Dr Frank Lucido

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AUSTIN420: Tell me a bit about yourself and how you first became involved as a medical cannabis consultant?

DR-FRANK: After the passage of Proposition 215, I began performing cannabis evaluations on a very limited number of my existing primary care patients, who requested it and whom I knew had clear indications such as nausea of cancer chemotherapy, severe migraine headache, and chronic pain. Soon I was receiving referrals for medical cannabis evaluations for patients I had not seen before. These referrals came from both patients and other health care providers. This is not surprising, since most doctors are reluctant to approve medical cannabis. Most physicians don't know the law, and have never studied the medicinal uses and history of cannabis. Medical schools do not teach about cannabis' potential benefits, medicinal uses and history. When this lack of information is added to concerns that many health care providers have about the legal and professional implications of cannabis recommendation, it is understandable that a minority of doctors are doing the majority of evaluations on many cannabis patients. As I began seeing more patients who were benefiting in a wide variety of ways, it became clear to me that I had to become better acquainted with the professional literature on cannabis as a medicine. To the extent that my general primary care practice is typical, I would guess that most general primary care practices in the Bay Area have seriously ill patients who would be likely to benefit from the use of medical cannabis. Possible benefits might include improved symptom relief, fewer side effects, and/or lower cost than many commonly prescribed pharmaceuticals. What is not typical about my practice is that even among the limited number of doctors who are performing medical cannabis evaluations I am one of the few who does them in the context of a full-scope general medical practice. Since that time, I have been conducting medico-legal consultations for patients who are weighing cannabis as a treatment option. I have worked to develop my own standards by reading the scientific literature, learning from the experience of other practitioners, and through application of my past experience in making clinical decisions. In describing my own approach, I in no way intend to define the standard that is appropriate for all providers or all clinical situations. Rather, these are the accumulated insights from my experience with medical cannabis as a treatment, with patients who have benefited from its use, and with the practice of family medicine in a patient population that includes persons from a wide variety of backgrounds, age groups and states of health. My goals are to give patients some ideas about what might be expected from a medical cannabis consultation as it would be conducted in my office, and to give clinicians some information about which aspects of the patient's history, diagnosis and physical condition I consider most relevant in decision making about medical cannabis use.

AUSTIN420: As a doctor of family practice, how has the medical cannabis laws of California allowed you to speak more freely with your patients about cannabis as a possible treatment option?

DR-FRANK: I was investigated early on by the Medical Board of California. I am one of approximately nine physicians who have been investigated by the Medical Board of California in relation to recommending medical cannabis. My strong belief that I was practicing the highest standards of medicine provided a level of comfort and confidence that I would not have expected to maintain during such a stressful, time-consuming ordeal. I was also reassured by having good legal counsel and the support of many fellow physicians, as well as my patients, family, and friends. In August 2003, one year after I was served a subpoena to appear at a Medical Board hearing, I was effectively exonerated.  Regrettably, my experience with the Board has been shared by a number of other responsible physicians who were also inappropriately targeted for investigation for having recommended medical cannabis. The complaints triggering these investigations have not come from patients or caregivers, but almost exclusively from officials in various branches of law enforcement, which is why I started the MedicalBoardWatch and my subscription blog for physicians: http://aimlegal.blogspot.com

AUSTIN420: When considering a medical cannabis recommendation for a patient, what are your biggest concerns in regard to you and that patient?

DR-FRANK: That the patient has documentation of ongoing care of a qualifying illness under the States medical cannabis law.

AUSTIN420: Which aspects of a patient’s history, diagnosis and physical condition should a physician see as most relevant when recommending the medicinal use of cannabis? 

DR-FRANK: The seriousness of the illness or symptom, and how cannabis benefits them compared to other medicines they have tried for this illness.

AUSTIN420: While many states have their own approach in regard to medical cannabis legislation, as a physician, what do you believe are the major factors that lawmakers should be considering overall?

DR-FRANK: They should treat cannabis like any other medicine, prescription or non-prescription that a doctor may prescribe or recommend to patients. And they should include at the end of their list of illnesses: "or any other illness for which marijuana provides relief". This is how medicine is actually practiced in all states. A doctor may use any medicine for "off-label use" if it provides relief of their illness. They just need to document why they are using it for that symptom or illness.

AUSTIN420: In educating our children properly about the risks and the medicinal benefits of cannabis, what are the most important aspects to bring to attention in regard to not just protecting them, but to educate them in respecting, for example, “grandma’s medicine”?

DR-FRANK: It’s good medicine. It's not everybody's medicine. It may not be anybody's medicine all the time.

AUSTIN420: While cannabis is not a curative to most conditions, what strides has it made or can it make for patients in managing the “symptom distress” of coping with a chronic debilitating condition?

DR-FRANK: It can help many distressing and serious symptoms, including: chronic pain, nausea, anxiety, depression, insomnia, as well as muscle spasticity, to name a few.

AUSTIN420: While cannabis is not a curative to most conditions, what strides has it made or can it make for patients in managing the “symptom distress” of coping with a chronic debilitating condition?

DR-FRANK: It can help many distressing and serious symptoms, including: chronic pain, nausea, anxiety, depression, insomnia, as well as muscle spasticity, to name a few.

AUSTIN420: What advice would you offer to doctors who may want to help, but are reluctant to get involved out of fear of the legal and/or professional implications of a medical cannabis recommendation?

DR-FRANK: Read my free blog at: http://drfranklucido.blogspot.com

Subscribe to my doctor's only blog at: http://aimlegal.blogspot.com

Join Society of Cannabis Clinicians (SCC) http://societyofcannabisclinicians.com

Join American Academy of Cannabinoid Medicine (AACM) http://aacmsite.org

Attend to great medical cannabis conferences put on by Patients Out of Time that occur every 2 years. http://www.medicalcannabis.com ~