title: The Medicinal Cannabis Treatment Agreement: Providing Information to Chronic Pain Patients Through a Written Document.
abstract: OBJECTIVE
  Pain practitioners would seem to have an obligation to understand and inform their patients on key issues of the evidence base on cannabinoid therapeutics. One way to fulfill this obligation might be to borrow from concepts developed in the prescription of opioids: the use of a written agreement to describe and minimize risks. Regrettably, the widespread adoption of opioids was undertaken while harmful effects were minimized; obviously, no one wants to repeat this misstep.
  
  
  OBJECTIVE
  This article describes a method of educating patients in a manner analogous to other treatment agreements.
  
  
  BACKGROUND
  Surveys have demonstrated that pain is the most common indication for medical use of cannabis. As more individuals gain access to this botanical product through state ballot initiatives and legislative mandate, the pain specialist is likely to be confronted by patients either seeking such treatment where permitted, or otherwise inquiring about its potential benefits and harms, and alternative pharmaceuticals containing cannabinoids.
  
  
  METHODS
  PubMed searches were conducted using the following keywords: cannabis guidelines, harmful effects of cannabis, medical marijuana, medicinal cannabis, opioid cannabis interaction, cannabis dependence and cannabis abuse
  
  
  RESULTS
  : The authors selected individual tenets a medicinal cannabis patient would be asked to review and acknowledge via signature.
  
  
  CONCLUSIONS
  Undoubtedly, the knowledge base concerning risks will be an iterative process as we learn more about the long-term use of medicinal cannabis. But we should start the process now so that patients may be instructed about our current conception of what the use of medicinal cannabis entails.
authors.affiliation: *Department of Physical Medicine & Rehabilitation, VA Northern California Health Care System †Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento ‡VA San Diego Health Care System §Department of Psychiatry, University of California, San Diego, La Jolla, CA.
authors.forename: Barth
authors.initials: B
authors.lastname: Wilsey
authors.forename: J Hampton
authors.initials: JH
authors.lastname: Atkinson
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: D059350:Chronic Pain / Q000188:drug therapy*; D032921:Consensus; D005260:Female; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D010353:Patient Education as Topic
chemical_list: D064086:Medical Marijuana