Despite increasing amounts of anecdotal and research evidence and increasingly easy access to it, many doctors are taking a more cautious approach to prescribing cannabis outside of its well-known use for ailments like anxiety and depression. Its use remains controversial specifically among psychiatrists, according to a piece in Merry Jane.
Doctors willing to talk to their patients about cannabis say there needs to be a stronger dialogue about where cannabis could be helpful, where research continues to leave big unknowns, and where cannabis could even be harmful in treatment.
Cannabis, when suggested, is most widely used for depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD). In New York, in fact, PTSD is “the only mental health indication for which doctors are legally allowed to prescribe cannabis.”
According to Merry Jane clinicians have varying perspectives on treating clients with cannabis. For example, of those clinicians who do not prescribe it themselves, some will help their clients with harm reduction as well as with using it most effectively for a particular ailment. Psychiatrist Julie Holland, the author of The Pot Book: A Complete Guide to Cannabis, says cannabis can be a great choice in the treatment of opioid addiction, as it is a much safer alternative to opiates.
"If someone tells me about their cannabis use, I'll find out what they're doing, and try to help them make it safer," says Holland. "Like if you're trying to treat your anxiety, [I’d recommend patients] use a high-CBD strain or CBD supplements."
Holland, however, is one of the more liberal clinicians when it comes to treating patients with cannabis. While some research has shown wide-ranging benefits, many professionals call for more testing. With federal prohibition still on the books, little has been approved by the FDA. Plus, drug interactions and cannabis’ proper use with more complicated medical conditions is still unknown. Finally, the DIY mentality of cannabis patients can be downright lethal. Consider this scenario:
“The DIY mentality that often comes with marijuana legalization can be detrimental for regular adults who don't know how cannabis could affect them, physically or psychologically. For example, for people taking the drug Tacrolimus after a procedure such as a liver transplant, cannabis and CBD in particular can be lethal. Patients ingesting this immunosuppressant must take a very exact dose — without enough Tacrolimus, they could have liver failure, and with too much, they could overdose. "It turns out that CBD interacts with Tacrolimus and increases the [dosage], and that can be lethal," says Dr. Jordan Tishler, a cannabis specialist. "As we get more and more sick people into our care provision system, we'll have more of these problems come up."”