How to Speak to Your Doctor About Medical Cannabis

For many of us, interacting with our doctor even under the best of circumstances can be an intimidating experience. Are you bracing yourself for bad news? Unconsciously neglecting uncomfortable—but nevertheless important—details of your symptoms? Add in the potentially divisive subject of cannabis to this mix, and subtle discomfort can flare up into full-blown anxiety or even panic. So, how do you speak to your doctor about medical cannabis?

If you’re nervous about broaching the topic with your doctor, provider or caretaker, we’d like to ask you to take a deep breath and relax. Yes, cannabis has been a controversial subject in the medical realm, at least for the last 100 years or so. But before that time there was remarkably little debate about cannabis’ therapeutic effectiveness; it was used as a remedy for anxiety, chronic and menstrual pain, indigestion, and a host of other symptoms for which it’s still prescribed today.

Today, careful research is validating the efficacy of these treatments and suggesting a wide range of other applications, ranging from neurological conditions, such as epilepsy and multiple sclerosis, to ulcerative colitis, chronic pain, Crohn’s disease, and conditions that coexist with depression and anxiety.  

That said, the medical profession’s acceptance of cannabis isn’t universal, and some doctors still hold antiquated or unexamined views about its therapeutic usefulness. If you’re preparing to speak with your physician about cannabis treatments—or bringing up your preexisting cannabis use—we’d like to smooth the waters with a few tips and talking points that may ease this potentially challenging conversation.

We asked Dr. Stephen Dahmer, M.D., chief medical officer of Vireo Health, for advice on how to speak to your doctor about medical cannabis and what advice he had for patients. He noted that medical cannabis is unique among medications in that patients — more often than not — broach the topic with their physicians.  “Something that has really amazed me from the beginning of my involvement with medical cannabis is that it is one of the first medications in my career that has been brought to the medical community by patients,” said Dr. Dahmer. “It has been patient advocates that have pushed for it. I highly encourage all patients to continue to be their own advocate, and they should feel comfortable discussing it with their provider.”

Of course, not every patient nor physician feels comfortable discussing it. However, Dr. Dahmer advises: “There’s no reason to fear the conversation. If your physician doesn’t feel comfortable having an objective conversation about risks and benefits, or even being open to learn more, that says a lot about the provider.”

Before you do speak to your doctor about medical cannabis, here are some practical steps you can take that will help you feel more comfortable and ensure you get the most out of the conversation.

How to Speak to Your Doctor About Medical Cannabis: Be Prepared, Thorough and Curious

If you’re interested in trying cannabis therapy, we invite you to research the topic as it relates to your condition. Why do you believe cannabis can help your condition? Are there any studies or research indicating cannabis might be an effective treatment? Is there anything about medical cannabis that would NOT work well with you as a patient (eg. pregnant, unstable heart disease, breastfeeding, etc). If you can approach the conversation with your doctor with validated, authoritative information about cannabis being an appropriate treatment for your condition, you’ll approach the conversation better prepared and with greater confidence.

Fortunately, you can find a wealth of widely available resources and information online. “One of the best resources you can take to your physician or a provider comes from Americans for Safe Access,” added Dr. Dahmer. “The mission of Americans for Safe Access is to ensure patients and researchers have safe and legal access to cannabis for therapeutic uses and research. And, they have fact sheets and condition-based booklets that you can share with your physician.” (See the Publications section on the Americans for Safe Access website.)

Gather Important Personal Details, Including Your Medical History

If you’re already using cannabis to treat a specific condition, make sure to gather as much relevant information about your experience as you can. This includes such details as:

• How have your symptoms changed since beginning cannabis therapy?
• How often do you take cannabis? What delivery method works best for your condition?
• What is THC / CBD ratio of the products you’ve tried? Have you found a ratio or strain that works best?
• Does cannabis cause unwanted side effects or symptoms of its own? Has changing the dosage, timing, or other factors helped mitigate these?

Learn About the Endocannabinoid System (ECS)

Dr. Dahmer also highly recommends patients learn about the endocannabinoid system (ECS). The endocannabinoid system is arguably our body’s most important physiological system, as it is implicated in virtually every aspect of our physical and emotional health.

In fact, the ECS is our body’s own cannabinoid system whose primary function is to preserve homeostasis. “The endocannabinoid system is ubiquitous, present all over the human body,” reports Dr. Dahmer. “It’s a super homeostatic regulator that affects so many different processes within the body, from inflammatory response to the immune system to cognitive function. It really is an amazing system that any scientist and any physician would be excited to explore further.”

Remarkably few physicians are familiar with the ECS. “The endocannabinoid system is something that we were not taught about in medical school,” notes Dr. Dahmer. “But any physician who is open to exploring new ways of helping their patients is going to be fascinated by phytocannabinoids and the endocannabinoid system.”

Be Open, Direct and Honest

At Vireo Health, we strongly believe that honesty is the best policy, and we recommend you be as direct as possible when speaking with your doctor. After all, you are the “boots on the ground” when it comes to your health, and the more transparent and forthcoming you are about your needs, your symptoms and your experience, the better your doctor can advise you and prescribe to you.

If you’re concerned about the legal ramifications of admitting to previous or current cannabis use, it’s important to remember that doctors are legally obligated to keep confidential any information you share with them. Their primary concern is in keeping you healthy, not in busting you.

There’s one important exception: If you’re currently pregnant, or administering cannabis to a minor—for example as a treatment for epilepsy or other condition for which it’s been shown to be effective—be aware both that there is plausible evidence that cannabis use during pregnancy may impact the fetus, and that in some states, your doctor may be legally obligated to alert child protective services.

In these specific cases, you may want to do some research before initiating that conversation with your doctor to be sure that no one is put in an uncomfortable or, worse still, legally challenging position.

Ask Lots of Questions

Curiosity is a valuable tool here when preparing to speak to your doctor about medical cannabis. One element of the doctor-patient relationship we sometimes forget is that it’s a two-way street; yes, the physician is the one writing the prescriptions, but he or she is also there to provide answers, judgment, and feedback. Some questions you might put to your doctor include:

• Will medical cannabis interact with any of my other medications?
• What type of cannabis would be the best for my particular condition?
• How do you recommend that I consume my cannabis?
• Do you know of any studies or research on cannabis and my particular condition?
• Where can I find reputable information about cannabis?
• What type of side effects should I expect?

Be Prepared to Find a Cannabis-Knowledgeable Doctor if Necessary

For all the exciting potential cannabis has shown in treating a wide and growing list of chronic conditions and diseases, when you speak to your doctor about medical cannabis, it might reveal an uncomfortable truth: Some doctors are inexperienced when it comes to treating patients with cannabis, and may not feel comfortable prescribing a medicine they feel they don’t completely understand.

Fortunately, this appears to be changing as cannabis gains wider and wider acceptance within the medical community; it’s worth noting that an overwhelming majority of Americans now support decriminalizing medical cannabis. That said, a percentage of doctors may not only be inexperienced with cannabis but feel that it’s merely a recreational drug with no valid medical use. Remember that medical cannabis was never taught in medical school.

If you’re in the process of trying to find a doctor sympathetic to your concerns, we suggest you request a telephone consultation before committing to a visit or inquire with their medical office to try and feel out their stance on medical cannabis.  Check in with the online community or other support groups to find where they have turned and had success.   

If you’re already in a doctor’s care and are encountering resistance towards the idea of seeking medical cannabis treatment, encourage them to reach out (a provider link is available on the Vireo Health website). Urge them to learn more about the Endocannabinoid System. If you truly feel medical cannabis is a fit, ask them about the possibility of exploring medical cannabis as a therapeutic option with another provider. Reinforce that you prefer discussing this openly with them, but also feel very strong about exploring medical cannabis to improve your own life.  Remember: you’re the best judge of your health, your needs, and your limits.

Further Resources & Publications:

• Americans for Safe Access: State-by-State Legal Information and Forms for Recommending Cannabis
• Americans for Safe Access: Resources for Patients
• Americans for Safe Access: Becoming a State-Authorized Patient
• Project CBD: What Is The Endocannabinoid System
• Medscape: Endocannabinoids
• Healer.com: Cannabis Education
• Australian Government Department of Health: Health Professional Information & Education
• Government of Canada: Information for Health Care Professionals