“Do you smoke?” asks every single doctor, physician, specialist, therapist, or any healthcare professional you can imagine. They all asked you this question while reviewing your medical history. However they’re almost always only referring to tobacco use.
Many of us when asked this question find ourselves with more questions than answers. If you don’t smoke cigarettes but you do smoke cannabis, it can be difficult to know what to say. Beyond what to say, you may also be considering how comfortable you are disclosing your cannabis use to your doctor.
They didn’t even mention cannabis use at all. So do you…?
The Stigma of Talking to Your Doctor About Cannabis
Cannabis is versatile in many ways. Its different forms can be utilized by each individual to meet their needs and purposes. To do so safely, it is important to answer, “yes, I smoke cannabis” for a variety of reasons.
Therein lies a huge problem: many of us are not comfortable answering this question with the truth. Even despite the burgeoning legal and social support behind cannabis, many of us feel as though our doctors will still look at us funny if we openly admit to using cannabis.
Getting funny looks is only the start of the string of potential harmful effects that might happen. Some patients face discrimination in their doctor’s office, particularly those of color or low income who have to deal with disparities in American healthcare in basically all facets (U.S. Department of Health and Human Services, 2015).
Others fear the documentation of their cannabis use might impact future office visits or care, or they might simply not want their cannabis use documented at all .
Even in places like Canada, where cannabis has been legally available for medicinal use for over a decade now, patients admit to hiding cannabis use from their doctors due to these same fears. According to a Canadian study conducted in 2018, “the vast majority of respondents (79.3%) reported hiding their medical cannabis use, most commonly to avoid judgement” (Leos-Toro et al., 2018). This proves that legalizing it is not the only route to destigmatizing it.
Uneducated Healthcare Professionals
For too long a while, and to this day, the benefits of cannabis use likely do not even cross the minds of some healthcare professionals- which can be a little concerning when you take into account the nurses, doctors, surgeons, psychiatrists, and other healthcare professionals who treat patients face to face every single day. Even worse, some might continue to stigmatize cannabis the way it has been done for centuries, and completely disregarding any evidence to support its proven medicinal properties.
Unfortunately, one explanation for this total disconnect could be the lack of education in United States medical schools. Did you know that the endocannabinoid system is not taught in most medical schools? According to a survey conducted in 2016, “In the United States of America, only 13% of the medical schools surveyed teach the endocannabinoid science to our future doctors” (Allen, 2016). This is unsurprising, but pretty astonishing when you consider how much of our bodily functions the endocannabinoid system regulates (the brain, liver, lungs, and immune system, for starters).
Medical Cannabis is Cost Prohibitive
The cost of obtaining a medical cannabis card is prohibitive to many patients. Registration fees to obtain a medical cannabis card throughout the country can range anywhere from $20 to several hundred dollars. That doesn’t always include the cost of office visits or a Patient ID card, either.
While state programs are raking in the money, there are so many people who simply cannot afford to obtain one. They don’t have a spare few hundred dollars to spend to get access to medicine. Instead they self-medicate with cannabis purchased on the streets. This might be one reason they don’t want to be honest with their medical doctor about their use- some might fear social, legal, and financial consequences.
How does this disconnect impact the mental and physical health of patients?
The disconnect between healthcare professionals and the medicinal uses of cannabis can have disastrous results, as it puts a patient’s physical health at risk.
If a doctor is unaware of a patient’s cannabis use, they are missing vital information and risk subjecting patients to incorrect diagnoses and/or negative drug reactions (Ryan & Sharts-Hopko, 2017). Proper treatment cannot be provided, which puts the patient in harm’s way.
This disconnect can also damage the relationship between doctor and patient.
It can result in patients being labeled or ostracized, and ultimately not trusting in their doctors. This can lead to decreased visits to the office and less consistent care for their own physical health. Some may forgo regular check ups altogether!
This is the case not only for a patient’s physical health but mental health; in a world that stigmatizes cannabis, it makes sense users might internalize the negative perceptions of others or feel embarrassed to open up about it. Moreso, the stigmatization from the very people who are meant to be there for you and help you can severely affect mental health wellness, leading to stress and anxiety which can deteriorate a patient’s physical health further (Ryan & Sharts-Hopko, 2017).
How to Manage Your Medical Cannabis Care
It is important to understand that any information you provide a medical professional is confidential and cannot be used against you in any legal way. That includes any information about your cannabis use. The only exception is if there is concern that a patient is going to seriously harm themselves or others.
Seeing as you are your biggest advocate, you do not need to subject yourself to any medical or mental health professional that makes you feel uncomfortable. Medical professionals who care about treating you with compassion do exist. The reality of your situation is- you may just need to find one.
It is imperative to feel comfortable sharing with your doctor about cannabis use and anything else that may play a role in your overall health and well-being. Sometimes this takes a bit of trial and error – if you need, do not hesitate to “date” your doctors! Do your research and speak with different healthcare professionals to find the ones who you click with the most and who you feel you can trust.
It is always best to be as honest as possible with your healthcare providers regarding your smoking and cannabis use. There are reasons you might feel inclined not to, but there can be serious risks in holding back. Always remember that you are your biggest advocate! Your health is the most important thing.
Ryan, J. & Sharts-Hopko, N. (June 2017). The Experiences of Medical Marijuana Patients: A Scoping Review of the Qualitative Literature. Journal of Neuroscience Nursing: 49(3): 185-190. doi: 10.1097/JNN.0000000000000283
- Subritzky, PhD
Allen, D. (2016). Survey Shows Low Acceptance of the Science of the ECS (Endocannabinoid System) at American Medical Schools. Retrieved 26/04/2019 from http://www.outwordmagazine.com/inside-outword/glbt-news/1266-survey-shows-low-acceptance-of-the-science-of-the-ecs-endocannabinoid-system.
Evanoff, A., Quan, T., Dufault, C., Awad, M., & Bierut, L. (2017). Physicians-in-training are not prepared to prescribe medical marijuana. Drug and Alcohol Dependence, 180, 151.
Perceived support for medical cannabis use among approved medical cannabis users in Canada
Cesar Leos‐Toro, Samantha Shiplo, David Hammond
Drug and alcohol review 37 (5), 627-636, 2018
About the author
Caroline Platzman is a Behavioral Health Counselor working with adults diagnosed with schizophrenia. She is passionate about mental health, journalism, nonprofit advocacy, and public relations. Caroline is also a dedicated guitarist and artist in her free time.