I’ve treated a number of patients with head and neck cancer who have used cannabis, … and they seem to tolerate treatment better than the ones who are not using cannabis. —Rafi Kabarriti, MD
Explore This IssueSeptember 2019
AMA and ACP Positions
Leading medical associations have published position papers on medical marijuana, but both the American Medical Association and American College of Physicians declined to grant interviews to ENTtoday for further guidance on how physicians can navigate the confusing landscape, saying they had nothing to add beyond the publications already available.
In addition to calling for steps designed to promote additional research into medical marijuana, the American College of Physicians position paper encourages the use of non-smoked forms of THC that have “proven therapeutic value.” The college also urges authorities to do an evidence-based review of marijuana’s status as a Schedule I controlled substance, to see whether it should be reclassified, and “strongly supports” exemption from federal criminal prosecution, civil liability, or professional sanctioning for physicians prescribing or dispensing medical marijuana in accordance with state law.
The AMA also calls for steps for more high-quality research and says it “believes that cannabis for medicinal use should not be legalized through the state legislative, ballot initiative, or referendum process.” The association also says it supports legislation granting immunity to physicians who recommend cannabis for medical conditions in accordance with state laws. Patient care, the policy says, “requires the free and unfettered exchange of information on treatment alternatives and that discussion of these alternatives between physicians and patients should not subject either party to criminal sanctions.”
Although the interest in medical marijuana seems to be keener in neurology, mainly for a role in epilepsy and multiple sclerosis, and rheumatology, which involves many disorders that bring chronic pain, otolaryngologists are also eager to learn more about medical marijuana, Dr. Winkler said. Recently, at a medical meeting in Portland, Ore., a colleague suggested they do a study looking at post-operative pain with or without CBD.
“Right now it seems like CBD oil is the cure-all for everything, which of course it’s not,” he said. “But, that said, what things might it be beneficial for? And we all talk about that, and maybe we’ll do some studies in the near future. … It’s one of those things that we all think could have some potential—just the studies, to my knowledge, haven’t been done. While CBD oil and cannabis may have potential as a therapy for a variety of diseases, we need more well-controlled studies to guide our clinical practices.”