Some doctors uneasy about medical marijuana

Although Illinois’ medical marijuana program rolled out this week, some doctors aren’t participating, potentially limiting the program’s success.

Two of the four main medical institutions in Springfield have advised their doctors to avoid the program out of uncertainty over a potential crackdown by the federal government.

The Illinois General Assembly approved the medical marijuana pilot program in 2013, and the first licensed dispensaries opened on Nov. 9. Out of concern that Illinois’ program would be abused by recreational drug users, lawmakers put strong restrictions on who qualifies. Among other requirements, a patient must be certified by a doctor as having one of the approved medical conditions.

Despite the state-based program, marijuana remains illegal at the federal level, creating uncertainty among some doctors about their role.

Dr. Harald Lausen, chief medical officer of SIU School of Medicine in Springfield, says the school doesn’t have a policy against its doctors certifying patients for the program, but doctors have been advised that doing so could endanger their license to prescribe controlled substances, a license overseen by the federal Drug Enforcement Agency. The DEA classifies marijuana as a Schedule I drug – the most severe classification – meaning it has a high potential for abuse, has no accepted medical use and lacks an accepted safe usage level. Other Schedule I drugs include heroin and LSD, while drugs like methamphetamine and cocaine are listed on Schedule II.

Lausen says doctors don’t technically need a prescribing license to practice medicine, but a doctor without a prescribing license is very limited. SIU’s concern about the medical marijuana program is due to the drug’s Schedule I classification, not its stigma, he said, adding that if the DEA downgraded marijuana to Schedule II, SIU would advise its doctors to make their own call.

Edgar Curtis, CEO and president of Memorial Health System, says Memorial has also advised its doctors of the risk to their prescribing license and urged them not to certify patients for the program.



Dr. J. Michael Zinzilieta, chief medical officer for Springfield Clinic, says the clinic’s doctors will make their own choice. While he acknowledges the potential for risk, he notes that doctors won’t actually be prescribing marijuana to patients. Instead, they will only certify that the patient has had an approved medical condition for one year or longer and that the patient may benefit from marijuana use.

“We believe that a doctor treating a patient knows best,” Zinzilieta said.

Dr. Loren Hughes, president of HSHS Medical Group, says doctors at St. John’s Hospital will make their own decision.

“The decision is a private medical matter between the patient and his or her health care provider,” Hughes said.

Jay Cook is director of community education and outreach for HCI Alternatives, which plans to open medical marijuana dispensaries in Springfield and Collinsville in December. Cook is frustrated that doctors at SIU School of Medicine and Memorial Health System won’t be participating in the medical marijuana program. He believes the risk to a doctor’s prescribing license is minimal, and he says the reluctance of some medical providers to certify patients limits the program’s reach.

About 3,300 Illinoisans with medical conditions have qualified so far, which is far fewer than the roughly 250,000 people the program’s backers expected. Cook says that’s not enough to sustain the industry in Illinois, but he hopes that patients will push more doctors and medical institutions to participate.

Seth Yakatan is interim CEO of Los Angeles-based Kalytera Therapeutics, a pharmaceutical company developing non-psychoactive drugs based on marijuana. Yakatan says there has been no rash of doctors in California – the first state to legalize medical marijuana – being targeted by the DEA for recommending marijuana to their patients. He points to a U.S. District Court ruling in California – Conant v. McCaffrey – which held that doctors cannot be sanctioned for recommending marijuana. While the California decision technically doesn’t apply to doctors in Illinois, it would likely serve as a precedent if a similar legal challenge is raised here.

Dr. Marc Sloan, director of Pain Management Consultants near St. Louis, believes that medical marijuana is part of the solution to a national problem: the rapidly increasing use of narcotic pain medications and an associated increase in narcotics overdoses. Compared with many other controlled substances, marijuana has few side effects, Sloan says, and studies have shown marijuana use can decrease the perception of pain and the use of narcotics.

“I have a strong conviction that patients should be afforded every opportunity to feel better,” he said. “If I can get patients to replace narcotics with something that doesn’t have negative respiratory or cardiac effects, why wouldn’t I?”

Sloan doesn’t expect a niche of doctors exclusively certifying patients for medical marijuana to develop because the current system doesn’t make it lucrative. However, he says certification should only be done by physicians who are trained to recognize the approved medical conditions. Sloan draws a distinction between medical marijuana and recreational drug use.

“This is not about Cheech and Chong,” he said. “This is about a medication.”

Contact Patrick Yeagle at [email protected].