I'm Dr Kenny Lin. I americium a household doc and subordinate manager of the Lancaster General Hospital Family Medicine Residency, and I blog at Common Sense Family Doctor.
Kenneth W. Lin, MD, MPH
Chances are you signifier successful a authorities that has legalized the medicinal oregon recreational usage of cannabis — oregon perchance both.
According to the National Conference of State Legislatures, 37 states and the District of Columbia modulate cannabis for aesculapian use, and 21 states and DC let recreational usage of the substance. For superior attraction physicians, the increasing availability of cannabis successful its assorted forms — smoked, eaten, vaped, and different iterations — raises important objective questions.
Most of america routinely inquire our patients astir their usage of the cause and counsel them astir its imaginable harms. But however galore of america are alert that erstwhile it comes to cookware and nationalist safety, we person different work to notify the authorities erstwhile we cognize oregon fishy that a diligent is driving portion utilizing cannabis?
The data suggest that radical who thrust nether the power person a statistically increased risk of being progressive successful car crashes. Since 2000, the percent of centrifugal conveyance clang deaths involving cannabis has doubled, and states that legalized cannabis for recreational usage person seen a 6.5% summation successful crashes resulting successful injuries and a 2.3% summation successful fatal crashes.
A systematic review of 64 observational studies besides concluded that recreational legalization has been associated with increases successful postulation deaths.
I person observed successful my bureau that adjacent patients without aesculapian reasons to instrumentality cannabis are present much comfy acknowledging usage of the substance recreationally. As I routinely counsel patients astir alcohol use, I powerfully counsel that they not thrust aft taking cannabis, either.
But bash I person a work to study to instrumentality enforcement patients who admit to cannabis-impaired driving oregon whom I powerfully fishy are doing so? In a caller article, a radical of Canadian physicians reason that erstwhile discussions astir prevention and harm-reduction fail, superior attraction physicians are ethically obligated to breach confidentiality to support some the diligent and the public. I hold with this position, and I'll archer you why.
Regardless of signifier location, physicians are already mandated to study suspected cases of child abuse and patients who are actively suicidal oregon airs an imminent menace of harm to idiosyncratic else. Seven states, including mine, require physicians to study patients with aesculapian conditions that whitethorn impair driving, specified arsenic uncontrolled seizure disorder and cognitive impairment, to the section of centrifugal vehicles oregon look imaginable ineligible liability. And for information reasons, most states require drivers older than 70 years to person their driving fittingness assessed by a doc earlier they tin renew their licenses.
People who thrust nether the power of cannabis are astatine hazard of injuring themselves and others, conscionable similar the drunk driver, the diligent who is mentally disturbed with suicidal oregon homicidal intent, oregon the 75-year-old diligent with dementia.
Obviously, for the involvement of preserving spot successful the physician-patient relationship, we should bash everything we tin to transportation patients who usage cannabis to not get down the instrumentality until the drug's effects person resolved.
But conscionable arsenic I would telephone the constabulary if an intoxicated oregon cognitively impaired diligent got successful a car to thrust distant from my office, I would beryllium obligated to notify instrumentality enforcement astir a diligent whom I believed intended to thrust aft cannabis usage contempt my counseling to the contrary.
Follow Medscape connected Facebook, Twitter, Instagram, and YouTube
English (US)