Keep physicians from losing their jobs just because they use marijuana.

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Please sign if you are a clinician and agree that physicians should not lose their jobs--or be forced to go for costly evaluations--just because they use marijuana.

PLEASE INCLUDE YOUR CREDENTIALS AND STATE IN THE "LAST NAME" BOX  OF YOUR SIGNATURE (Example: Jane Doe, M.D., CA).

 
Some physicians in the US have had to surrender their medical licenses because they used marijuana in their free-time, despite no complaints about their work and no allegations of malpractice, even in states where marijuana is fully legal.  


We think this is wrong, and we have drafted this petition to send to the AMA, to state medical societies, and to state Physician Health Programs (PHPs) to stop penalizing physicians who use marijuana on their own time.


Marijuana is illegal in the United States even though many believe that it is far less harmful than either alcohol or tobacco (1,2).  Despite opposition from the pharmaceutical industry, the alcohol industry, the tobacco industry, and the for-profit prison industry, cannabis has increasingly been legalized for medical and recreational use.   States that have legalized marijuana have increased their tax revenues, decreased marijuana-related arrests, and had a decrease in opioid overdoses (3), without a significant increase in traffic fatalities or youth marijuana use (4).


Across the country--even in states that have legalized marijuana-- doctors run the risk of losing their licenses if they use it, despite no allegations of workplace impairment or patient harm.  And many have been strong-armed by their state PHP’s into paying thousands of dollars out-of-pocket for diagnostic evaluations or lengthy inpatient treatment stays for merely using cannabis (5,6). To complicate matters, these evaluation and treatment programs often have significant conflicts of interests: first, some stand to profit directly, especially if a physician is compelled to stay at their facility for months of inpatient treatment; second, they generally have major financial ties with the PHPs that refer physicians to them.


As physicians, we find this unacceptable. By signing this petition, we affirm that doctors in states where recreational marijuana is legal have the right to use this substance responsibly, even if we do not use recreational marijuana ourselves. We ask that legislatures in states where marijuana is legal protect these rights by enacting the following:


1) Banning the inclusion of marijuana on routine drug screening tests for physicians.  Like alcohol, marijuana can cause impairment for several hours after someone has used it.  But unlike alcohol, a test for exposure to marijuana can remain positive for weeks after its use and long after it ceased causing any impairment.

2) Allowing employers to conduct substance use screens (including marijuana) for physicians only in instances where there is a high index of suspicion that their clinical performance is impaired as a result of substance use.

3) Requiring that all physicians with suspected substance use disorders receive a thorough evaluation by providers and institutions who are financially independent from the treatment institutions to which the physicians with diagnosed substance use disorders are referred.   We favor having physicians evaluated by reputable addiction experts through medical school and university practices. In our experience such experts are far less likely to have financial conflicts of interest with PHPs.

4) Instituting external oversight and national standards for all state PHPs.  

5) No longer mandate referrals to state physician health programs simply because of a positive test for marijuana, given that screens for cannabis can stay positive for weeks after the last use of cannabis.

REFERENCES:

1) Nutt, David J et al. Drug harms in the UK: a multicriteria decision analysis. The Lancet, Volume 376 , Issue 9752 , 1558 - 1565

2) Baum, Dan. “Legalize it All: How to Win the War on Drugs.” Harper’s Magazine, April 2016. https://harpers.org/archive/2016/04/legalize-it-all/

3) Wen H, Hockenberry JM. Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees. JAMA Intern Med. Published online April 02, 2018. 

4)http://www.drugpolicy.org/sites/default/files/Marijuana_Legalization_Status_Report_101316.pdf

5) https://www.kevinmd.com/blog/2018/03/using-marijuana-2-times-month-cost-doctor-license.html

6) https://herb.co/marijuana/news/doctor-yolanda-ng-lost-medical-license-for-cannabis-use/