Issues and Ethical Considerations
The use of medical marijuana in anxiety disorders and PTSD (Post Traumatic Stress Disorder) has many concerns. Cannabis is criminalized by the federal government, but many states have legalized it for medical purposes (Redinger et al., 2020). Healthcare providers have legal, medical, and moral considerations (Redinger et al., 2020). Patients are interested in improving their conditions and believe that marijuana can treat anxiety and manage pain (Philpot, 2019). Prescribing medical cannabis (marijuana) can potentially benefit a patient but can cause additional health and legal issues.
- Medical marijuana: legalized by some states but criminalized by the federal government.
- Healthcare providers: legal, medical, and moral considerations.
- Patients: concentrate on improving health.
- Ethical dilemma: Prescribing medical cannabis can benefit a patient but can cause additional problems. With long-term use of marijuana, tolerance to the effects of the drug is formed: a patient takes increasing doses of marijuana. This product affects cognitive abilities and emotional balance, which in certain cases, can be a threat to society. In this regard, the use of marijuana, even for medical purposes, requires regulation.
Practitioners’ Perspectives
Issues and medical considerations of marijuana usage revolve around the provider’s moral principles, professional obligations, law obedience, philosophical, cultural, or religious reasons, and what is best for the patient. When other alternatives do not help, practitioners must consider that cannabis can be helpful in dealing with anxiety and PTSD (Azcarate et al., 2020; Fowler, 2021). Chronic and short-term use of cannabis can lead to mental health disorders and disproportional use of drugs (Glickman & Sisti, 2020; Sagy et al., 2018). Doctors can prescribe marihuana if the state where they practice allows it (Redinger et al., 2020; Nussbaum et al., 2011). US Food and Drug Administration (FDA) considers cannabis illegal and can revocate licensure and press criminal charges (Redinger et al., 2020). Practitioners must consider their moral beliefs, the benefit for the patient, and the possibility of legal problems.
- Main considerations:
- Moral principles: the existence of a risk of dependence in a person;
- Professional obligations: side effects on cognitive abilities and emotional state;
- Law obedience: extraction and distribution for medicinal purposes is possible only in states where this product is not prohibited;
- Philosophical, cultural, or religious reasons: marijuana may be a significant plant in terms of the patient’s religious or cultural beliefs;
- What is best for the patient: the ratio of the expected benefits must exceed all the risks.
- Cannabis can help in dealing with anxiety and PTSD.
- Marijuana can lead to more mental health problems.
- Prescription is allowed in some states.
- FDA can revocate licensure and press charges.
Patients’ Perspectives
Patients and their families desire to take marijuana because they are focused on improving health. Patients believe that cannabis can help with such mental health disorders as anxiety (Philpot, 2019). People who have experience with other prescriptions state that marijuana is more efficient in dealing with mental health issues (Bruce et al., 2018). Some patients prefer cannabis to reduce harm from reliance on other medications (Bruce et al., 2018; Chaudhry et al., 2016). Most people seem to be willing to take medical marijuana to achieve better outcomes and are not concerned much with other issues.
- Patients believe that cannabis:
- Can help with mental health disorders.
- Is more efficient than other drugs.
- Can reduce harm from other prescriptions.
The main ethical dilemma is related to the unique properties of cannabis and its effect on the human body. A positive effect can only be observed in specific cases, while the risks of addiction and negative influences must be strictly assessed by experts and require long-term work. The effect of marijuana use could theoretically spread to various systems within the body, and with certain checks, the relevant organs could deprive the patient of the ability to, for example, drive a car. Moreover, application is complicated by extraction and distribution to medical facilities due to strict prohibitions in certain states.
References
Azcarate, P. M., Zhang, A. J., Keyhani, S., Steigerwald, S., Ishida, J. H., & Cohen, B. E. (2020). Medical reasons for marijuana use, forms of use, and patient perception of physician attitudes among the US population. Journal of General Internal Medicine, 35(7), 1979-1986.
Bruce, D., Brady, J. P., Foster, E., & Shattell, M. (2018). Preferences for medical marijuana over prescription medications among persons living with chronic conditions: Alternative, complementary, and tapering uses. The Journal of Alternative and Complementary Medicine, 24(2), 146-153.
Chaudhry, H. J., Hengerer, A. S., & Snyder, G. B. (2016). Medical board expectations for physicians recommending marijuana. Jama, 316(6), 577-578.
Fowler, C. (2021). The use of marijuana derivatives in primary care: An evidence-based approach to cannabidiol.The Journal for Nurse Practitioners, 17(9), 1058-1063.
Glickman, A., & Sisti, D. (2020). Prescribing medical cannabis: Ethical considerations for primary care providers.Journal of Medical Ethics, 46(4), 227-230.
Nussbaum, A. M., Boyer, J. A., & Kondrad, E. C. (2011). “But my doctor recommended pot”: Medical marijuana and the patient–physician relationship. Journal of General Internal Medicine, 26(11), 1364-1367.
Philpot, L. M., Ebbert, J. O., & Hurt, R. T. (2019). A survey of the attitudes, beliefs and knowledge about medical cannabis among primary care providers. BMC Family Practice, 20(1), 1-7.
Redinger, M., Fledderman, N., & Crutchfield, P. (2020). An ethical framework to manage patient requests for medical marijuana. The Journal of the American Board of Family Medicine, 33(1), 147-151.
Sagy, I., Peleg-Sagy, T., Barski, L., Zeller, L., & Jotkowitz, A. (2018). Ethical issues in medical cannabis use.European Journal of Internal Medicine, 49, 20-22.