Louisiana Administrative Code › Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS › Part XLV - Medical Professions › Subpart 3 - Practice › Chapter 77 - Marijuana for Therapeutic Use by Patients Suffering from a Debilitating Condition › Subchapter D - Marijuana for Therapeutic Purposes, Limitations, Access to Records › Section XLV-7717 - Use of Marijuana for Therapeutic Purposes, Limitations

Current through Register Vol. 50, No. 6, June 20, 2024
A. Required Prior Conditions. Nothing in this
					 Chapter requires that a physician issue a written request or recommendation for
					 marijuana. However, if a physician determines it medically appropriate to do so
					 to treat or alieve symptoms of a patients qualifying medical condition the
					 physician shall comply with the following rules.
1. Medical Diagnosis. A medical diagnosis of
					 a debilitating medical condition shall be clinically established and clearly
					 documented in the patient's medical record, based on an in-person physical
					 examination. The diagnosis shall be supported by an assessment of the patient
					 which, at a minimum, shall include a review of the patients present illness,
					 medical and surgical history, social history, alcohol and substance use history
					 (including addiction, mental illness and psychotic disorders), prescription
					 history, and an assessment of current coexisting illnesses, diseases, or
					 conditions.
2. Prescription
					 Monitoring Program. The physician shall review the patients information in the
					 Prescription Monitoring Program database prior to issuing any written request
					 or recommendation for marijuana.
3.
					 Independent Medical Judgment. A physicians decision to utilize marijuana in the
					 treatment of a patient must be based on the physicians independent medical
					 judgment. The indication, appropriateness, and safety of the recommendation
					 shall be evaluated in accordance with current standards of practice and in
					 compliance with the laws of this state and the rules of this Chapter.
4. Treatment Plan. An
					 individualized treatment plan shall be formulated and documented in the
					 patients medical record which includes medical justification for the use of
					 marijuana. In addition, the plan shall include documentation:
a. that conventional treatment for the
					 patients debilitating medical condition have been considered, are being
					 undertaken or have been attempted without adequate or reasonable success or a
					 statement that the patient has refused such methods;
b. whether therapeutic marijuana could
					 interfere with any ongoing conventional treatment; and
c. the intended role of therapeutic marijuana
					 within the overall plan.
d. of
					 compliance with the boards rules on chronic or intractable pain, set forth in
					 6915-6923 of this Part, if therapeutic marijuana is utilized for the treatment
					 of non-cancer-related chronic or intractable pain.
5. Informed Consent. A physician shall
					 explain the potential risks and benefits of both the therapeutic use of
					 marijuana and any alternative conventional treatment to the patient. Among
					 other items, informed consent should caution against driving, operating
					 machinery or performing any task that requires the patient to be alert or react
					 when under the influence of the drug and the need for secure storage to reduce
					 the risk of exposure to children or diversion by others. Unless approved by the
					 USFDA for treatment of the patients debilitating medical condition, a physician
					 shall also advise patients that therapeutic marijuana is experimental,
					 unconventional, and has not been approved by the USFDA for the treatment of the
					 patients debilitating medical condition, and that possession may be viewed as
					 illegal under federal law and subject to federal (and workplace) enforcement
					 action. Discussion of the risks and benefits should be clearly noted in the
					 patient's record. If the patient is a minor a custodial parent or legal
					 guardian shall be fully informed of the risks and benefits and consent to such
					 use.
6. Continued Use of
					 Marijuana. The physician shall monitor the patient's progress at such intervals
					 as the physician determines appropriate to assess the benefits of treatment,
					 assure the therapeutic use of marijuana remains indicated, and evaluate the
					 patient's progress toward treatment objectives. During each visit, attention
					 shall be given to the possibility that marijuana use is not masking an acute or
					 treatable progressive condition or that such use will lead to a worsening of
					 the patients condition. Indications of substance abuse or diversion should also
					 be evaluated.
7. Medical Records. A
					 physician shall document and maintain in the patient's medical record, accurate
					 and complete records of the medical diagnoses of a qualifying medical
					 condition, PMP inquiries, consultations, treatment plans, informed consents,
					 periodic assessments, and the results of all other attempts which the physician
					 has employed alternative to marijuana. A physician shall also document the
					 date, type, quantity, dosage, route, and frequency of each written request or
					 recommendation for marijuana which the physician has made for the patient. A
					 copy of a written request or recommendation shall suffice for this
					 purpose.