Medical cannabis: 5 questions to bring to your appointment

For those living with pain, nausea, spasticity, or other symptoms and starting to consider medical cannabis, a conversation with their doctor can be decisive. But it doesn't always happen. An article published by El Planteo draws attention to the silence of some professionals and, above all, to the questions patients can bring to their appointments.

The point, however, is not to turn that silence into a recommendation to use medical cannabis. Nor does it mean that every doctor should prescribe this type of treatment. The central issue is different: a clinical decision must consider evidence, risks, potential interactions, individual characteristics, and therapeutic alternatives.

And for that, talking is essential.

Why do some doctors avoid talking about medical cannabis?

According to the article published by El Planteo, there are several reasons why a professional might avoid or limit this conversation. One of them is related to medical training itself.

A study published in 2017 in the journal Drug and Alcohol Dependence investigated the readiness of physicians-in-training in the United States to answer questions and prescribe medical cannabis.

The study gathered responses from 101 medical school curriculum deans and 258 residents. Among curriculum deans, 66.7% stated that their graduates were not prepared to prescribe medical cannabis, while 25% said they were not prepared to answer patients' questions.

Among the residents surveyed, 84.9% reported receiving no education on medical cannabis during medical school or residency. The survey also found that only 9% of the medical curricula analyzed documented content on the topic.

The numbers date back to 2017 and reflect the educational landscape of the United States at that time. Still, they help explain why knowledge about cannabinoids can vary widely among practitioners.

There is also another layer: the science itself.

Cannabis is not a single treatment. Different products can have distinct concentrations of THC and CBD, in addition to varying doses, routes of administration, and frequencies of use. 

Therefore, simply asking whether "cannabis works" does not capture the full complexity involved. Below, we list 5 questions to ask your doctor without fear.

Five questions to bring to your doctor

The article written by Dr. Joseph Rosado suggests five questions that can help turn a difficult conversation into a more objective evaluation.

1. Do you have clinical training in cannabis or cannabinoids?

This question does not need to be seen as a test of the professional. It helps the patient understand where the guidance is coming from: up-to-date knowledge, clinical experience, or a personal opinion.

2. What evidence exists for my diagnosis?

This may be one of the most important questions.

The evidence available for chronic pain does not automatically apply to anxiety, insomnia, spasticity, or other conditions. Each indication must be analyzed separately.

3. Can cannabis interact with my medications?

Bringing an up-to-date list of medications, supplements, and other products you use can make this assessment much easier.

4. If you don't work with this topic, can you refer me to a qualified professional?

No healthcare professional is expected to master every field of medicine.

Acknowledging a limit in knowledge and referring the patient to someone with appropriate training can be more helpful than offering an uncertain answer.

5. What are the risks in my case?

This question opens the door to an individualized analysis.

The article highlights the need for special attention in situations such as pregnancy and breastfeeding, adolescence, personal or family history of psychosis, unstable cardiovascular disease, substance use disorders, and treatments that already cause sedation. It is also important to discuss potential impacts on driving, work, memory, and fall risk.

What if the doctor does not want to talk about cannabis?

Silence can mean different things.

It may represent a lack of training, concern over regulations, uncertainty regarding available evidence, or simply a clinical decision not to recommend treatment in that particular case.

Because of this, one question can help distinguish between these scenarios:

“Are you not recommending it for a specific medical reason, or because you do not work with medical cannabis?”

The distinction matters.

A practitioner may evaluate a patient's medical history and conclude that medical cannabis is not appropriate. That is part of clinical practice. It is quite another situation when the practitioner simply lacks sufficient knowledge to provide guidance on the topic.

According to the article in El Planteo, it can also be useful to request that questions and decisions be recorded in your medical chart, supporting continuity of care across different healthcare providers.