As an interventional pain physician for Spine and Wellness Centers of America, I treat acute and chronic pain patients throughout South Florida in hospitals, skilled nursing facilities and the outpatient setting. I personally believe in a holistic approach to manage pain emphasizing wellness and function.All five of our doctors are certified medical cannabis recommending physicians with the goal of maximizing patient’s quality of life with patient specific tailored treatment plans. As a patient advocate I believe that medical cannabis can and should play a role in patient care. I would like to comment on the recent piece of pending legislation offered by State Rep. Ray Rodrigues (HB 1397.)
The proposed measure examines many of the complex facets of implementing new medical marijuana laws and seems to take this matter with the seriousness it deserves. Seventy one percent of Florida voters overwhelmingly supported Amendment 2, the measure to legalize medical marijuana for the sick under the care of a physician.
The proposal seems to ensure that patients who are genuinely ill and who, under the treatment of a physician, have access to safe, tested and relatively pure medical cannabis. Nonetheless, the bill maintains the 90-day patient/doctor requirement which is nonsensical. I have had patients who have passed away before the 90-day relationship requirement was met. I have current patients who are suffering due to their terminal illness or debilitating condition who are not able to get relief with medical cannabis because I have not been their physician for 90 days. Yet, I am able to prescribe any medication including opioids with the potential for overdose and uncomfortable side effects. This is truly disturbing and unjust
The bill seems to go too far in dictating the ways in which physicians can administer cannabis to patients in that it prohibits (for some) the use of edible products. For many patients, especially those who are very sick, having a variety of ways to administer a medicine is a vital part of a physician’s toolbox. Patients who take a variety of pills may benefit from an edible, as not to add yet another pill and offering a more appealing, comforting alternative form of medicine. An edible can be a delightful relief. It is important to clarify that these edibles do not have to be attractive to children or people who are not medical cannabis patients but rather a form that can be easily taken and comfortably ingested by a compromised person.
Further, the proposal also eliminates the use of vaporizing cannabis. In understanding why this is important, it is worthwhile to consider other non-marijuana-related medicines. Physicians often use pharmaceutical nebulizers and systems that “vaporize” medicine for safe inhalation especially when fast relief is needed. Administering medicine in this way provides rapid and simple relief.
For example, if a veteran is having a PTSD or panic attack, waiting for a pill to be metabolized is not an effective, successful method for treating this event. On the other hand, vaporizing can provide instant relief. Further, when a cancer patient is experiencing debilitating nausea secondary to chemotherapy, is seems inhumane and cruel to make the patient suffer for an hour until the pill takes effect.
Lastly, the bill puts government employees in the position of superseding physicians' medical knowledge, clinical experience and ability to dose. A well-trained physician who has established a relationship by monitoring the patient is witness to how their condition may be debilitating such as my chronic pain patients. The physician should be the only one making these choices and treatment plans. Non-physicians should not be involved in dictating how we practice by limiting physicians with a list of diagnoses in which we can recommend medical marijuana or the route of administration the patient may take their medication.
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</aside>In conclusion, the House’s conservative and measured approach to the implementation of Amendment 2 is a start. Allowing more latitude for physicians to use their training and experience to determine who is a candidate and what dose should be used as well as having variety in terms of routes of administration for medical cannabis patients would allow this bill a more effective framework for moving forward from a physician’s perspective.
Dr. Michelle Weiner, is an Interventional Pain Management Physician, board certified in Physical Medicine and Rehabilitation. She believes in an all-inclusive approach to manage pain emphasizing wellness and function. Dr. Weiner is a Certified Medical Cannabis recommending physician with the goal of maximizing her patients’ quality of life with patient-specific tailored treatment plans.
http://www.sun-sentinel.com/opinion/commentary/sfl-florida-house-medical-marijuana-bill-story.html
P.S. G-d bless you Dr Weiner , we need more doctors like you to stand up for us. Thank you
The proposed measure examines many of the complex facets of implementing new medical marijuana laws and seems to take this matter with the seriousness it deserves. Seventy one percent of Florida voters overwhelmingly supported Amendment 2, the measure to legalize medical marijuana for the sick under the care of a physician.
The proposal seems to ensure that patients who are genuinely ill and who, under the treatment of a physician, have access to safe, tested and relatively pure medical cannabis. Nonetheless, the bill maintains the 90-day patient/doctor requirement which is nonsensical. I have had patients who have passed away before the 90-day relationship requirement was met. I have current patients who are suffering due to their terminal illness or debilitating condition who are not able to get relief with medical cannabis because I have not been their physician for 90 days. Yet, I am able to prescribe any medication including opioids with the potential for overdose and uncomfortable side effects. This is truly disturbing and unjust
The bill seems to go too far in dictating the ways in which physicians can administer cannabis to patients in that it prohibits (for some) the use of edible products. For many patients, especially those who are very sick, having a variety of ways to administer a medicine is a vital part of a physician’s toolbox. Patients who take a variety of pills may benefit from an edible, as not to add yet another pill and offering a more appealing, comforting alternative form of medicine. An edible can be a delightful relief. It is important to clarify that these edibles do not have to be attractive to children or people who are not medical cannabis patients but rather a form that can be easily taken and comfortably ingested by a compromised person.
Further, the proposal also eliminates the use of vaporizing cannabis. In understanding why this is important, it is worthwhile to consider other non-marijuana-related medicines. Physicians often use pharmaceutical nebulizers and systems that “vaporize” medicine for safe inhalation especially when fast relief is needed. Administering medicine in this way provides rapid and simple relief.
For example, if a veteran is having a PTSD or panic attack, waiting for a pill to be metabolized is not an effective, successful method for treating this event. On the other hand, vaporizing can provide instant relief. Further, when a cancer patient is experiencing debilitating nausea secondary to chemotherapy, is seems inhumane and cruel to make the patient suffer for an hour until the pill takes effect.
Lastly, the bill puts government employees in the position of superseding physicians' medical knowledge, clinical experience and ability to dose. A well-trained physician who has established a relationship by monitoring the patient is witness to how their condition may be debilitating such as my chronic pain patients. The physician should be the only one making these choices and treatment plans. Non-physicians should not be involved in dictating how we practice by limiting physicians with a list of diagnoses in which we can recommend medical marijuana or the route of administration the patient may take their medication.
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</aside>In conclusion, the House’s conservative and measured approach to the implementation of Amendment 2 is a start. Allowing more latitude for physicians to use their training and experience to determine who is a candidate and what dose should be used as well as having variety in terms of routes of administration for medical cannabis patients would allow this bill a more effective framework for moving forward from a physician’s perspective.
Dr. Michelle Weiner, is an Interventional Pain Management Physician, board certified in Physical Medicine and Rehabilitation. She believes in an all-inclusive approach to manage pain emphasizing wellness and function. Dr. Weiner is a Certified Medical Cannabis recommending physician with the goal of maximizing her patients’ quality of life with patient-specific tailored treatment plans.
http://www.sun-sentinel.com/opinion/commentary/sfl-florida-house-medical-marijuana-bill-story.html
P.S. G-d bless you Dr Weiner , we need more doctors like you to stand up for us. Thank you
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