Despite the majority of US states having some form of legal marijuana, many patients don’t tell their physician about marijuana use. Withholding this important fact can be risky.
We spoke with Dr. Sarah T. Melton, Associate Professor of Pharmacy Practice at the Gatton College of Pharmacy at East Tennessee State University. Dr. Melton, a Fellow of the American Society of Consultant Pharmacists, also serves the public as a pharmacist, has contributed to pharmacy textbooks, and has published numerous peer reviewed articles.
Q: Dr. Melton, why is it important for a patient to share with his/her doctor that they may use marijuana with their regular medicine regimen?
A: “Prescribers should take detailed substance use histories from patients in order to make the best decisions about medication therapy choices. It is important for patients to share details of marijuana use, including the type of marijuana used, route of administration, and frequency of use.
Marijuana has potentially serious drug interactions with prescription and over-the-counter medications. By sharing details of marijuana use, the prescriber can best make decisions about medication choices and educate the patient about any potential contraindications or need for monitoring.”
Q: Has marijuana legalization affected the way pharmacists do their jobs on a day to day basis?
A: “As more states legalize marijuana for medicinal and recreational use, pharmacists are stepping up to become more educated about potential drug interactions, adverse effects, and how to monitor a patient that uses marijuana containing products. All patients should expect to be asked by their pharmacist about marijuana use in order for the pharmacist to appropriately screen for any contraindications or need for increased monitoring for adverse effects.”
Q: What are your hopes for the future regarding cannabis use and public understanding?
A: “We need more research performed that clearly identify and quantify interactions between medications and marijuana. More evidence is needed to support the use of medical marijuana for certain disease states, as well as any long-term consequences of use.
The public should be aware of potential interactions with FDA-approved and over-the-counter medications. I hope it becomes standard of care to ask each patient about marijuana use, just as we ask about nicotine and alcohol use — all of which can have potentially significant drug interactions.”
Q: What advice would you have for a patient whose doctor is uncomfortable discussing cannabis use or says he/she doesn’t have enough information to provide an opinion?
A: “If a patient engages with a prescriber who does not have information about potential interactions with marijuana or declines to discuss this important topic, they should contact their pharmacist to help obtain needed answers. Pharmacists are the drug experts on potential drug interactions and readily accessible to the public in every community.”