As part of its plan to change the healthcare community’s cavalier attitude towards the distribution of dangerous prescription painkillers, the federal government has advised physicians across the United States to stop testing their patients for marijuana.
Last week, the Centers for Disease Control and Prevention (CDC) released an updated set of guidelines for prescribing opioids to patients suffering from chronic pain. Buried inside the language of this attempt to put a leash on the prescription painkiller epidemic, the CDC urged doctors to modify their drug screening policies in an effort to prevent those testing positive for THC metabolites from being disqualified from treatment.
Although the agency wrote that it still believes urine testing is necessary to discover any “undisclosed use” of illicit substances, it specifically states that this rule no longer applies to THC.
“Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear,” reads the statement. “For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahydrocannabinols (THC).”
The latest CDC guidelines suggest that this old philosophy leads to “stigmatization” and “inappropriate termination of care,”
Although passing a drug test is not usually a prerequisite for an initial prescription to painkillers, patients who end up passing through the corridor from the family doctor to a pain management clinic are often held to a higher standard in order to continue receiving these medications. Typically, these patients are required to test free of any illegal substances, including medical marijuana, before being allowed to participate and/or continue in a pain treatment plan.
However, the latest CDC guidelines suggest that this old philosophy leads to “stigmatization” and “inappropriate termination of care,” which inevitably creates additional hardships for those patients in need of these types of treatment programs.
“Clinicians should not dismiss patients from care based on a urine drug test result because this could constitute patient abandonment and could have adverse consequences for patient safety, potentially including the patient obtaining opioids from alternative sources and the clinician missing opportunities to facilitate treatment for substance use disorder,” the CDC guidelines reads.
According to a report by the Pain News Network, which originally detected the pro-marijuana provision tucked inside the CDC’s new opioid prescribing guidelines, point-of-care urine drug screens are infamous for providing false positive and false negative results for a number of substances, including marijuana.
“False positive readings for marijuana, for example, were given over 21% of the time, while false negative results for marijuana also appeared about 21% of the time,” the article reads.
Interestingly, the latest guidelines for prescribing painkillers come just a month after Senator Elizabeth Warren fired off a letter to CDC director Dr. Tom Frieden urging his agency to research the “effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal.” The letter also asked the CDC to study “the impact of the legalization of medical and recreational marijuana on opioid overdose deaths.”
A 2014 report published in JAMA Internal Medicine provides some evidence that fewer people are dying from opioid overdoses in states that have legalized medical marijuana. The study found nearly a 25% reduction in prescription painkiller deaths in states where marijuana is a legal treatment option. However, this information was not cited in the CDC guidelines.