by David Bearman, M.D.
The lack of education from grade school through grad school and medical school regarding cannabis, cannabinoids and the endocannabinoid system (ECS) is directly a result of bad policy. Up and down this is due to the government dealing with many psychoactive substances on a criminal justice basis not as medicine and not following the science.
Much of education problem can be traced to our medical schools. The majority of U.S medical schools are not even addressing the ECS, arguably the largest neurotransmitter system in the human brain, let alone the medicinal utility of cannabis and the appropriate cannabis dosage for various medical indications.
In 2013, Cardiologist Dr. David Allen did a preliminary survey to determine which schools teach the ECS and found that only a total of 13 percent of U.S. medical schools even mentioned it. The ECS is arguably the largest neurotransmitter system in the human brain. It was characterized almost 30 years ago in the late 1980s and early 1990s.
The ECS is arguably the largest neurotransmitter system in the human brain.
This lack of provision of education in medical school means the vast majority of physicians have no professional basis to assess the medical utility of cannabis. I have been an expert witness for several physicians who were being investigated by the Medical Board of California and one physician by the Colorado Medical Board. Of the seven cases, or so, I would say that two or three physicians did provide some education and three or four did not. Whether this is because they don’t know or don’t care is hard to say. In some cases, a physician may just be part of a clinic and the clinic provides the education, while the physician just does a history and physical and signs the recommendation. Whether by the doctor, the clinic, or both, the patient must be educated about cannabis, cannabinoids, the ECS and the major side effects of cannabis.
The quality and quantity of the education provided to a patient frequently depends on how much time the physician allocates to spend with them. There are several methods which can be used: video, handouts and/or discussion and Q&A with the patient. The so-called pot docs who spend only five to fifteen minutes with their patient face a real challenge to allocate a sufficient amount of time for the necessary patient education regarding possible side effects including possible impaired driving education.
The medical education area is in many ways a void, or near zero when it comes to teaching prospective physicians about cannabis, cannabinoids and the endocannabinoid system. Cannabis has been used and recognized as an analgesic for over 4,000 years. It is now seen as one of the tools for dealing with the opiate epidemic, at least by science but not by law.
As recently as the summer of 2018, the Substance Abuse and Mental Health Services Administration (SAMSHA) cancelled a webinar regarding the use of cannabis for treating pain. They were providing the funding to the American Academy of Pain Management which was hosting this webinar in an effort to help fight the opiate epidemic, but SAMSHA stopped the webinar by pulling the funding.
As medical professionals, we must look past this sort of partisan posturing, educate ourselves and push for policies that best benefit our patients. A great way to get educated about the ECS is through the certification at The American Academy of Cannabinoid Medicine.