In this special three-part series, Compassionate Cultivation Chief Medical Officer Dr. Karen Keough discusses the important role Texas physicians play in the medical cannabis program and the impact this has on patients—from prescribing CBD oil, to research findings and the future of the program.
In two recent posts, I’ve outlined some concerns that have emerged for Texas physicians regarding the Texas medical cannabis program: The legal and professional implications of prescribing cannabis-derived medicine, and the fact that research is in its early stages after decades of federal restrictions on studying medical applications of cannabinoids such as cannabidiol (CBD).
In this final post, I’ll address a third issue for Texas physicians whose patients qualify for medical cannabis, and how to fix it: Some physicians feel that they do not have enough familiarity with cannabinoids and CBD medication to confidently prescribe it.
There’s no denying it takes effort to dig into research findings and figure out how to create an effective treatment regimen involving state-regulated medical cannabis products. My colleagues and I do this all the time when we integrate treatments with new medications—this isn’t unprecedented. But now we’re doing it in a controversial setting, and that can be challenging. Some doctors are saying, “Well, I just don’t want to get involved.”
The reality is that our patients need us to take this initiative. And this is more critical than ever in Texas, now that the state medical cannabis program has expanded to include a much broader patient base.
The expanded state program, enacted in June 2019 via House Bill 3703, now includes the following medical conditions: epilepsy of all forms; other seizure disorders; multiple sclerosis (MS); spasticity; autism; terminal cancer; and incurable neurodegenerative diseases such as Alzheimer’s and other dementias, Parkinson’s and Huntington’s diseases.
Lawmakers also simplified the process for establishing a patient’s treatment plan by lifting the requirement that treatment plans must receive a concurring approval from a fellow physician before a prescription can be issued.
Once a physician has enrolled in the Compassionate Use Registry of Texas (CURT) and received regulatory approval, he or she can prescribe state-regulated medical cannabis products. CURT serves another useful purpose: It connects us all as a group of physicians who are pursuing carefully monitored treatment plans for patients who have exhausted other options. We can collaborate and learn from each other, thanks to this registry and other recent efforts to expand the knowledge base to determine what’s working, what’s not and which conditions and patient populations should be targeted.
Boosting Knowledge about Medical Cannabis Research
When the Texas program launched in 2018 exclusively for intractable epilepsy patients, as one of the early program participants I quickly saw the value of a collaborative approach with the treatment plans, particularly since I and my fellow epileptologists were working with limited data on dosages at the time.
We continue to learn as we go. I consult regularly with colleagues about low-THC medical cannabis as a treatment option and the baseline dosage regimen I’ve developed. As we’re sharing research news and journal articles, along with patient case studies and our personal observations, I feel the Texas medical community is playing a crucial role: We’re contributing to the knowledge base about what cannabinoids can do, while establishing important guardrails on their limits. With the current drumbeat in media and marketing that CBD is a miracle panacea, it’s important to adjust patient expectations with facts.
Learning about medical advancements is an essential element of every physician’s practice. As time passes and the Compassionate Use Program evolves, the involvement and input we get from physicians who can offer their informed feedback will go a long way toward improving the process and propelling it forward, which ultimately represents better outcomes for Texas patients.
We all know that extra time is not exactly a part of a physician’s everyday vocabulary. However, medical CBD displays such efficacy that I believe it’s well worth the effort to develop and implement a treatment program for a qualifying patient. Beyond that, there are many other patients—and their physicians—who stand to benefit from what we’re learning today.