For doctors and nurses certifying patients for marijuana use, host of unknowns remain

HONOLULU (HawaiiNewsNow) - Hawaii's medical marijuana dispensaries are still waiting for the green light to sell their products.

And in the meantime, just over 100 doctors and nurses continue to certify new patients to use cannabis — putting them into the pipeline for when dispensaries can come to market.

The state Department of Health says there were 108 physicians and 10 advanced practice registered nurses who have certified 17,591 patients statewide. There are about 3,000 licensed physicians and APRNs in Hawaii.

Some 68 percent of medial marijuana patients were certified for severe pain, 13 percent for muscle spasms, 6 percent for nausea, 4 percent for PTSD.

Dr. David E. Roth is triple board certified in pediatrics, adult psychiatry and neurology, and child and adolescent psychiatry. He has a private practice at Diamond Head and signed up with the Department of Health last October to certify patients to use medical marijuana to expand his practice.

So far, he's certified about a dozen patients and no children yet.

While he supports the medical use of cannabis for qualifying conditions like severe pain, PTSD, seizures, cancer and AIDS, he said there are still unknowns about the different strains of marijuana.

"That's the challenge is that we don't understand completely which of these new strains would best fit a condition," he said. "People talk about the uppers, or the head highs or the body highs, those are very different clinical effects being produced by a substance to then treat a condition."

Certifying physicians don't write prescriptions like traditional medication. They certify that a patient has a qualifying condition.

Dr. Tyrie Jenkins, an ophthalmologist, said it's the dispensaries that will control a patient's dose.

"Interestingly, the people who will be advising the patients will be the person at the dispensary so I think it's really important for physicians to be educated on the current status of medical cannabis and the current status of the research," Jenkins said.

Jenkins signed up with the Department of Health to certify patients and learn the process, but she decided not to certify patients since she's now serving on a voluntary advisory board for Manoa Botanicals.

Asked if physicians could abuse the certifications, she said there are controls in place to prevent that.

"Any physician would be subject to an audit," she said. "You've only seen this patient once and you've been writing prescriptions for three years. I think it's important for physicians to know the legitimate uses for medical cannabis."

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