Abbott, Novartis, Pfizer, and Sepracor. Dr Lynch has no conflicts of interest concerning the subject matter of this article.

The use of cannabis as a viable medical treatment for people with cancer, eating disorders, chronic pain, and a number of other illnesses, remains an area of concern for everyone involved. Here, we ask the experts, Marie-Josée Lynch, MD, and Tony P. George, MD, about the use of cannabis and regulations surrounding its use.

Question: Which of the following statement(s) about medical marijuana is/are true?

A. California’s Proposition 215, also known as the Compassionate Use Act, was the first law in the US that stipulated that individuals could legally possess and use marijuana if recommended by their physicians.
B. The majority of medical marijuana patient identification cards are granted for the treatment of cancer and AIDS-related symptoms.
C. The potency of medical marijuana tends to be fairly uniform among dispensaries.
D. Evidence from case-control studies suggests that long-term use of medical marijuana confers a greater risk of respiratory, cardiovascular, and psychiatric illness.

For the answer and discussion, please click here.

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by Melenie Meyers | January 15, 2013 7:29 PM EST

There is no such thing as "medical" marijuana and the term is offensive to medical professionals.

by Genevieve McBride | September 28, 2012 12:24 AM EDT

If this drug is regulated and controlled there may not be the concern. Having seen how this drug can be obtained w/o actual diagnosis resulting from an exam from a real doctor, I see many issues with unregulated medical marijuana. BY unregulated I mean not dispensed by pharmacies. Dispensaries that allow those to order it via the internet should be banned. Marijuana can interact with SSRI's and cause a severe psychosis in some individuals. High THC level marijuana can cause mania and psychosis in some individuals without interacting with other medications. I have seen this happen in the same individual in each scenario. There have been cases in Colorado as told to me by a psychaitrist who saw numerous cases where she practiced, of psychosis induced by marijuana without the aide of other substances. Maybe one or two cases of psychosis or mania among many doesn't seem like a BIG deal, but believe me if it is your family member or you, IT IS A BIG DEAL and very traumatic.There is also the link between marijuana and schizophrenia. There are just too many factors to consider. The longer the first initial psychotic episode is delayed the better the prognosis for schizophrenic individuals. I do not know if there are statistics for those with bipolar disorder but it makes sense that the same would go for those individuals as well. SO until the issues revolving screening and not supplying those who have no legitimate reason to use marijuana are resolved, then it should not be avaiable except in capsule form and only when prescribed by those who have no stake in the success of the dispensaries.

by Alison Moore | September 21, 2012 7:36 AM EDT

I really do not understand why there is such an issue over using Cannabis. It was originally used for a whole heap of remedies hundreds of years, and inspired many an artist, musician and poet. I wonder why nowadays individuals cannot choose to use something of which side effects they are well aware of, over medication which is more toxic and less effective...and is it psychosis, or enlightenment?

by Bryan Krumm | September 20, 2012 6:21 PM EDT

I currently manage hundreds of patients in our medical cannabis program and I see daily proof of the benefits of using cannabis for the treatment of PTSD. In my practice, cannabis has proven itself to be more consistently beneficial and better tolerated than any pharmaceutical drug available.
Bryan Krumm CNP

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