November 11, 2019 – At their meeting at the end of October in Los Angeles, the House of Delegates of the California Medical Association voted to adopt a recommendation stating, “That CMA oppose policies of health plans, health systems, and hospitals that have pain management programs that automatically eliminate patients who use therapeutic cannabis.”
The CMA’s new policy is consistent with federal CDC and VA policies.
The Centers for Disease Control and Prevention, in guidelines on prescribing opioid medications for pain issued in 2016, states: “Urine drug testing results can be subject to misinterpretation and might sometimes be associated with practices that might harm patients (e.g., stigmatization, inappropriate termination from care)….Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear. For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahyrdocannabinol (THC)…Clinicians should not dismiss patients from care based on a urine drug test result because this could constitute patient abandonment and could have adverse consequences for patient safety.”
In December 2017, the Veteran’s Administration issued VHA Policy Directive 2017-1315 stating, “Veterans must not be denied VHA services solely because they are participating in State-approved marijuana programs.” The directive replaced VHA Directive 2011-004 which had the same language.
Cal NORML regularly hears from patients who are terminated from pain management medications because of their use of medical marijuana. A great many studies have shown cannabis is effective for pain, and can allow patients to reduce their use of opiates.
A poll being taken by Cal NORML shows that 17% of respondents have been denied prescription drugs, including painkillers, because of their cannabis use, and 23% said they have increased their use of opioid or other medications because of drug testing for cannabis by their doctor or employer. Eight other states have laws protecting cannabis patients’ rights to medical treatment.
“We hope that with the support of CMA we can finally see the end of discrimination against California pain patients who use medical cannabis,” said Ellen Komp, Deputy Director of Cal NORML.
Another recommendation approved by the delegates states, “That CMA support physician expert led development of more consistent and clinically informed policies and protocols for health plans, health systems and hospitals around the use of cannabis.” Cal NORML also supports this recommendation.
Cal NORML, the state chapter of the National Organization for the Reform of Marijuana Laws, is a non-profit, membership organization that has advocated for consumer rights and evidence-based policies since 1972.