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Additional anathemas in psychiatry.

While reading Dr. Nasrallah's "Anathemas of psychiatric practice" (From the Editor, CURRENT PSYCHIATRY. November 2019, p. 13-15), 2 additional anathemas immediately came to mind:

* Cash-only suboxone clinics. Suboxone was never intended to be used in "suboxone clinics"; it was meant to be part of an integrated treatment provided in an office-based practice. Nevertheless, this treatment has been used as such in this country. As part of this trend, an anathema has grown: cash-only suboxone clinics. Patients with severe substance use disorders can be found in every socioeconomic layer of our society, but many struggle with significant psychosocial adversity and outright poverty. Cash-only suboxone clinics put many patients in a bind. Patients spend their last dollars on a needed treatment or sell these medications to maintain their addiction, or even to purchase food.

* "Medical" marijuana. There is no credible evidence based upon methodologically sound research that cannabis has benefit for treating any mental illness. In fact, there is evidence to the contrary. (1) Yet, in many states, physicians--including psychiatrists--are supporting the approval of medical marijuana. I remember taking my Hippocratic Oath when I graduated from medical school, pledging to continue educating myself and my patients about evidenced-based medical science that benefits us all. I have not yet found credible evidence supporting medical marijuana.

Greed in general is a strong anathema in medicine.

Leo Bastiaens, MD

Clinical Associate Professor of Psychiatry

University of Pittsburgh School of Medicine

Pittsburgh, Pennsylvania

Disclosure: The author reports no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.


(1.) Radhakrishnan R, Ranganathan M, D'Souza DC. Medical marijuana: what physicians need to know. J Clin Psychiatry. 2019;80(5):45-47.

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Title Annotation:Comments&Controversies
Author:Bastiaens, Leo
Publication:Current Psychiatry
Article Type:Letter to the editor
Date:Jan 1, 2020
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