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Medical marijuana patients can become resistant clients

July 7, 2011
by Gary A. Enos, Editor
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Washington counselors find it difficult to implement motivational strategies

Two counselors with a Washington state outpatient treatment agency say they have been encountering a troubling consequence of the proliferation of medical marijuana programs. When a medical marijuana patient becomes a treatment client, often by way of a court-ordered referral, that person’s resistance to treatment can sabotage clinicians’ best efforts, they say.

“There’s so much resistance, because of the attitude of, ‘It’s my medication,’” says Stephanie Sherve, a licensed mental health counselor and chemical dependency professional with Pend Oreille County Counseling Services in Newport, Wash. “It makes it difficult to apply motivational enhancement strategies.”

Moreover, with many of the treatment agency’s services conducted in group settings, the presence of a resistant client holding a medical marijuana card can do larger harm to the treatment process, Sherve believes. Overall, Sherve calls these mandated clients the most challenging she has worked with so far.

Sherve and colleague Mary LaVille believe that if medical marijuana laws are here to stay in their state and elsewhere, more thought should go into what constitutes proper use of the drug for medical conditions such as pain. “We provide UA testing for clients; how do we test for therapeutic levels vs. abuse?” LaVille asks. At present there are no accepted criteria for this, she says.

The agency also discovers, in many cases where a medical marijuana patient ends up getting referred to treatment, that a client had a previous diagnosis of substance dependence in their history before he/she received a medical marijuana card, Sherve says.

Both clinicians describe frustrating experiences with specific clients who would perform various treatment exercises but could not achieve that important breakthrough in treatment. In one case, a client dealing with both marijuana and alcohol dependence had clearer insight into how alcohol was harming his life than he did about marijuana.

Sherve points out that her agency does not appear to be seeing an overall increase in marijuana-related problems because of the state’s medical marijuana law, but is seeing a clear connection in individual cases between medical marijuana use and a resistance to engage in the therapies the program has to offer.