Health

18 HEALTH • Fall 2016 Four years after legalization, Mass. doctors far from consensus \\ By Laura Finaldi I t's been about four years since Massachusetts residents voted to legalize marijuana for medical use, but the state's health care community as a whole is far from a consensus on how or even if it should be used. State records show that the number of Massachusetts physicians registered to certify patients for the use of medical marijuana has increased steadily over time, but also that a concentrated number of physicians are the ones handing out the certifications. Just 19 of the registered doctors in Massachusetts issued over three-fourths of the approximately 65,000 unique patient certifications given through Aug. 22. IS MARIJUANA GOOD MEDICINE? While some doctors have registered with the state to certify medical marijuana themselves, many doc- tors and large health care systems aren't ready to get on board just yet. Some are unsure of marijuana's medicinal value, saying the science isn't there to back up the claims. Others are afraid that providing a cer- tification for use of a substance that is still illegal under federal law could lead to liability issues. But medical cannabis advocates and doctors said that its use has been transformative for those suffer- ing from everything from chronic pain to HIV or cancer, and that pushback from those who oppose it is contributing to a stigma felt by patients who just want some relief. The Massachusetts Medical Society opposed the medical marijuana ballot question before Massachusetts residents voted to legalize it in 2012. The society's president, Dr. James Gessner, said there is a lack of consensus on medical marijuana because there isn't enough scientific evidence sup- porting the claim that marijuana is safe and effec- tive medicine. "Doctors like to take care of their patients. And they like to use proven therapies and follow best practices, but there isn't any data about marijuana. There aren't good studies on its clinical effective- ness," Gessner said. Differing approaches According to the Massachusetts Medical Society, the 2002 federal appeals court decision of Conant v. Walters set the precedent for the role of physicians in the business of medical marijuana. The decision said under the first amendment, physicians have the right to discuss medical marijuana with their patients, but that doesn't mean they can help them obtain medical cannabis. That's why doctors have to issue written certifica- tions of potential patient benefits for marijuana, instead of prescriptions. Physicians issuing certifi- cations have to have a full license with an estab- lished place of business in-state, complete two P H O T O / C O U R T E S Y

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