Cannabis

[MitchLevi]

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Georgia has 5% THC tincture for those with cannabis cards. This was rolled out summer '23.

I've had...I think 3...pts show up and disclose to me they got a card from their PCP and they've tried it. None have benefitted, and one actually ended up having to be physically carried out of a Cracker Barrel and put into his car by the restaurant staff bc he couldn't move. Literally stuck to the dinner table (80 yo man BTW).

I just realized today that cannabis is not on the state's PDMP site. These previous patients all disclosed to me the fact they had received the tincture and used it, but for some reason I did not realize there is no reporting.

WTF? How am I supposed to know if you're using cannabis tincture if it isn't on the PDMP?

Urine isn't guaranteed to pop positive if you know what you're doing, and PCPs don't always send records.

How many of you practice in states where this is commonplace, and is it listed on your PDMP?

 

[lobelsteve]

UDS + gets warning, 2nd offense and I stop opiates.
DEA sets the schedule and owns your registration to prescribe.
Roll the dice, win stupid prizes.

 

[GoBeers]

UDS + gets warning, 2nd offense and I stop opiates.
DEA sets the schedule and owns your registration to prescribe.
Roll the dice, win stupid prizes.

Even if it's off schedule 1, would you then allow patients to get thc and opioids?

I would still think not, similar to our concerns with mixed opioids and alcohol

 

[Agast]

Yeah, it’s a major flaw in the PMP monitoring system that it’s not reported and tracked. I’m guessing it’s because it’s still illegal at the federal level.

 

[Ferrismonk]

Cannabis is not in the PDMP because IT'S NOT MEDICINE.

In my state, we have "legal" recreational and medical marijuana. We don't allow it to be used if we're prescribing their opioids. It's in the contract, patient should know not to.

If positive on UDS, the patient gets a warning. Third violation we stop the opioids.

 

[Ducttape]

we see medical marijuana on the PMP in my state. its still a prescription.

we do not see legal marijuana.

 

[lobelsteve]

Even if it's off schedule 1, would you then allow patients to get thc and opioids?

I would still think not, similar to our concerns with mixed opioids and alcohol

Nope. Lots of other prescribers out there.

 

[pmrmd]

Huge percent of my patients have positive UDS for THC for “sleep”. Hmmmm

 

[Crybaby]

thc not on pmp here. We have weed shop on every corner , house of dank. Very classy. I prescribe very few opiates anymore to a select few of patients so luckily I have had only couple of issues. Many of the pain clinics in my area no longer test for THC routinely.

Anyone else read that they are considering bringing THC down to schedule 3. I believe I saw on my phone news feed a while back. Will this change how you rx?

 

[Ducttape]

i might change the treatment agreement form to specifically note that while it is THC is not Schedule I, the office policy will be to not prescribe opioids to those concurrently taking THC....

 

[Ferrismonk]

thc not on pmp here. We have weed shop on every corner , house of dank. Very classy. I prescribe very few opiates anymore to a select few of patients so luckily I have had only couple of issues. Many of the pain clinics in my area no longer test for THC routinely.

Anyone else read that they are considering bringing THC down to schedule 3. I believe I saw on my phone news feed a while back. Will this change how you rx?

lol, Michigan too?

 

[barnebasguitano]

I've noticed a similar issue in my practice. In my state, cannabis isn't listed on the PDMP either, which makes tracking usage really challenging. It's frustrating because, like you, I rely on accurate information to provide the best care. Interestingly, I've heard from colleagues in the UK that patients can buy medical cannabis online. They seem to have more streamlined processes for tracking and reporting, which might help avoid situations like your Cracker Barrel incident. For those interested, you can check out Buy cannabis online UK. It's worth considering if we need better systems for monitoring cannabis use here as well.

 

[Pain Applicant1]

Georgia has 5% THC tincture for those with cannabis cards. This was rolled out summer '23.

I've had...I think 3...pts show up and disclose to me they got a card from their PCP and they've tried it. None have benefitted, and one actually ended up having to be physically carried out of a Cracker Barrel and put into his car by the restaurant staff bc he couldn't move. Literally stuck to the dinner table (80 yo man BTW).

I just realized today that cannabis is not on the state's PDMP site. These previous patients all disclosed to me the fact they had received the tincture and used it, but for some reason I did not realize there is no reporting.

WTF? How am I supposed to know if you're using cannabis tincture if it isn't on the PDMP?

Urine isn't guaranteed to pop positive if you know what you're doing, and PCPs don't always send records.

How many of you practice in states where this is commonplace, and is it listed on your PDMP?

In Virginia cannabis is on the pmp. It's funny to read the names. The pmp is this legal gov medical document and you have names on there like purple haze, Pineapple Jager, birthday cake Kush, Pablo's revenge.

 

[Agast]

“I see you got a 30 day supply of the Pineapple Jager and a 90 day supply of the Birthday Cake Kush??”

“Oh, my son just had a graduation party”

 

[Pain Applicant1]

Looks like Virginia got smart and realized how ridiculous these names came across. Now they just list it as THC and THCA. They must have recently changed things around.

 

[sahabarun]

That definitely raises some questions. I’ve been seeing a lot of discussions about cannabis products like delta 9 thc gummies. Personally, I’ve tried a few myself, and while I know people swear by them, I’ve had mixed experiences. The gummies definitely kicked in differently compared to tinctures, and I’ve had a few friends report some pretty wild side effects – not to the extent of being physically stuck at a dinner table like your story, but still, some of them ended up feeling more “out of it” than they expected. I’m surprised to hear that it’s not being reported in your state’s PDMP. It’s a gray area, for sure. I get why you’d be concerned about not being able to track it.