Guidelines say skip smoking marijuana for non-cancer pain, AZ doctor says more research is needed

The American College of Physicians has published a list of best practices for doctors advising patients who want to take marijuana for chronic pain not related to cancer.

A Phoenix pain-management physician at Valleywise Health says he sees a lot of patients still hurting after medications, steroid injections and surgery.

The new guidance, published in the Annals of Internal Medicine, says doctors should advise against inhaling marijuana smoke or vapor to manage chronic non-cancer pain. And they should go over the short-and-long-term harms tied to marijuana, such as psychosis.

Dr. Sarang Koushik said marijuana can improve the quality of life for patients still hurting after conventional treatments, but more research is needed.

Koushik hopes to see the dangers of marijuana measured against opioid risks and medical procedures that don’t always give relief.

KJZZ's Reefer Growing Madness

Nearly a century after cannabis was criminalized by the United States, most Americans live in a place where local police no longer arrest all marijuana users. Weed has become so abundant in places like metro Phoenix that you have to wonder how it’s even grown. Reefer Growing Madness from KJZZ’s Hear Arizona podcast unit tracks the roughly four-month journey of marijuana plants from tiny clones to ashes and smoke.

“So we need to really compare the side effects directly before we can make a judgement on which one should be offered first,” Koushik said.

State-authorized patients get marijuana from a medical dispensary, instead of a pharmacy. Koushik said this means he cannot control the dose, form or volume a patient takes.

The ACP guidelines talk about conditions like fibromyalgia, osteoarthritis and neuropathic pain.

The research is based on reviews of dozens of random trials and observational studies.

“They did their due diligence in looking at the literature that’s out there commenting on specific patients with clinical situations that would benefit from this,” Koushik said.