Consensus statement from APS on medical Marijuana:

On April 26th, we had a panel of experts to discuss the regulatory, legal and treatment aspects regarding the ensuing approval of medical marijuana. From this meeting, the board of directors has agreed to a consensus statement regarding our current stance on medical marijuana in Arizona:

As pain management providers, we recognize the risks and benefits of all of the medications we prescribe. In review of the data that is available regarding medical marijuana as it applies to chronic pain (recognizing most of the studies are in the cancer pain population), and in review of the limited data that has come out from other states that have legalized medical marijuana statutes (specifically California), we have concerns with the existing law.

1) If medical marijuana is to be used “medicinally”, there are shortfalls in key areas. Certainly for a medication that has central nervous system properties (typically depressant) there are essentially no recognized parameters, in terms of the dispensing of the drug. For the consumer, there are no guidelines as to how much medication is to be used for the specific chronic pain issue. We have concerns that this could lead to too much ingested medication (THC) and the resulting implications for driving, operating heavy machinery, and any supervisory role - just to mention a few circumstances.

2) While Arizona is now one of 16 states to approve medical marijuana, there is still federal law that usurps state law. We must recognize that federal law prohibits marijuana for any use, and “prescribing” marijuana for medical use is illegal under federal guidelines. Clearly this puts a health care provider prescribing medical marijuana in a practical and theoretical dilemma; essentially to help the patient and put ones license at risk.

Overall, in reference to our first concern, we feel from a safety perspective, there should be more stringent regulations involved in the type and quantity of THC that is dispensed, and more transparency for the patient.

In reference to our second concern, we hope that the future holds further discussion and subsequent resolution to the disparity between the federal and state guidelines.

Ultimately our goal is to be the advocate for patients with chronic pain issues, and we feel that THC has a place in the spectrum of our treatments, but we remain concerned regarding the safety and regulatory issues stated above.

Arizona Pain Society Consensus Statement:
Urine Drug Testing

Chronic pain management involves multiple avenues to treat patients, which may include a trial of opioid therapy or, in some cases, long-term use of opioids to treat chronic pain conditions.
As pain management physicians, we strive to treat the increasing need of our patients with various painful acute and chronic conditions, while avoiding and addressing the potential negative consequences that can be associated with opioid therapy. Specific to this, we utilize multiple tools to address opioid diversion and abuse.
Urine drug testing is one of the most important tools that we have at this time to monitor our patients to ensure that the opioids and/or Schedule II and III medications that we prescribe are not abused or diverted into our communities. Additionally, urine drug testing identifies patients who are concurrently abusing illicit substances or obtaining controlled substances from multiple providers (aka “doctor shopping”), thus preventing these patients from harming themselves through potentially fatal combinations of prescription and/or illicit substances.