Physician FAQs


What are the responsibilities of a health care provider in the Vermont Marijuana Registry application process?

A health care providers must verify that their patient has a debilitating medical condition to qualify them for the Vermont Marijuana Registry. A health care provider must also verify that they have a bona fide health care provider-patient relationship with the applicant. The phrase a bona fide health care provider-patient relationship means a treating or consulting relationship of no less than six months duration, in the course of which a health care provider has completed a full assessment of the registered patient's medical history and current medical condition, including a personal physical examination.

What protections does a health care provider have with regards to the provisions of Title 18 V.S.A. Chapter 86?

A health care provider who has participated in a patient's application process under the rules, policies or procedures of the Marijuana Registry shall not be subject to arrest, prosecution, or disciplinary action under Chapter 23 of Title 26, penalized in any manner, or denied any right or privilege under state law, except for giving false information, pursuant to Title 18 Section 4474c(f).

Do health care providers prescribe medical Cannabis?

No, health care providers do not prescribe medical Cannabis. A health care provider may only verify that their patient has a debilitating medical condition to qualify them for the Vermont Marijuana Registry.

What is the legal definition of debilitating medical condition?

Title 18 V.S.A. Chapter 86 defines debilitating medical condition to include the following conditions:

  1. Cancer, acquired immune deficiency syndrome (AIDS), positive status for human immunodeficiency virus (HIV), multiple sclerosis (MS), or the treatment of these conditions if the disease or the treatment results in severe, persistent, and intractable symptoms
  2. A disease, medical condition, or its treatment that is chronic, debilitating and produces severe, persistent, and one or more of the following intractable symptoms: cachexia or wasting syndrome, severe pain or nausea or seizures.

What is the safety profile of Cannabis?

The safety profile of smoked Cannabis, based on the ratio of therapeutic to lethal dose, is excellent. There is no established lethal dose or record in the medical literature of a cannabis-induced fatality.

In contrast, many commonly prescribed and abused substances such as barbiturates, opiates, and benzodiazepines have a more narrow therapeutic window and can be lethal in overdose. Adverse effects of cannabis include anxiety attacks and cognitive impairment.

Dependence to cannabis has been reported in 9% of regular users, but withdrawal symptoms are mild and self-limiting. A recent study published in the Journal of the American Medical Association, one of the leading biomedical journals, found that long-term exposure to cannabis smoke was not associated with adverse effects on pulmonary function, in a large cohort of over 5000 men and women over a 20-year period.

Is Cannaibs effective?

Cannabis has been used for medicinal properties for centuries, but a complicated federal approval process has limited modern research. The American College of Physicians has called for increased research into the therapeutic role of medical Cannabis, reclassification of the drug from the Schedule I level, and exemption from federal criminal prosecution for physicians who prescribe or dispense medical marijuana in accordance with state law.

Medical benefit for use of the synthetic marijuana extracts is well-establshed and less inhibited by regulations. In the human body, different cellular receptors exist that respond to different cannabinoid molecules; susceptibility varies among humans. The cannabinoid-1 (CB1) receptors may modulate psychoactive properties, while CB2 receptors may provide anti-inflammatory or regenerative benefits.

The synthetic delta-9-tetrahydrocannabinol (THC), dronabinol (trade name Marinol), was approved by the FDA in 1992, and the synthetic analog Nabilone was approved in 1985, for therapeutic uses as an antiemetic and as an adjunct analgesic for neuropathic pain.

Recent studies of the liquid marijuana extract Sativex, which contains a mixture of THC and cannabidiol (CBD), have lead to its approval in Canada, New Zealand, and several European countries. Phase III trials of Sativex for the treatment of pain associated with cancer are underway in the US.