The promise of much-needed tax revenues is helping lead more states to pass legislation allowing the prescription of medicinal marijuana, and clinicians and pharmacists should become familiar with the potential effects on patients and healthcare costs.
That’s according to speakers at the AMCP Managed Care & Specialty Pharmacy Annual Meeting, in Denver, during the March 28 session, “Current ‘State of Affairs’ of Medical Marijuana.”
Early evidence suggests that opioid drug overdose deaths might decline in states that allow medical marijuana, noted Babette S. Edgar, PharmD, MBA, FAMCP, of BluePeak Advisors.
The regulatory landscape is complex and changing fast, said Edgar and her fellow presenter Greg Miller, RPh, a senior BluePeak Advisors consultant.
Medical, legal landscape
Marijuana-derived cannabinoids are under development as pharmaceutical agents. Marinol (dronabinol), a synthetic delta-9 tetrahydrocannabinol (delta-9-THC), was introduced in 1986 as an anti-nausea medication for patients undergoing cancer chemotherapy and was subsequently granted approval for treating nausea and appetite loss among patients with HIV/AIDS.
But the vast majority of medical marijuana is dispensed as plant tissue for smoking or consuming in edibles, or as plant-derived ointments and tinctures.
Marijuana is still illegal under the federal Controlled Substances Act—and the U.S. Constitution’s Supremacy Clause states that federal law supersedes state and local statute, Miller said.
The federal government classifies cannabis as a Schedule I drug, a category reserved for highly addictive drugs with no medicinal purposes. That designation prohibits medical research on marijuana and, technically, prescribing of marijuana.
“However, physicians can recommend its use under the First Amendment freedom of speech,” Miller said.