Most healthcare professionals aren't going to put their career / lives / family on the line to fight against State laws so I'm not surprised that they're playing it safe and covering their own backs rather than risk being dragged through the courts for years. And of course, unlike prescribing vast amounts of opiates, there's no money in Methotrexate.

Most of the world looks at this (and many other things in the USA) with disbelief.