Doctors need marijuana training [Letter]

I would like to share my organization's thoughts with regard to recent discussions about medical marijuana in Maryland and the question of whether physicians should receive additional training ("Medical pot rules raise concern," July 26).

As a statewide pharmacists' program with a mission to educate our field about drug and alcohol abuse, we are aware of the harmful effects substance use has especially when illicit drug and prescription drugs interact. Many clinicians outside of the pharmacy community lack the background necessary to discern the dangers recreational use of drugs can have on various health conditions due to prescription drug interplay. Therefore, we fully support the notion of further training for physicians prescribing medical marijuana within the state of Maryland.

Why? Unlike prescription medications, there will likely be no U.S. Food and Drug Administration oversight in the prescribing and dispensing of medical marijuana. Additionally, medical schools have not educated students on "indicated uses", appropriate dosing, adverse effects and drug interactions of medical marijuana. This educational void should be filled in order to ensure that patients are receiving appropriate care. One solution that will improve patient outcomes and minimize diversion is to require that physicians receive appropriate medical education before working with this patient population and prescribing medical marijuana.

Potential lack of quality control is another concern. Like other medications, stringent quality standards should ensure a consistent and reliable percent of cannabinoids in the product. This should include a low percent of delta-9-THC and a higher percent of cannabidiol than found in "street" marijuana in order to maximize the medical benefit of medical marijuana while decreasing the "high." Finally, there are no medications where the route of administration is by smoking.

Ideally, medical marijuana should be sold in a way that it can be vaporized or ingested orally. Nevertheless, given the lack of lack of addiction content in the educational programs for all our health professionals, it seems little to ask that physicians complete training in addiction and marijuana effects before prescribing it to the citizens of Maryland.

Tony Tommasello, Pylesville

The writer is president and interim executive director of the Pharmacists' Education and Advocacy Council Maryland.

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