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Mass Dept of Public Health- Medical Use of Marijuana

Instructions for Patient Registration after MD certification

Terms to know:

1. Cannabinoids are derived from cannabis (marijuana)
2. Medical marijuana refers to the use of cannabinoids obtained from a state certified dispensary with the intent to improve specific medical symptoms
3. Two primary components of medical cannabis are delta-9-tetrahydrocannabinoid (THC) and cannabidiol (CBD), though the plant does contains more than 100 unique compounds known as (phyto)cannabinoids
4. There are available pharmaceutic cannabinoids commonly prescribed in oral and sublingual forms. 

Introduction:
Medications using active ingredients of cannabis (such as CBD) have been available and prescribed in the United States for many years. The most commonly known prescribed cannabinoids are dronabinol and nabiximol. These medications have been used as an addition to therapy for some patients.

Recent Advances
Research findings suggests there are a wide range of medical conditions that may improve with cannabinoid therapy

Safety:
While pharmaceutic cannabinoid-derived medications such as Dronabinol, Epidiolex have been manufactured to the standards and approval of the Food and Drug Administration, it is important to note that the various forms of "Medical Cannabis" or "Medical Marijuana" are not FDA approved. Medical dispensaries are designed to provide a relative standard for purity and safety, these standards may not be as rigorously as the FDA. As a result, there can be variation in the uniformity, quality, and dosing of cannabinoids. This is an important aspect that consumers should be aware of. You should discuss your plan to add cannabis to your medical regimen with your primary care doctor/provider. It is important that you discuss all of your medical conditions and current medications with the doctor when you go for a medical marijuana certification.

Some notable research Findings
Some studies suggest that inhaled cannabis may be more effective than other manufactured cannabinoids in the management of some diseases such as HIV neuropathy. Other studies suggest that THC provides similar pain relief when compared to opiate medications in the management of chronic pain.
Overall, there is increasing evidence that cannabinoids may be beneficial in helping patients manage symptoms in a number medical conditions including 

• non-cancer related chronic pain 
• Neuropathic pain
• Multiple sclerosis
• Epilepsy
• Severe nausea associated with Cancer
• Alzheimer's disease
• Arthritis
• Glaucoma
• Crohns disease
• Parkinson's disease
• Other debilitating conditions as certified by the patients certifying physician (after a thorough medical evaluation)

​Side Effects of marijuana use
Cannabis as an adjunct to medical therapy may not be for everyone. It is important that your individual risk and benefit of therapy be assessed by a licensed clinician. Risks of cannabis use include infection, exposure to unintended toxic agents, cancer, lung irritation, habituation and dependence, uncontrolled nausea, cyclic vomiting, delayed reaction time, decrease in motivation, increased risk of falls, disorientation, memory impairments, increase appetite and more. Chronic cannabinoid use with abrupt cessation may result in acute withdrawal symptoms such as anxiety, headache, increased sleep. 

Where does the Medical Profession stand on medical cannabis therapy?
There remains some controversy surrounding cannabinoid therapy within the medical community. Many concerns center around the inability to accurately know the concentration, reliably titrate individual doses, or tell the dose that may be beneficial in a specific patient. Nonetheless, the evolving general medical consensus suggests that it is reasonable to accept the patient's decision to try medical cannabis in certain medical situations. A medical evaluation by a state registered clinician is necessary to obtain certification for medical cannabis. Certification evaluation may be performed by clinicians who may not know your medical history as well as your primary care provider, it is important that you discuss your desire to add medical cannabis to your medical regimen with your primary care provider. A copy of your medical records may be requested by the certifying doctor.

If you are interested in evaluation for the medical use of marijuana, you may contact us by clicking here or call us at 781-561-0460. Each certification is provided after consideration for medical need

Consult for Medical use of marijuana evaluation