12/08/2016    Jay Kerner, DPM

Medical Marijuana and Podiatry

As per my previous posts regarding prescribing
medical marijuana for such conditions as
diabetic neuropathy, ishemic pain and
debilitating arthritis, I again wish to raise
my concern that as podiatrists, we de-value our
profession by not retaining parity with the
other medical professions.

As stated in Newsday last weekend, as of
November 29th nurse practitioners may certify
patients for medical marijuana in New York
State. Physician assistants will no doubt
eventually be included, as they are already
licensed to prescribe opioids and/or other
controlled substances.

I would like to summarize a recent landmark
report from the U.S. Surgeon General, which
places drug and alcohol addiction alongside
smoking, AIDS and other pubic health crises of
the past half century.

1) Nearly 21 million Americans struggle with
substance abuse, more than the number of people
who have all cancers combined

2) One in seven Americans face substance abuse

3) 78 people die each day from opioid abuse

4) Only 10 percent of those currently addicted
get treatment

I'd like to add that, in addition to smoking,
obesity and a risk of falling, it behooves us
to raise our awareness of patients at
significant risk of, or who are already
addicted to opiates. A proper referral in such
cases may prove lifesaving.

To those who are nervous about medical
marijuana, it is incumbent upon you to be
respectful of those with serious medical
conditions who might benefit from this as an
alternative treatment. Certainly it is worth
considering this option in lieu of other
prescriptions that may create more life-
threatening complications. Further training and
clear prescribing guidelines can be of benefit.
Podiatry should take a leading role in
addressing these complicated issues.

Jay Kerner, DPM, Rockville Centre, NY

Other messages in this thread:

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01/30/2019    Gary S Smith, DPM

Medical Marijuana and Podiatry (Allen Jacobs, DPM)

I realize this is a controversial subject with
many points of view. I am not against the
legalization of Marijuana. I do believe that
doctors and users need to be better educated
because any view that comes across anti-pot
seems to be a source of contention. First of
all, there is no such thing as "medical
marijuana". Any ailment you have from terminal
cancer to depression and pain, marijuana will
make you feel better.

Snorting coke, shooting heroin and over using
opioids will make you feel better as well. This
doesn't mean they are the best ethical choice of
treatment. Ninety percent of heroin addicts say
marijuana was their gateway drug. If you
prescribe marijuana and a person becomes a
heroin addict shouldn't you be held liable?

In my practice of 28 years and 20,000 patients
in a very depressed area I have had several
patients that had used marijuana daily. It's
come to the point where they don't tell me they
use pot, I tell them. If you are a man and use
pot daily you will have serious impotence
problems by age forty. In your forties, you will
begin getting neuropathy. By the time you are
fifty, you will have complete neuropathy in your
feet and legs and be diabetic because smoking
pot daily causes diabetes.

In your sixties, you will go on dialysis. All of
you have seen these patients. When you have a
diabetic patient with complete neuropathy but
normal skin texture, palpable pulses, and normal
hair distribution they are most likely a daily
marijuana user. If you prescribe marijuana to a
patient, even if the person is well on their way
to these symptoms, you will be held liable.

Gary S Smith, DPM, Bradford, PA