May 6, 2010 – For doctors long accustomed to prescribing carefully tested medications by the exact milligram, medical marijuana presents a particular conundrum.

On Tuesday, District of Columbia officials gave final approval to a bill establishing a legal medical marijuana program. If Congress signs off, D.C. doctors – like their counterparts in 14 states, including California – will be allowed to add pot to therapies they can recommend to certain patients, who will then eat it, smoke it or vaporize it until they decide they are, well, high enough.

The exact dosage and means of delivery – as well as the sometimes perplexing process of obtaining a drug that remains illegal under federal law – will be left largely up to the patient. Doctors say that upends the way they are used to dispensing medication, giving the straitlaced medical establishment a whiff of the freewheeling world of weed.

Even in states where marijuana is allowed for medical use, doctors cannot write prescriptions because of the drug’s status as an illegal substance. Physicians can only recommend it, and have no control over the quality of the drug their patients acquire.

Because there are no uniform standards for medical marijuana, doctors have to rely on the experience of other doctors and their own judgment. That, they say, can lead to abuse.

California’s “quick-in, quick-out mills” that readily hand out recommendations have proliferated, worrying advocates. The state, the first to legalize medical marijuana 14 years ago, allows for a wider range of conditions, including anxiety.

To guard against abuse, some doctors say they recommend marijuana only after patients exhaust other remedies. Some doctors perform drug tests as part of pre-screenings.

Todd Handel, a Rhode Island rehabilitation specialist, recommended marijuana to Chris Snow, 23, who has spina bifida and used the drug as a teenager.

He would get stoned, Snow said, but pot also made the pain bearable. Only after consulting with Snow’s mother and father – a police sergeant – did Handel recommend marijuana.

Snow, who lives with his parents, grows 12 plants – the state’s maximum allowed. He uses a vaporizer that heats the drug, releasing a mist that he inhales four breaths per session, two to three times a day.

Handel says he wishes he had more knowledge about marijuana and more control over dosage. But he is figuring things out as he goes along. “There isn’t one dosage that works for everybody,” he said. Source.