Thursday, August 1, 2013

Are Most Patients Who Get A Medical Card Faking?


Prior to marijuana experiencing prohibition in 1937, it was a significant part of the US pharmaceutical market. It was commonly prescribed in the early 1900's, because at that time it wasn't on a controlled substance list.

After the Marijuana Tax Act of 1937, marijuana was not technically illegal but heavily taxed. Within 4 years, the US pharmaceutical market grew tired or paying the hefty taxes, so cannabis was removed from the market altogether. In the 1970's, it officially became a Schedule 1 narcotic, and illegal to prescribe.

Sixteen states have legalized marijuana medicinally, and for various conditions. California, for instance, has the most lax rules with what medicinal marijuana can be recommended and ID cards received. Forty six percent of CA voters actually said yes recently to outright legalization. Medical marijuana has been legal in CA since 1996.

In a recent survey of close to 2000 patients at multiple CA marijuana evaluation clinics, there was an interesting array of conditions patients maintained. Thirty one percent had chronic pain in the back, spine, or neck, with sixteen percent having a sleep disorder. Anxiety and depression amounted to thirteen percent. Eighty percent of these patients reported trying traditional medications (typically opioids) prior to marijuana.

The fact they were trying regular prescription medications could argue against faking, but even people faking can often bilk the system to get narcotic prescriptions. The patients were asked if they had used marijuana recreationally prior to receiving patient cards, with 40% saying yes. Interestingly, studies have shown that approximately 30% of narcotic patients divert their prescriptions (selling or trading them), with the percentage spanning all socioeconomic classes.

Most states now require evaluation of a patient's medical records and an in-person physical exam for the debilitating qualifying condition. For instance, if a patient has Crohn's disease in a state that has legalized cannabis for Crohn's, there should be some medical records for it. If not, a workup should commence for it to make sure the disease is present prior to approving for medical marijuana.

So it is not exactly clear how many medical marijuana patients are faking. Based on the CA survey, we do not have a clear number. Considering the sheer number of patients in the US who doctor shop for narcotics and become illegitimate patients, if it's any way equivalent the number may be over 20%. This is speculation.

One thing is certain though. Despite the illegitimate patients receiving ID cards, it is also apparent that medical marijuana represents a valid treatment than some of the more conventional existing treatments for numerous conditions. There are less side effects and often an ability to decrease the more harsh side effects of traditional medications by decreasing dosages.

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