Marijuana remains the most abused drug in the United States. The arguments for and against legalizing marijuana continue to mount. This article is not intended to set the stage for a debate on the legalization of marijuana. Instead, I want the precautionary professionals whose patients in their care test positive for marijuana. Marijuana use is still prohibited by federal law, and patients who self-medicate or abuse marijuana should not be prescribed controlled substances.

Unfortunately, many physicians are often faced with the dilemma of whether or not to prescribe controlled substances to patients who test positive for drugs for marijuana. This is particularly the case in states that have modified state laws to legalize marijuana. These changes in state law do not change the federal guidelines that physicians must follow. As a former career DEA agent, I remind doctors that marijuana remains an illegal Schedule I controlled substance with no accepted medical use in the US The fact is, all state laws have federal oversight, such as it is established in the Supremacy Clause of the Constitution. "The Supremacy Clause is a clause within Article VI of the United States Constitution that dictates that federal law is the supreme law of the land. Under the doctrine of preference, which is based on the Supremacy Clause, federal law prevails over state law, even when the conflict of laws ". (one)

When a physician becomes aware that a patient is using marijuana, alternative methods of therapy must be implemented in addition to prescribing controlled substances. Doctors should also take steps to refer the patient for treatment and stop if illegal drug use, including marijuana, is revealed. Doctors should also keep in mind that the marijuana produced today is much more potent than in the past and that the use of high-potency marijuana in conjunction with controlled substances is not safe for patients.

Is there FDA approved medical marijuana? There are two FDA-approved drugs in the US that contain a synthetic analog of THC (tetrahydrocannabinol), which is the main chemical (cannabinoid) responsible for the psychoactive effects of marijuana. A synthetic version of THC is contained in the FDA-approved drugs Marinol (List III) and Cesamet (List II) that are prescribed to treat nausea in cancer patients undergoing chemotherapy. Marinol is also prescribed to stimulate the appetite of patients with cancer and anorexia (2). The FDA is currently monitoring ongoing trials on Epidiolex (3), a drug manufactured by GW Pharmaceuticals and developed to reduce seizures in children. The drug contains cannabinoids from marijuana, known as cannabidiol or CBD, which does not contain the psychoactive properties of traditional marijuana and does not produce an effect. If this drug receives FDA approval, it would make history by being the first approved drug containing CBD in the US.

Additionally, the DEA has issued a special registry for a University of Mississippi research laboratory to grow various strains of marijuana for clinical trials (4). This research will continue, but at the time of writing, ingesting or smoking botanical marijuana or the cannabis plant itself is not federally approved as an accepted medical treatment in the U.S. Patients who smoke or ingest marijuana should be aware of They are violating federal law and could be prosecuted under federal statutes. Additionally, physicians must conduct tests for marijuana use and, if detected, must not prescribe controlled substances, regardless of their diagnosis and the patient's symptoms, according to current federal statutes, https://smartandsafeaz.com/.

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Unfortunately, many physicians are often faced with the dilemma of whether or not to prescribe controlled substances to patients who test positive for drugs for marijuana. This is particularly the case in states that have modified state laws to legalize marijuana. These changes in state law do not change the federal guidelines that physicians must follow. As a former career DEA agent, I remind doctors that marijuana remains an illegal Schedule I controlled substance with no accepted medical use in the US The fact is, all state laws have federal oversight, such as it is established in the Supremacy Clause of the Constitution. "The Supremacy Clause is a clause within Article VI of the United States Constitution that dictates that federal law is the supreme law of the land. Under the doctrine of preference, which is based on the Supremacy Clause, federal law prevails over state law, even when the conflict of laws ". (one)