By Aaron Bloom
Medical cannabis has emerged as a transformative alternative treatment for a myriad of conditions, including cancer-related symptoms, epilepsy, chronic pain, and PTSD. For many patients, medical cannabis is a last resort option after traditional treatments have proven ineffective or side effects too intolerable. Its ability to provide relief and improve quality of life is widely recognized, however, the ethical landscape surrounding its prescription, particularly for PTSD, demands careful scrutiny.
DocMJ addresses the critical ethical concerns associated with medical cannabis licensing, focusing on the implications of using PTSD as a qualifying condition. By examining the potential for misuse and advocating for stringent ethical standards, DocMJ ensures that medical cannabis remains a legitimate, effective, and trusted option for patients truly in need.
Misuse of PTSD Diagnoses in Florida’s Medical Cannabis System
The practice of prescribing medical cannabis, particularly in states like Florida, has given rise to ethical and practical challenges. A notable concern is the role of “pot docs” – physicians who primarily issue cannabis recommendations with minimal medical scrutiny. In Florida, PTSD is one of the most easily accessible diagnoses for obtaining a medical cannabis card. The disproportionately high number of PTSD cases among cannabis patients raises questions about the misuse of diagnostic criteria.
A review of the 2024 Physician Certificate Pattern Review published by the Florida Board of Medicine, which tracks and reports the number of physician certifications and the qualifying medical conditions of approved medical cannabis cards, revealed that several physicians issued a large number of medical cards for PTSD. Specifically, one doctor approved 16,892 certificates in one year, meaning that they wrote 1.92 certificates per hour for every hour of the year and of those certifications, 98.47% were for PTSD. Based on this information, one can question if the physician upheld their ethical obligation to the patient. Since a PTSD diagnosis requires the least amount of work for a doctor to enroll a patient in the state registry, it has become the easiest way for both a doctor and a patient to obtain certification for a medical card.
In another example, one doctor approved 34,383 certificates in one (1) year, equating to 94 certifications per day or four (4) per hour for 365 days. This doctor charged $249 per visit, generating $8.56 million in one year. It is clear there is money to be made from issuing medical cannabis cards, however at what cost?
Such practices can erode trust in the medical cannabis system and devalue legitimate PTSD diagnoses. Exploiting PTSD for recommendations not only trivializes a serious condition but also diverts essential mental health resources from genuinely affected patients. This commercialization of medical endorsements can undermine the professional integrity of physicians and diminish the perceived legitimacy of medical cannabis programs. In addition, the misuse of licensing power tarnishes the reputation of both the medical community and the cannabis industry, providing ammunition for opponents of medical cannabis programs and threatening their viability.
Blurred Lines Between Medical and Recreational Cannabis Use
While individuals with serious illnesses do benefit from medical cannabis, many manipulate the healthcare system to obtain medical cards, especially in states without access to recreational cannabis. The ease of acquiring a medical cannabis license under dubious pretenses blurs the distinction between medical and recreational use. This issue is compounded by states that promote medical cannabis primarily as a stepping stone toward recreational legalization, exploiting public compassion for seriously ill individuals and trust in the medical system. This not only complicates regulatory efforts but also influences public perception and legislative measures on cannabis use.
Promoting Ethical Standards and Patient-Centric Approaches
Unlike traditional medications, medical cannabis lacks standardized clinical guidelines and training, posing challenges in dosage, efficacy, and safety. To address these issues, states like Massachusetts have implemented specific training requirements for physicians, highlighting the need for more structured regulatory frameworks to guide medical cannabis recommendations. For instance, in New York, regulations recommend that practitioners thoroughly review the criteria for a PTSD diagnosis to ensure accuracy and proper documentation in the patient’s medical record before issuing a certification for medical cannabis. Additionally, practitioners are strongly encouraged to consult with the patient’s behavioral health specialist before initiating medical cannabis treatment. If the patient does not have a relationship with a behavioral health specialist, a referral is advised. Other states mandate that PTSD patients receive their medical cannabis permits only with the approval and ongoing guidance of a psychiatrist. Such measures aim to curb the misuse of medical cannabis certifications.
By examining the intersection of medical ethics, patient care, and regulatory challenges, DocMJ aims to foster a more ethical, responsible, and patient-centric approach in the industry. As a facilitator of affordable medical treatments, DocMJ hopes that all facilitators uphold the integrity and credibility of medical cannabis programs, ensuring they serve patients’ best interests and maintain high ethical standards in medical practice.
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