More and more often we’re seeing government officials and government entities becoming more relaxed on marijuana policies. The newest example of this was found in the CDC report called “Guideline for Prescribing Opioids for Chronic Pain, United States 2016”.
Within the newest guidelines created to help physicians manage patients’ dosage throughout treatment for chronic pain conditions was a statement discouraging urine testing for THC – which we all know is the psychoactive cannabinoid in marijuana.
This statement comes as a bit of a surprise because for years now testing for many drugs, including cannabis, has been done alongside routine testing to determine if prescriptions are being taken responsibly. Patients who tested positive for THC were in many cases (more often than not it appears) dropped from pain management programs due to their marijuana use.
Unfortunately, when an individual has been a part of a pain management program for a long period of time they do become dependent on opioids – a large number of these people who are turned away from doctors for their alternative approach will continue to medicate with the same prescription drugs bought on the black market, leading in some cases to a downward spiral of drug use.
“Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear,” the CDC stated. “For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahydrocannabinol (THC). In addition, restricting confirmatory testing to situations and substances for which results can reasonably be expected to affect patient management can reduce costs of urine drug testing…”
Dropping patients from treatment programs because of cannabis only makes the situation worse for the patient. “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, potentially including the patient obtaining opioids from alternative sources and the clinician missing opportunities to facilitate treatment for substance use disorder,” the CDC wrote.
Not only has the CDC recognized that too many people are dropped from pain management programs (even some who are consuming marijuana – medically prescribed or not – in a state where the plant is legal) is a real problem. They have also pointed out the costs of unnecessary drug testing, which comes to anywhere in between $211 – $363 per test.
In the end however – the main reasoning here is that testing for THC will not affect the course of treatment and therefore is not a necessary test to be had. It is an expensive additional test taking up time in labs and leaving patients without access to medication in a safe and controlled environment.
“It is prudent for clinicians to restrict use of any medical test to situations when results of the test would be helpful in decisions about patient management. This is particularly important when testing or test results might have unintended negative consequences for patients. Some experts noted that in some cases, positive THC results might have legal or other consequences for patients but might not inform patient care decisions. While CDC is not stating that urine tests for THC should never be used, the guideline recommends that clinicians should only test for substances (including THC) if the clinician knows how he or she would use the results to inform patient management,” the CDC representative stated.
All in all – this is a great step forward. With the CDC now instructing doctors to no longer drop patients from the program over unnecessary testing for marijuana we will hopefully see a large decrease in the number of opioid related deaths.
In states where medical marijuana is a legal treatment for chronic pain the number of opioid related deaths has decreased by as much as 25% – imagine what legalized marijuana could do for our country with this addiction epidemic.