The Journal of the Arkansas Medical Society Issue 1 Vol 115 - Page 5

David Wroten Executive Vice President Penny Henderson Executive Assistant Journal Advertising Nicole Richards Managing Editor Jeremy Henderson Art Director EDITORIAL BOARD Appathurai Balamurugan, MD, DrPH, MPH Family Medicine/Public Health Tim Paden, MD Family Medicine Sandra Johnson, MD Dermatology Issam Makhoul, MD Oncology Naveen Patil, MD, MHSA, MA, FIDSA Internal Medicine/Infectious Disease Benjamin Tharian, MD, MRCP, FACP, FRACP Gastroenterologist/Hepatologist Robert Zimmerman, MD Urology Tobias Vancil, MD Internal Medicine Darrell Over, MD Family Medicine 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. References 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. 2018;49:37-43. 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. 2018. doi.10.1001/jamainternmed.2018.0266. 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/ jamainternmed.2018.0266. Live Your Dream, Learn To Fly EDITOR EMERITUS Alfred Kahn Jr., MD (1916-2013) Training Pilots Since 1939 ARKANSAS MEDICAL SOCIETY 2018-2019 OFFICERS Lee Archer, MD, Little Rock President Amy Cahill, MD, Pine Bluff Immediate Past President Dennis Yelvington, MD, Stuttgart President Elect Chad Rodgers, MD, Little Rock Vice President George Conner, MD, Forrest City Secretary Bradley Bibb, MD, Jonesboro Treasurer Since 1939 Eugene Shelby, MD, Hot Springs Speaker of the House of Delegates Contact Us Today and Go Fly! 501.975.9330 / Jim Ingram, MD, Little Rock Vice Speaker of the House of Delegates Danny Wilkerson, MD, Little Rock Chairman of the Board of Trustees NUMBER 1 2 3 0 1 C r i s p D r i v e | L i t t l e R o c k | A r k a n s a s | 7 2 2 0 2 | c e n t r a l . a e r o JULY 2018 • 5