Because of the Controlled Substances Act (CSA) that was put into law in 1971 as part of Richard Nixon’s plan to start a war on drugs, physicians are unable to prescribe marijuana to patients. The Act prevents any schedule 1 substance from being prescribed by a doctor because it states that these substances have no therapeutic value and are highly addicting and harmful. Of course, this has been passed on legally since that time even though cannabis is on that list and it is clear that there indeed are plenty of medical benefits to using cannabis and that it is physiologically not addicting, unlike legal cigarettes and alcohol.
Since this act was put into place, physicians have been in a situation that they can not prescribe cannabis like other drugs. Most drugs are prescribed using a dose, frequency and an amount to be given. If this were done with cannabis it would look something like this:
“THC 90% cartridge 1-2 puffs vaporized Q2H PRN anxiety, 10 cartridges, no refills.”
In this example, Q2H means every two hours and PRN anxiety means as needed for anxiety. This would provide exact instructions for how a patient should use the cannabis they are prescribed. Maybe one day we will be able to get such a script from our doctors. At the moment, however, physicians are not taught medical cannabis therapy in medical school or residency and they are usually clueless about what patients should use (though they can learn from this book). Until they are more informed, it is probably better that patients pick and choose the forms and amounts of cannabis they use at dispensaries.
As states began to legalize medical marijuana for patients, physicians needed a way around the federal regulation against prescribing cannabis. That is how the marijuana card came into existence. Rather than writing a prescription and going to jail, doctors made recommendations for their patients to use cannabis to their state marijuana programs, which would issue a certificate to a patient and the patient would receive a marijuana card that would be shown to dispensaries, designating them as certified marijuana patients of the state.
This work-around has protected physicians in states that have legalized cannabis so they are not tracked down by the DEA for breaking the CSA. While it does provide a buffer between the doctors and the federal government, it also distances them from the ability to provide specific instructions to patients and only allows them to make vague recommendations instead. As the industry becomes more legitimate and accepted by the federal government, doctors will be able to prescribe to patients exactly what they feel the patient should use.