Pubdate: Sat, 10 Jul 2010
Source: Bangor Daily News (ME)
Copyright: 2010 Bangor Daily News Inc.
Contact: http://drugsense.org/url/MWLhV21W
Website: http://www.bangordailynews.com/
Details: http://www.mapinc.org/media/40
Author: Meg Haskell

DOCTORS WARY OF MEDICAL MARIJUANA PROGRAM

BANGOR, Maine -- Marijuana dispensaries are a hot topic, but Maine
doctors remain lukewarm about the key role they play in the state's
emerging medical marijuana program.

Many physicians are skeptical about the benefits of treating medical
conditions with marijuana, and others are unclear about the
implications of recommending a drug that remains illegal for
nonmedical use. Physician skepticism and ambivalence may prolong
patients' inability to legally obtain a drug they say brings them
significant relief.

Dr. John Woytowicz of Augusta says marijuana's effectiveness in
relieving pain, nausea and muscle spasms is well-established. For the
past decade, Woytowicz has provided the documentation his patients
have needed to legally possess small amounts of marijuana under
Maine's previous law. But that law didn't help patients obtain
marijuana, leaving them either to grow their own or purchase it from
illicit dealers.

"The dispensaries are a great feature," Woytowicz said Thursday.
"People are going to feel much more comfortable because they don't
have to do anything illegal."

But patients can purchase from the dispensaries only if they sign up
with the state's program, and that includes getting a doctor's
certification. Woytowicz said many doctors are hesitant to participate
in the program.

Some have concerns about the possibility of running afoul of federal
law if they prescribe the use of a drug that not only does not have
the endorsement of the Food and Drug Administration but that also
remains illegal under federal statutes, he said. Other doctors doubt
the effectiveness of marijuana over mainstream pharmaceuticals, or
fear that their practices will be overrun by drug-seekers if it
becomes known they're willing to certify patients for the program.

But if doctors cultivate good relationships with their patients, use
good clinical judgment and keep careful documentation, he said,
marijuana can provide an important alternative to prescription drugs.

Dr. David McDermott, president of the Maine Medical Association and
director of emergency services at Mayo Regional Hospital in Dover
Foxcroft, said many physicians do not understand how the new medical
marijuana program works or what their obligations are.

The medical association, which neither endorses nor opposes the use of
marijuana, has held several physician education programs around the
state that have been well-attended. But that doesn't mean doctors will
decide to get on board, McDermott said.

"The law does not obligate physicians to prescribe marijuana for their
patients," he said.

In Bangor, Dr. Erik Steele, chief medical officer for Eastern Maine
Healthcare Systems, said he is unaware of any decision about the
organization's member hospitals, physician practices or individual
doctors participating or not participating in the medical marijuana
program.

"I know the debate is going on, but I know of no decision that has
been made," he said.

Steele, a practicing emergency room physician, said some patients
recently have asked him to certify them for the marijuana program.
"I'm struggling with it," he said. "I'm not sure it's a good thing."

For patients nearing the end of life who find that marijuana relieves
their pain and nausea, he said, he would be more comfortable.

But for chronic disorders, he said, "I would probably rather you used
other treatment."

Steele predicted it would take at least a year for most Maine
physicians to make an informed decision about whether to participate
in the new program.
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