We've come a long way since 1996 when California became the first state to legally allow marijuana to be used for medical purposes. Now, 23 states have laws on the books, according to the National Conference of State Legislatures. Putting aside the political debate surrounding these measures, there seems to be a growing awareness that clinicians need to be better educated on if, when and how to recommend the drug.

"It's the Wild West out there pretty much, being driven by patient demand and also by the research that is coming to light on the benefits and the risks of using it," says Stacey Marie Kerr, M.D., a family physician who serves on the executive board of the Society of Cannabis Clinicians. "The movement is growing and education for physicians and for patients is essential."

To that end, the society last week rolled out a package of online CME-certified courses for docs, called the Medical Cannabis Institute, covering everything from the history of cannabis as a medicine, to a review of clinical studies on its effectiveness.

State medical societies also are trying to ensure that their members not only are able to properly recommend the drug, but also effectively answer patients questions. In Illinois, where lawmakers approved a medical marijuana measure in 2013, the state medical society offers free online training that details the certifying process for patients and the physician's role. Illinois docs have been slow to work with the drug, but that could change with more info, says William McDade, M.D., president of the Illinois State Medical Society.

"Before I really tell a patient that this is going to be a good thing for him or her, I want to see the data that are behind it," he says. "But it's coming out very slowly because it's so hard to do research with a controlled substance."

Physicians in Minnesota are in the throes of trying to figure out their strategy as well. They have until July 1 to figure things out as that's when manufacturers will begin making medical marijuana available to patients. In an email statement, Dave Thorson, M.D., president-elect of the Minnesota Medical Association, says they're working to educate physicians on any clinical studies that exist, along with the process of certifying patients.

Thorson says that the association did not support the state legislation, but is glad that the Minnesota Department of Health is launching some research on the drug's impact. "At this point, the science is far from clear on its effectiveness," he says. Meanwhile, the American Academy of Neurology issued a call last month, asking the feds to remove marijuana from Schedule 1 to allow for further testing on its usefulness in treating disorders of the brain, spine and nervous system.