Discriminating Healthcare

Advocates for medical cannabis have been making great strides. More and more states are allowing for the use of medical cannabis and the versatile plant has gotten more positive press than ever before. If you live in a state like California, with medical cannabis laws, you might think that for seriously ill patients, getting medical cannabis is now an easily accessible option.

What most don’t realize is that even in states that allow medical cannabis, patients suffering with serious medical conditions often face barriers to medical cannabis use. Widespread and often systematic discrimination from health-care providers poses a huge hurdle to integrating cannabis into a patient’s preexisting medical care. Ironically, healthy recreational users are often able to get a recommendation, never mention it to their primary care physician and continue to have normal medical care. However, patients who are in the most need are often under much more active medical scrutiny, and are already utilizing a variety of other treatment options. This creates a need for doctors and health organizations to educate themselves about the effects, possible drug interactions, and potential uses and benefits of cannabis, so they can appropriately advise their patients who are already using cannabis therapeutically. Unfortunately, many health-care institutions and insurance providers have sidestepped this need with system-wide policies against cannabis use, and instruct their doctors to simply not engage with cannabis. For patients, these uninformed cannabis policies can create incredibly dangerous situations.

Patients on opiates, for example, can actually use cannabis to reduce their opiate use. In states with medical cannabis laws, deaths from opiates go down around 25%. Still, doctors regularly tell patients they need to stop using cannabis or be taken off opiates entirely. Such discriminatory policies can force patients into a difficult and otherwise unnecessary choice between cannabis and conventional medicine.

I experienced a similar situation myself when I was beginning the withdrawal process from two addictive prescription medications that were no longer working for my chronic pain condition. The withdrawal process needed to be a slow one because a sudden stop could cause seizures – potentially deadly ones. Cannabis was working to manage my symptoms and I planned to continue using it to aid in the dangerous and painful withdrawal process.

Unfortunately, after explaining to a new doctor how helpful cannabis had been in dealing with my painful symptoms, I was told I would be drug tested. If tests came up positive for cannabis, the doctor would take me off of my other medications abruptly without a withdrawal process. Although other doctors had repeatedly warned that an abrupt stop could be fatal, the doctor explained her hands were tied. It was corporate policy. Unable to get out of the insurance plan for the year, another doctor outside of my insurance policy was needed. This required me to pay out-of-pocket for all my medical costs including doctors visits and over $500 a month in prescriptions.

Looking into the insurance company’s policies on cannabis, I found that they have not publicly stated any policies against cannabis use. But their patients tell another story and online message boards are filled with stories like mine. And this company is not the only one. Given the current schedule 1 drug status of cannabis, many doctors and health institutions see cannabis as a risk – not for the patient, but for the doctor, who could face jail time if he/she is found to be “prescribing” rather than “recommending” cannabis.

The safest path for doctors is to avoid cannabis completely until it is rescheduled. But for patients, this can increase risks drastically. More education for doctors about the effects of cannabis is greatly needed. Continuing education for doctors could help fill the gap by bringing the latest cannabis research from reputable journals to the medical community. Still, until the medical institutions catch up with the science, cannabis patients should be careful about who they trust with their medical care.