A leading addiction specialist has urged doctors to start treating patients for cannabis dependency rather than conditions such as sleep and pain, arguing it could help them avoid regulatory action.
Professor Nicholas Lintzeris told a gathering of practitioners last night that they should stop “pretending” to treat chronic, long-term conditions and treat the indication the patient is more likely to have – cannabis dependency.
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There is a lot of merit in this. There are 1000’s of patients who say they have been weaned off debilitating opioids because their medicinal cannabis works as well without the side effects so I agree entirely. However, if a patient wants a script and the Dr and patient know the underlying cause is because they would like to access cannabis legally then the Dr should work with the patient to understand the overall health of the patient and keep them off the streets which is where they will go if the medical “door” is closed. Doctors will do more harm by saying no rather than saying yes and working with the patient to properly diagnose and ensure the product is being used appropriately. A “holier than though approach” by Doctors may make them feel better for reducing drug dependency but the outcome is probably a lot worse!
I think some people have taken this article out of context. What Dr Lintzeris was saying is that there are 10-20% of patients who meet the criteria for Cannabis Use Disorder (CUD). The best way to treat CUD is actually with cannabis, he wasn’t suggesting to refuse cannabis treatment for CUD patients. He was saying that practitioners legally need to JUSTIFY the condition they are treating and in a lot of cases where a patient has been consuming cannabis for decades, but they have never been treated for pain, sleep or anxiety, then how do you justify cannabis as a first-line treatment for those conditions? It is more likely you can justify CUD if the patient meets the CUD criteria here:
1. Using cannabis in larger amounts and for longer than intended
2. Wanting to cut down or quit but being unable to do so
3. Spending a lot of time getting, using, or recovering from the effects of cannabis use
4. Cravings and urges to use cannabis
5. Not managing to do what you should at work, home or school, because of cannabis use
6. Continuing to use despite relationship problems
7. Giving up important social, occupational or recreational activities because of cannabis use
8. Using cannabis again and again, even when it puts you in danger (driving, legal). Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by cannabis use
9. Needing to use more cannabis to get desired effect (tolerance)
10. Development of withdrawal symptoms