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Pot as Prescription Drug: Where it Stands Today with the Health System

Submitted by David Borden on

Patients who need medical marijuana are constantly caught in the crossfire between the State and the Feds. In early 2008, the battle intensified yet again.  The DEA, which had been after medical marijuana dispensaries and clubs throughout California, closed 7 of 28 clubs in San Francisco, and threatened action against others.

The city of Berkeley declared itself a “medical marijuana sanctuary” which would not cooperate with the Feds in the event that they went after dispensaries there. At the same time, Marijuana vending machines were placed in Los Angeles to ease access for dispensary users there, with the Feds threatening closure. Since 1996, 12 states have legalized medical marijuana use, placing them at odds with federal law.

The science of medical marijuana is also still controversial, despite strong evidence of benefits under certain circumstances. Still, some researchers and health insurance providers have contended that medical marijuana causes cancer.

Is There a Prescription Substitute for Marijuana?

A form of synthetic THC, the chief therapeutic compound in marijuana, has been developed by Solvay Pharmaceuticals called Marinol. Marinol was specifically developed as a Schedule III prescription drug, and is covered by most insurance health plans.

Marinol supposedly has many of the same therapeutic benefits, but lack other cannabinoids (substances other than THC) found in marijuana that also have therapeutic benefits.  As a result, many patients prefer medical marijuana to Marinol. Although Marinol is covered by prescription plans and medical marijuana is not, the average cost is approximately the same, and may be less, prompting patients to pay for it themselves, once they obtain the necessary recommendation from a physician and accompanying state card.

Permits for Medicinal Marijuana

States issue permits for patients and/or caregivers to possess and/or grow a pre-defined amount of marijuana. While not providing prescription coverage, Med-Cal or other state medical insurance may cover a portion of the application fee to obtain a medical marijuana identification card.

Unlike Marinol which has been approved by the FDA, Medical Marijuana cannot be prescribed by a physician, only “recommended,” thus removing the possibility of benefit coverage until FDA approval is possible. Several benefit providers, such as Kaiser Permanente, are known to be positively disposed toward medical marijuana, which may well pave the way for benefit coverage in the future.


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