You’ve seen the question many times. It’s always on the form the receptionist asks you to fill out when you see a new doctor. Perhaps you pause for a few seconds. Then you probably answer “No.” The question is some variant of: Have you ever used illegal drugs? And although you smoke weed, perhaps on a regular basis, and although it is illegal in your state, you probably answer “no” because... well, it’s just easier that way. You don’t want to prejudice a new doctor against you. And what if your illegal behavior becomes part of your medical record? What if your employer or insurance company finds out about you? With all the havoc it might conceivably cause, is it really worth coming out to your physician? I believe the answer is yes. Of course, it depends upon your boldness and your risk tolerance, but I think you should let your doctor know if you use marijuana on a regular basis. The insurance companies don’t care about your cannabis use: They review charts just to locate financial irregularities. Your employer does not have access to your medical record. And if you’re still concerned, you don’t have to check “yes” to the infamous question; you can leave the answer blank or even check “no.” You will never be charged with perjury! But when the physician takes a history, you can still be honest with him or her. Let’s say you are asked about what medications you take or could take for a medical condition: That would be an appropriate time to discuss your cannabis consumption. Before discussing marijuana, you might ask your doctor if what you say next could be off the record — not entered into your chart. He or she is likely to turn away from the screen, look you in the eye — and finally pay you some attention! 1. Give Your Doctor a Complete Picture of Your Health Your physician wants to know about anything that might impact your health one way or another. A good medical history includes questions about your exercise habits, vitamin use, diet, and sleep. Regular cannabis use might also be relevant. Your endocannabinoid receptors are getting the very molecules they were designed to receive! Your physician is likely to read more health studies than you do, and he or she may know the latest cannabis recommendations, or cautions, for a person with your medical profile. Let’s say a patient of 70 is noticing some memory lapses and is worried about dementia. If she confides that she has a history of marijuana use, the physician can assure her that some age-related memory loss is normal and that cannabis is probably not the culprit. The doctor might even allay the patient’s fears by citing recent research suggesting that THC could actually reduce plaque formation in the brain. Or suppose a patient of 40 is trying to lose weight. A physician might question the patient’s habit of toking up every day before dinner. Sometimes one needs to hear the obvious from an authority figure! While there have been few reports of cannabis/pharmaceutical drug interactions, the doctor should know about your marijuana use before making prescribing decisions. He or she might prescribe a less powerful dose of, say, a painkiller, because the cannabinol in your system is already providing you with some pain relief for your rheumatoid arthritis. Alternatively, and counter-intuitively, cannabis smoking may dictate a higher dose of some drugs. A Santa Barbara anesthesiologist recommended that a friend of mine stop smoking marijuana for a week before an operation or he would have to receive more anesthetic. 2. Benefit From Your Doctor’s Expertise You are the authority on what feels right for your body and your mind, but your physician is the expert on the conditions that may ail you. It’s good to at least consider what the doctor has to say. You may think you’re controlling your glaucoma by smoking weed (which has been shown to reduce intra-ocular pressure), but your ophthalmologist may recommend that you supplement your regimen with certain eye drops. Instead of needing to take them twice a day like most people, because you smoke weed, you may be advised to take them only once a day. A doctor may be able to warn you that consuming cannabis may interfere adversely with some common pain medications, such as aspirin and acetaminophen. In each case, weed, unsurprisingly, increases transient side effects such as dizziness, drowsiness, and confusion (especially in the elderly) in a small percentage of people. Grandpa, you’ve just had your Tylenol! Go easy on that vaporizer! 3. Create Teachable Moments Perhaps you’re an elementary school teacher or a state employee, so you can’t be publicly enthusiastic about cannabis without jeopardizing your career. You can’t participate in the #ComingOutGreen movement on Twitter for fear of losing your job. But you can be an advocate for change on the micro level, one to one, with the people in your life, including your health care providers. Earlier in this piece I assumed you had a knowledgeable, marijuana-friendly physician. But perhaps he or she is the opposite: a doctor who doesn’t know about (or dismisses) the many medical uses of cannabis, or a doctor who regards pot-smokers as a bunch of stoners. This person might be an excellent physician who could, with your help, experience a change of mind. You can share the success you’ve had, say, in using cannabis as an anti-depressant: You can explain that it helps you get more sleep and feel more hopeful. You can tell your gynecologist that you’ve been using pot for menstrual cramps since you were 17. You can inform your doctor about how you use weed to ward off a migraine. If your physician gets many such reports, one day he or she might suggest to a patient, “You could try smoking a little marijuana when you get that aura announcing a migraine. Some people say it makes the migraine go away.” Even if smoking weed has no direct impact on your physical health, it’s good to let your doctor know that people of a certain caliber are cannabis users. We are not stoners living in our parents’ attics and garages. Cannabis is routinely and responsibly used by millions of happy, successful, and productive individuals, women and men, young and old — 30 million Americans used marijuana last year. Before marijuana becomes legal — both as a medical miracle and a harmless euphoriant — millions of educational encounters need to occur. Many will take place on the examination table. Source
