A doctor’s unique perspective on what doctors can learn from medical marijuana

I just got around to reading this fascinating New York Times op-ed piece authored by David Casarett, headlined “What I Learned at the Weed Dispensary.”  I recommend the full piece, and here are passages that especially caught my attention:

I met Robin and many others like her at a California medical marijuana clinic where I was doing research for a book.  She was one of almost a dozen patients seeking recommendation letters that would let them buy marijuana at designated dispensaries. I asked how marijuana helped her.  “I can’t live without it,” she told me.  She said it helped her sleep, and it relieved the constant pain in her joints.

But Robin was most eager to talk about how medical marijuana put her in charge.  She can decide whether to use it, when to use it and how much she needs.  She doesn’t have to rely on a doctor.  “I’m in control,” she said….

Many people with serious illnesses turn to medical marijuana because they’re not getting the careful, comprehensive treatment they need for symptoms like pain or nausea or anxiety.  That was certainly true for Robin, whose physicians didn’t seem to have the time or the skills to help her.  

As a palliative care physician, every day I see firsthand the suffering my patients have experienced, and the lengths to which they’ve gone to manage their symptoms and control their lives.  They stockpile medications in case their pain increases.  And some buy illegal drugs on the street because their physicians won’t prescribe opioids.  So is it any wonder that people like Robin with serious illnesses want to take matters into their own hands?

Yet it seems that many of my physician colleagues haven’t considered the possibility that patients are turning to medical marijuana because the health care system has failed them.  In general, their reaction to medical marijuana has been one of detached amusement, tinged with avuncular concern.  And when they recognize the challenges that patients like Robin face, they point out that they don’t have enough time in a typical 15­-minute visit to deliver the kind of personalized care that Robin needed.

Fortunately, Robin’s story offers solutions. I’ve identified at least three lessons the medical marijuana industry holds for our health care system. And none of them require doctors to spend any more time with patients.

First, we should give patients a chance to learn from one another….

Second, if physicians can’t spend more time with patients — and, in general, they can’t — we should give patients more time with other office staff members….

Third, we should give patients more ability to manage their treatment. What Robin wanted was a chance to treat her symptoms in her own way, using strategies that worked for her. She wanted to try, and maybe fail, and try again. She wanted to be in charge.