The American Society of Regional Anesthesia and Pain Medicine (ASRA) consensus guidelines on the management of pain medicine for the perioperative patient on cannabis and cannabinoids have spurred conversations among the medical community and cannabis users. These are the first U.S.-based guidelines on perioperative (before, during and after surgery) management of cannabis. The new guidelines call for all patients to be screened for cannabis before surgery. Marijuana consumers reacted to the pain medicine update, reporting a variety of positive and negative interactions during prior discussions with their physicians. The following statements came from a discussion regarding the published guidelines:
“Late in 2021, I had surgery on my retina and had a very good conversation about my cannabis use with the anesthesiologist, who told me that with some of the anesthesia he uses, cannabis consumers often need more than nonusers. I was sure I’d be the exception to that—it doesn’t take much cannabis for me to get high, but I do consume every day. We talked for quite a while; he was actually engaged in hearing about the cannabis industry and asked some good questions. It was a very positive discussion. Sure enough, I needed twice the normal amount of anesthesia for that procedure. Last week, same eye with cataracts. The anesthesiologist comes in and I tell him that I use cannabis and might need more meds; it’s the same guy and he remembers our discussion in 2021. This procedure uses different anesthesia that metabolizes differently, and cannabis isn’t a factor. It’s something we all need to be forthright about for normalizing cannabis use and for our own good.”—R.K.
“Some of us (myself included) have gotten so jaded by the lies about cannabis promulgated by mainstream medicine and groups like the American Medical Association, we no longer take anything they say about cannabis seriously.”—T.B.
“Great progress has been made, but there are still some potential issues. Perhaps the most obvious issue is when an individual is being prescribed pain medications. Some offices have had ‘contracts’ the patient must agree to, and if the clinic learns that other medications or illicit substances are being used, the patient will be discharged. Over the years, I have heard the same thing many times—my doctor learned I smoke weed, and now he won’t see me/refill my scripts. Maybe that has changed? Kind of doubt it . . .”—D.G.
“I think everyone who has been in the cannabis field and had to deal with the medical profession knows, NEVER TELL YOUR DOCTOR. I mean I hope things change, but you will be treated completely differently as if you are a heroin addict. We know this as fact. Proven over and over and over again. ‘More pain relief needed after surgery’ . . . I almost fell on the floor laughing. SOP is to give less. Or maybe take four ibuprofen instead of three. You are a drug addict. That’s how cannabis users have been treated for, well, my entire life basically. Once that marijuana word hits your permanent records, you are screwed. Doctors refuse to treat you or prescribe medicine to you. They will advise how to address your health issues differently because you use marijuana. They will deny treatments because you use marijuana. That is the reality. That is what has happened for decades . . . Will it get better? Maybe a tiny bit. But in the real world, never tell your physician you use marijuana, or ask them to not put it on the record. It will follow you and negatively affect your recommendations and care forever.”—C.C.
“A personal experience and why I choose to keep my cannabis use private when it comes to doctors. I was in an appointment and went there after trimming; yes, I smelled like cannabis. When my doctor walked in, she immediately said you smell like marijuana. I told her I was just trimming some earlier. She then said I can’t treat you, I’m pregnant and THAT SMELL CAN AFFECT MY PREGNANCY AND THE HEALTH OF MY DEVELOPING CHILD. That was the day I swore to never discuss weed with a doctor again.”—C.M.
Currently, it is illegal for doctors (even in states that have legalized medicinal marijuana) to prescribe marijuana because it is a schedule I drug, and prescribing it would constitute aiding and abetting the acquisition of marijuana, which could result in revocation of DEA licensure and even prison time. However, in states where medicinal marijuana is legal, doctors can write a recommendation for cannabis, after determining and certifying that the patient suffers from one of the conditions that the state’s law deems to warrant medicinal marijuana—i.e., generally debilitating conditions such as cancer, glaucoma, multiple sclerosis, and HIV/AIDS. This recommendation “loophole” was upheld by the U.S. Court of Appeals for the Ninth Circuit in Conant v. Walters, which decided that a physician’s discussing the potential benefits of medicinal marijuana and making such recommendations constitutes protected speech under the First Amendment.
In states where medicinal marijuana is legal, a majority of physicians are reluctant to write recommendations, and an influx of “pot docs” becomes obvious. For some doctors who do not embrace medical marijuana, the contempt for pot smokers is undeniable. It is important to gauge your primary doctor’s opinion of cannabis use. Typically, doctors who practice in states that have legalized cannabis for adult use eventually accept it and don’t reject patients and deny services, but as these testimonies demonstrate, some still suffer from reefer madness.
Pregnant persons who use cannabis need to be particularly cautious with these new guidelines’ recent publishing. “Mandated reporting” has resulted in many children being removed by child protective services, and even charges against the mother for crimes such as child abuse and endangerment.
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[*WARNING! This graphic is being used to educate doctors and is not endorsed by The Marijuana Report] |
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