Dr. Brian Nichol of North Little Rock already has seen how marijuana has helped his patients deal with stress and pain.
“Over time I noticed that these were the patients that did not need frequent dose escalation on their narcotics,” said Nichol, whose practice includes chronic pain management. “They coped better with their pain.”
Nichol has expanded his work to include medical cannabis consultation, as Arkansas’ first dispensary is likely to open for business within weeks. The industry is expected to take off in the late spring and summer. Arkansans voted in 2016 to change the state Constitution to allow medicinal cannabis.
Since January, Nichol has seen 20 new patients seeking certification to apply for a medical marijuana registry card.
“I am incorporating [medical cannabis consultation] in my practice for any of my patients,” he said. His fee is $200, which isn’t covered by insurance, but when patients need to renew their certification, the visit will cost just $100. “I give them recommendations on the type of cannabis they should use and the methods they should be using based on their history,” Nichol said.
He said he’s been loosely tracking some of his patients who say they use cannabis, and he’s been learning all he can about the plant as medicine.
Patients “might go from having a little improvement to an amazing improvement in their symptoms,” Nichol said.
But not all doctors will be able to prescribe cannabis, as federal law still classifies marijuana as an illegal drug.
“No federal facility is allowed to prescribe any sort of medical cannabis,” said Chris Durney, a spokesman for the Central Arkansas Veterans Healthcare System. “However, our doctors are not restricted from speaking to their patients about it.”
Nevertheless, doctors at the Central Arkansas Veterans Healthcare System can’t refer patients for cannabis or endorse its use, he said.
Physicians at CHI St. Vincent, which has four hospitals in Arkansas, also won’t prescribe cannabis at this time.
Based on current federal guidelines for institutions accredited through the Centers for Medicare & Medicaid Services, “doctors at CHI St. Vincent do not currently prescribe medical marijuana,” spokesman Joshua Cook said in an email to Arkansas Business.
CHI St. Vincent will monitor the issue, he said.
Doctors at the University of Arkansas for Medical Sciences and Baptist Health can prescribe cannabis to their patients.
“We have no policy prohibiting doctors from writing prescriptions for medical cannabis,” UAMS spokeswoman Leslie Taylor said in an email to Arkansas Business. “That decision is up to the individual physician.”
Baptist Health spokeswoman Cara Wade said the health care system, which has 11 hospitals in Arkansas, has no control over prescription options of physicians.
It’s unclear how many Arkansas doctors will prescribe cannabis.
“A major issue is the perceived lack of clinical evidence in support of cannabis-based medicine,” Joshua Kaplan, an assistant professor with the Behavioral Neuroscience Program at Western Washington University, said in an email to Arkansas Business. He is a science writer specializing in medicinal cannabis.
“Despite the fact that there have been over 18,000 patients who have participated in ‘successful’ cannabinoid-related clinical trials, many feel that the evidence doesn’t support its use.”
Nichol said some patients who might be helped by cannabis don’t want to try it, as the stigma of being a “pothead” remains.
Nichol said he will start a blog or a podcast to spread the word about any success stories shared by his patients using cannabis. “I’m going to try and take some of that stigma away and give people easily understood information in an easily understood format without all of the static that surrounds medical marijuana at this time,” he said.