The use of marijuana in the treatment of pain conditions is certainly controversial. A number of states have permitted it but it continues to conflict with the federal statute, at least as it relates to the Controlled Substances Act. Now different states are doing it in different ways and so this provides an awful lot of gray area, which is certainly a concern for physicians, as well as for patients.
If I were to recommend something that physicians should do in the context of medical marijuana, it certainly is to follow the law. They should check with their state medical boards about what the rules are, and what the laws are concerning medical marijuana and comply with those. As for the Controlled Substances Act/state law conflict, currently the Department of Justice has said that they will not prosecute any physicians who merely recommend marijuana to their patients provided, of course, that they are complying with the state law, and it’s quite clear and unambiguous as to their participation in that program. Certainly with the Department of Justice things could change. Right now they are saying if you’re complying with state law concerning medical marijuana, then we’re not going to use our scarce resources. That, of course, could change at any time because it is merely prosecutorial discretionary policy.