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Physicians won’t seek marijuana delay

WALTHAM — The state’s largest physicians organization decided Saturday that it will not push to delay a new law allowing the medical use of marijuana. Instead, the group will lobby for tighter protections for doctors whose patients want to use the drug.

The Massachusetts Medical Society also will advocate to include medical marijuana patients in an online state database that helps doctors and pharmacists monitor over-prescribing of addictive drugs.

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Some groups, including the Massachusetts Municipal Association, are calling for the Legislature to postpone the medical marijuana law, which takes effect Jan. 1. During a two-day meeting of the medical society attended by several hundred doctors, some physicians urged the organization to do the same, but ultimately, they decided the voters had spoken.

“The voters want it and our patients want it,’’ said Dr. Eric Ruby, a pediatrician in Taunton. “You cannot put the Massachusetts Medical Society above the law.’’

Ruby and several other physicians said some of their patients who suffer from severe pain, anxiety, and other debilitating medical conditions already have asked for permission to use marijuana. Under the law, patients who qualify will have to get a certificate from their doctors to buy the drug from state-sanctioned distribution centers.

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Patrick Lowe, 23, a medical student at the University of Massachusetts in Worcester, said he did not want the medical society “to appear to be hindering the process,’’ especially when a delay is likely anyway as the Department of Public Health develops detailed regulations.

“This is overwhelmingly favored by the people in the state,’’ he said. “It’s important that we be at the table.’’

‘We want to be clear . . . that the doctor has a relationship with the patient.’

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Dr. James Broadhurst, who headed the medical society’s opposition to the ballot initiative, proposed a broad policy to the organization that included supporting a delay. The society voted on two dozen resolutions during its two-day meeting, which are used to guide its policy and lobbying agenda. The rest of Broadhurst’s proposal on medical marijuana was largely approved and signal how doctors will seek to shape implementation of the law.

While the law allows physicians to provide marijuana certificates to patients with whom they have bona fide relationships, Broadhurst said The Board of Registration in Medicine, which licenses doctors in Massachusetts, needs to better define what this means.

“I am very concerned that the board of medicine was not mentioned in the initiative,’’ he said. The physicians group wants patients who are given permission to use medical marijuana to be reevaluated at specific intervals and for doctors to be trained in substance abuse and addiction.

The physicians organization also voted to push for inclusion of medical marijuana in the state’s Prescription Monitoring Program. The program is intended to prevent potential abusers from “doctor shopping” to obtain multiple prescriptions from several prescribers who are unaware of each other’s relationship with the patient. The medical society is investigating whether this change would require legislation because of patient privacy protections.

But Broadhurst said protecting patients from overuse or dangerous combinations of drugs also is important.

“You are asking [physicians] to make a judgment about the risks and benefits of marijuana” for a patient, Broadhurst said. “If I’m prescribing a benzodiazepine, which has sedative effects, I need to know if the person is taking medical marijuana.’’

Ultimately, he said, doctors want to make sure that only patients who are very sick and have exhausted all other remedies have access to marijuana.

“In California, you can basically walk into a clinic with a medical ailment, or fabricate one, and get a prescription for marijuana,’’ said Dr. Richard Aghababian, president of the medical society. “We want to be clear on the indications for this and that the doctor has a relationship with the patient.’’

Doctors have argued all along that medications should be used only after rigorous study and approval by the US Food and Drug Administration. But now that Massachusetts has become the 18th state to legalize marijuana for medical use, physicians will have to make a personal decision whether to make the drug available to their patients.

Ruby said he has kept a list of a half-dozen patients at least 18 years old who have requested the drug or who might qualify. He said he will make the drug available to certain patients.

“I have kids who can’t go outside their house because they are so anxious with social anxiety,” he said. “They are on Ativan, which is so much more addicting or on Prozac, which is very difficult for them to get off.’’

Broadhurst said that for him “it’s a very tough call. I’ll have to learn a great deal more,’’ he said.

Liz Kowalczyk can be reached at kowalczyk@globe.com.
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