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Supreme Court lets doctors discuss medical marijuana

Physicians view the court's denial to hear the case as a win in the battle to keep the federal government out of the doctor-patient relationship.

By Tanya Albert, amednews staff. Nov. 3, 2003.

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When infectious disease specialist Stephen Follansbee, MD, walked into his San Francisco exam room Oct. 15, his fears about discussing medical marijuana with patients had vanished.

A day earlier, the U.S. Supreme Court said it would not hear the appeal of a 9th U.S. Circuit Court of Appeals ruling that doctors may talk with patients about the pros and cons of the substance without fear of government reprisal. The high court left in place a lower court's permanent injunction against sanctions.

Doctors had been on edge since the federal government in 1996 adopted a policy allowing the Drug Enforcement Administration to yank the DEA numbers of physicians who recommended or prescribed marijuana. Discussing or prescribing the drug, a schedule I controlled substance, was not in the "public interest," government officials argued.

"I have felt constrained in my ability to talk freely and document the conversation because we were operating under the threat of prosecution or loss of our ability to prescribe any controlled substance," said Dr. Follansbee, one of the physicians who teamed up with patients to file the lawsuit. "Now I can explore the issue with patients and document it."

The high court's move reinforces the idea that the doctor's office is a safe place to have conversations about the most sensitive issues, said Stephen O'Brien, MD, medical director at East Bay AIDS Center in Berkeley, Calif., and a plaintiff in the suit.

"It feels like there is not a third person in the room with you anymore," Dr. O'Brien said. "There is a greater sense of ease in talking to patients. My concern before was that draconian things could be done."