More Doctors On Board With Prescribing Medical Marijuana

Jamie Howe has been disabled for years after complications from a gastric bypass surgery, and was diagnosed with exocrine pancreatic insufficiency, which she said causes debilitating pain.

After opiates put her in the hospital and then into rehab, she looked to marijuana to alleviate the pain.

"I do get it on the black market. But it's not something I like to do,” Howe said. “You know, I don't want to get busted. I don't want to go to jail, especially for healing myself. This should be treated as a health issue, not a criminal one."

Now she sees Dr. Daniel Rodriguez, a family practice doctor in New Port Richey in Pasco County. But Howe is not a fan of the 90-day waiting period to get on the patient registry, or that she had to switch doctors.

“It’s ridiculous to make patients wait 90 days when I have a mountain full of records,” Howe said. “I haven't just been sick overnight. I've been sick for years."

Howe found Rodriguez through a document updated weekly by the Office of Compassionate Use and Florida Department of Health. He's been on that list since Charlotte's Webb passed in 2014. He immediately signed up for the $1,000, eight-hour course through the Florida Medical Association to get registered with the state as a prescriber to help patients like Howe.

“I realized that this was something that I wanted to offer my patients when after listening to them, and that's one of the beautiful things about family medicine and may be why you have a lot of family medicine physicians (prescribing marijuana). You realize that a lot of them were relying on this substance to help them cope with their symptoms,” Rodriguez said.

A limited, low THC form of medical marijuana has been available in Florida since that law passed in 2014, and when Gov. Rick Scott signed the Compassionate Medical Use act - also known as Charlotte's Web - for epileptic and terminally ill patients.

But in November, Florida voters passed Amendment 2, fully legalizing medical cannabis - as long as you have a prescription.  

And more doctors, like Rodriguez, are getting on board.

“Once you get to know your patients for a while, you realize that there is a large population of people out there that because it is socially stigmatized to potentially use marijuana they don't want to tell people, but they do tell their doctors," he said.

In late December, more than 360 doctors in Florida had signed up to prescribe medical marijuana. And the list grows bigger every week. The physicians' specialties range from oncology and neurology to psychiatry and anesthesiology - and perhaps surprisingly - the biggest category of prescribers,  like Rodriguez, are under "Family Medicine," the generic term for most primary care physicians.

Before Amendment 2 passed, only Florida residents with cancer, or severe seizures or muscle spasms- qualified for the medication. The other people who took to self-medication, Rodriguez said, are not shopping for a legal high. Most his patients have tried marijuana before coming to him, but the vast majority have legitimate medical concerns, and aren’t using it recreationally, he said.

Those patients, he said, shouldn’t be punished for the few who try to game the system.

"In terms of people abusing the system, that has been true with multiple substances such as opiates, such as marijuana and listen, frankly, even with alcohol,” Rodriguez said. “You know kids, when they're 18, they go get fake IDs to get alcohol, and we don't vilify alcohol for those people trying to seek it illegally."

While more doctors are signing up to prescribe medical marijuana, many doctors are still careful to whom they issue prescriptions. That's because the treatment is not FDA approved and there are still few studies to back up the efficacy of it.

Dr. Selim Benbadis is a neurologist with the University of South Florida Health. He's also a prescriber, but specializes in patients with epilepsy. Since the science is unclear – and until more studies can prove it helps – Benbadis said it should remain an end of line option.

The anecdotes – personal stories and videos shared online that show marijuana users treating their symptoms successfully - are overwhelming and heartwarming, he agreed. But that’s not data, he said.

"Patients on whom I will consider medical marijuana are those who have exhausted the reasonable amount of conventional treatments,” Benbadis said. “Now am I going to be extreme and say they must have tried absolutely every seizure medication? No, that's not reasonable. But clearly it's not first or second or third line treatment."

Rodriquez, the family practice physician in New Port Richey, said it's only a matter of time before most doctors will add medical marijuana to their tool belt.

“The number of people in the registry right now is fairly small compared to the number that we would expect in a state with such a large population as Florida,” Rodriquez said. “Having said that I think that people now are beginning to really realize that this is an avenue that they can seek. So I would expect that number to rise in the near future.”

And more doctors in the registry means more patients like Jamie Howe can be evaluated for legal marijuana use.

"I hate to admit that I'm doing something illegal but at the same time people have to understand that that people like me - if I didn't have that medicine - I would give up on life," she said. "Because somebody to be in constant, constant excruciating pain every single day, it’s just not bearable for anybody.”

Right now, it’s all Howe’s got. But in the next month, once she rides out her remaining waiting period, she'll be taking marijuana legally. 

Copyright 2016 Health News Florida