However, the physicians questioned agree there is no indication the symptoms are caused by an overdose.

Those experienced with making the correct diagnosis are passionate in saying the key is getting the patient to trust them and be truthful.

“Taking a history about substance use requires the doctor to ask in a way that makes it possible for the patient to give an honest answer without feeling ashamed, and it requires people to be willing to give that honest answer. Until that happens you'll never make the diagnosis,'' said Lavonas.

"We’ve got to make it clear to the patient that none of us are going to judge you if you smoke pot. We just want to help you medically. The best way to do that is for us to have all the information,” he said.

At Billings Clinic, Montana’s largest hospital system, Dr. Daniel Hurst said that often when people are asked whether they use drugs, or alcohol or marijuana, initially they say no.

“But I’ve found here in Montana at least, that if confronted and you kind of explain why you’re asking, people will give you an honest answer and that makes the chance of an accurate diagnosis more likely,” Hurst said.