Different doctors and systems do different things. (Which is a problem like you pointed out). Having been at one of the largest in ”the” country, I can say the

Different doctors and systems do different things. (Which is a problem like you pointed out). Having been at one of the largest in ”the” country, I can say the only time anyone would get this added is if they are in some kind of intensive substance abuse program or, yet much less likely, if they are on other controlled substances (think opioids) or if the doctor really hates MJ or if the patient goes into the ER frequently for side effects like cyclical vomiting. Just my minor observation but your points ring true to my ears.