Bias and Burnout: Evil Twins

Carol Peckham

Disclosures

January 12, 2016

In This Article

Have Marijuana Use and Prescribing Increased Since Last Year?

This is the second year that Medscape has included questions on marijuana use. Both this year and last, one quarter of physicians claimed to have ever smoked marijuana. No differences in use were observed between 2015 and 2016 among any age groups, with the heaviest use in both years reported among physicians aged 56-65 years (about one third).

Given the increase in the number of states where marijuana has been legalized for medical use, physicians in this year's Medscape survey were asked whether they are now prescribing it. As one would expect, the highest percentages reporting that they had prescribed it resided in the Northwest (10%), West (8%), and Southwest (7%), where medical marijuana is now legal. These percentages are still quite low, given the current limited evidence for its use.

In this survey, physicians who prescribed marijuana most often did so for pain management (61%). Other conditions for which marijuana had been prescribed included multiple sclerosis (17%), glaucoma (10%), and inflammatory bowel disease (7%), conditions for which there is some evidence of benefit. A recent JAMA review on the benefits of medical marijuana found high-quality evidence supporting its use for chronic and neuropathic pain and for spasticity in multiple sclerosis.[32] Some physicians who prescribed marijuana did so for conditions that are more common, but for which the evidence of efficacy is much weaker (10% for insomnia, 12% for mood disorders, and 14% for drug-related adverse effects). Forty-three percent also chose "other." Many of these physicians anecdotally described situations not listed in the survey instrument for which they prescribed marijuana, notably as an appetite stimulant for patients with anorexia, HIV, and cancer. Respondents who prescribed marijuana also frequently used it to treat nausea and seizures.

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