The Journal of the Arkansas Medical Society Issue 1 Vol 115 - Page 5
Executive Vice President
Appathurai Balamurugan, MD, DrPH, MPH
Family Medicine/Public Health
Tim Paden, MD
Sandra Johnson, MD
Issam Makhoul, MD
Naveen Patil, MD, MHSA, MA, FIDSA
Internal Medicine/Infectious Disease
Benjamin Tharian, MD, MRCP, FACP, FRACP
Robert Zimmerman, MD
Tobias Vancil, MD
Darrell Over, MD
prescribing of 3.742 million daily opioid doses
(14.4%) annually in Medicare Part D populations.
Among Medicaid enrollees, implementation
of state medical cannabis laws or “adult use”
cannabis laws were associated with lower opioid
prescribing rates, 5.88% and 6.38% respectively.
The use of medical marijuana is not without
controversy. While numerous reputable physicians
and professional organizations have acknowledged
the observed or potential benefits of medical
cannabis, questions and concerns still abound.
Marijuana remains a Schedule I agent according to
the Drug Enforcement Agency and is illegal under
federal law. Numerous physicians are concerned
that, even if they could prescribe or recommend
cannabis for their patients, uncertainty remains
about the most effective strength or dose to use,
or which route of administration is most effective.
Others have expressed concern that medical
marijuana may actually serve as a gateway
to opioids. Over time cannabinoid receptors
proliferate and tolerance can increase. I share
these concerns with my colleagues; however, the
studies above are encouraging. If medical cannabis
will enable us to fight the scourge of opioid abuse,
I could become a fan.
1. Hedegaard H, Warner M, Miniño AM. Drug
overdose deaths in the United States. 1999-
2016. NCHS Data Brief. No. 294. Hyattsville, MD:
National Center for Health Statistics. 2017.
2. Abuhasira R, Schleider LB, Mechoulam R, Novack
V. Epidemiological characteristics, safety, and
efficacy of medical cannabis in the elderly. Eur
J Intern Med. 2018;49:44-50.
3. Schleider LB, Mechoulam R, Lederman V, Hilou
M, Lencovsky O, Betzalel O, et al. Prospective
analysis of safety and efficacy of medical
cannabis in large unselected population
of patients with cancer. Eur J Intern Med.
4. Bradford AC, Bradford WD, Abraham A, Adams
GB. Association between US state medical
cannabis laws and opioid prescribing in the
Medicare Part D population. JAMA Intern Med.
5. Wen H, Hockenberry JM. Association of
medical and adult-use marijuana laws with
opioid prescribing for Medicaid enrollees.
JAMA Intern Med. 2018.doi.10.1001/
Live Your Dream, Learn To Fly
Alfred Kahn Jr., MD (1916-2013)
ARKANSAS MEDICAL SOCIETY
Lee Archer, MD, Little Rock
Amy Cahill, MD, Pine Bluff
Immediate Past President
Dennis Yelvington, MD, Stuttgart
Chad Rodgers, MD, Little Rock
George Conner, MD, Forrest City
Bradley Bibb, MD, Jonesboro
Eugene Shelby, MD, Hot Springs
Speaker of the House of Delegates
Contact Us Today and Go Fly!
501.975.9330 / learntoﬂy@central.aero
Jim Ingram, MD, Little Rock
Vice Speaker of the House of Delegates
Danny Wilkerson, MD, Little Rock
Chairman of the Board of Trustees
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JULY 2018 • 5