Utah’s medical cannabis program is set to launch this weekend, with patients able to apply for a medical marijuana card online as early as Sunday morning.
But one of the first challenges they might face is finding a doctor willing to recommend it.
According to the Utah Department of Health (UDOH), as of Thursday evening 80 medical providers had applied and 59 had been approved during the pre-registration period announced earlier this month.
That’s a promising start, said Connor Boyack with the medical marijuana advocacy group Libertas Institute. Even if he eventually hopes to see hundreds enrolled in the program, he said he expected it to start with a trickle.
Dr. Marc Babitz, who’s overseeing the program, said he understands why some medical providers have been slower to sign on.
“This is new,” Babitz said. “It's one of those things where they have no personal experience.”
Most doctors don’t receive any training with the drug in medical school, he said. And even if marijuana is generally considered more benign than other medications, major questions like how much to prescribe a patient and how it interacts with other drugs have not been well-established.
“The problem with marijuana is there's much more that we don't know about it than what we do,” said Dr. Kyle Jones, a family physician in Salt Lake City.
Jones said he’s been interested to learn about marijuana’s medicinal uses, and went to an education conference to get started. But at this point, he’s leaning away from joining.
He said he found there is good evidence marijuana can help certain conditions, such as chronic pain and severe nausea. But for others, it’s less clear if and how it helps.
“Looking at the list of all the covered conditions from the Department of Health, it almost looks like they just kind of threw a whole bunch of stuff against the wall,” he said.
According to UDOH’s website, cannabis can be used to treat a range of conditions from HIV to PTSD. But Jones said he hasn’t seen much evidence that it can help his patients with autism — also on the list.
He said he worries that could hurt his relationship with patients, who may come to him wanting to try marijuana for something he doesn’t think it would help. And with the possibility that some may also want to use it recreationally, that could put doctors in the position of having to decide whether the patient’s interest in marijuana is legitimate or not.
“If I say [to a patient] I'm not sure that what you're telling me is accurate, that creates a big rift,” he said. “Because in some ways, I'm saying I'm not sure I trust what you're telling me. And that makes it very difficult in any treatment relationship.”
He said he’d rather see it fully legalized or not at all to avoid that dilemma altogether.
Dr. Isaac Noyes, also a family physician, said despite some concerns, he will still likely sign up.
“I think that patients are looking for things that will provide them relief, but in a safer, more accessible way,” Noyes said. “And our job as physicians is to learn how to do that, but also in a safe way, which takes some learning and some practice.”
He said he’s comfortable joining the program early on because he has a background in treating addiction and chronic pain. He’s also gone through a similar training process with buprenorphine, which is used to treat opioid addiction and requires a separate DEA license.
Noyes said his main worry stems from his type of practice. He takes care of in-patients at hospitals, so he can only make short-term drug recommendations. That creates complications for follow up, he said.
“Are they going to be able to get a refill? Are they going to be able to find a provider that can see them and pick up the ball with that treatment plan?” Noyes said.
Medical standards are slow to evolve, he said, and it could take years before the state’s infrastructure catches up with demand.
But for those early adopters, Babitz has this advice for starting out with marijuana recommendations.
“Start low, and go slow,” Babitz said. “Start with a low dose, increase it slowly and then see how the patient's doing and make changes as you need to.“
He said with that approach, he doesn’t see why marijuana can’t help physicians in their two main principles: do no harm and help people feel better.
Jon Reed is a reporter for KUER. Follow him on Twitter @reedathonjon
