Dr Kevin Hill: Policy Is Ahead of Science on Medical Cannabis

Right now, state policy regarding medical marijuana use is out ahead of the science, which can lead to predicaments where cannabis is prescribed in situations where it is not needed, explained Kevin P. Hill, MD, MHS, of Beth Israel Deaconess Medical Center and Harvard Medical School. 

What messages do payers give physicians in response to the rise in legal marijuana?
I think there are areas where it's, unfortunately, predicaments where the policy is ahead of the science. So I talked earlier about a handful of conditions: 3 beyond the 2 FDA-approved conditions. But when you look at the 29 states and the District that have medical cannabis policies, there are over 50 conditions for which various states say cannabis is effective. So I think a lot of times we have people who really are desperate, they want to have effective treatments available, but they're launching ahead using cannabinoids in ways that really haven't been shown to be effective in rigorous clinical trials. And so I think that's unfortunate.

A typical example is, in my field, in substance use disorders, there are people who say that cannabis could be an exit drug, and exit strategy for people using opioids or addicted to opioids. And my initial concern about that is that we actually have 3 FDA-approved medications for opioid use disorders that do actually work fairly well. And so I would be concerned if I knew that a patient who had opioid use disorder was being treated with cannabis as opposed to one of those 3 FDA-approved treatments.

I think there's a right way and a wrong way to do this, and when you have policy out in front of the science, and people launching ahead with these policies, sometimes they're doing it in the wrong way.
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