On Tuesday, the day before recreational pot is legalized, two doctors on opposite sides of the issue will participate in a live streamed debate sponsored by the College of Family Physicians of Canada. An employee monitors young marijuana in a grow room during a tour of the Sundial Growers Inc. marijuana cultivation facility in Olds, Alta., Wednesday, Oct. 10, 2018. (Jeff McIntosh/The Canadian Press)

Doctors to debate medical pot as more patients expected to ask for prescriptions

Marijuana will be legal in Canada on Oct. 17

Doctors with opposing views on whether medical marijuana should be prescribed for various conditions agree on one thing: their profession is ill-prepared to deal with patients asking for a drug that lacks adequate clinical research.

Two doctors with contrasting viewpoints on the issue will participate in a debate on Tuesday — the day before recreational cannabis is legalized — as part of a live streamed event hosted by the College of Family Physicians of Canada.

Dr. Mark Ware, who practises pain medicine in Montreal and has spent 20 years researching chronic pain, will be arguing for the use of medical cannabis for conditions such as neuropathic pain and chemotherapy-induced nausea and vomiting.

On the other side, Dr. Mel Kahan, medical director of Substance Use Services at Women’s College Hospital in Toronto, believes the overall evidence for medical marijuana is “incredibly weak.”

Ware, who has taken a leave from his job to work as chief medical officer for Ontario-based medical marijuana company Canopy Growth Corp., said most of the research on cannabis in the last 40 years has focused on recreational use and physicians aren’t taught even the basics of the drug as part of their training.

He and some colleagues have tried developing an educational program for medical schools “but even those run into challenges because the evidence base is limited so we have challenges getting them through education program reviews,” Ware said.

“It’s a tough situation. I empathize with the practising clinicians who may sit and feel they don’t have much information,” he said, adding the neuroscience of cannabinoid pharmacology is “extremely robust.”

“I think with recreational cannabis coming on stream patients are now going to come and talk about cannabis for a wide range of reasons.”

READ MORE: 2/3 of Canadians don’t know their workplace rules for cannabis: poll

READ MORE: StatsCan: BC cannabis consumption second highest in Canada

However, Kahan, who is also an associate professor in the department of family medicine at the University of Toronto, said very few controlled trials have been done on cannabis, adding the drug has not been found to be useful for anxiety and post-traumatic stress disorder despite some claims, and may well worsen such conditions.

“THC has been shown in pre-clinical studies to cause anxiety,” he said, referring to tetrahydrocannabinol, the main psychoactive ingredient found in cannabis. “So I think a lot of the claims are false.”

“We have to understand that there’s a greedy and dishonest industry,” he said of the proliferation of marijuana clinics.

“It’s Cowboyland out there right now. You can prescribe marijuana for anything you want, regardless of the evidence,” he said. “As far as I can tell many of them are prescribing very high doses for all sorts of conditions: arthritis and anxiety etcetera. And this is dangerous. Sure, if they prescribe judiciously and carefully to people with true, organic pain conditions that’s OK.”

The Canadian Medical Association maintains that while some patients may benefit from medical cannabis, many doctors feel uncomfortable prescribing a substance that hasn’t undergone the same regulatory review processes required for all other prescription medicines to provide physicians with information about dosages and potential interactions with other drugs.

Health Canada said in an emailed response that the department “recognizes the concerns regarding the level of evidence on the risks and benefits of cannabis for medical purposes, as well as on dosage and potential interactions with other medications.”

It says new regulations coming into effect on Wednesday permit “research activities” and support pre-clinical and clinical research on the use of cannabis and cannabinoids for medical purposes.

Provincial and territorial medical regulatory authorities have put medical marijuana policies in place for doctors.

For example, the College and Physicians and Surgeons of British Columbia has advised doctors that cannabis is not generally appropriate for anyone who is under 25, has an active substance use disorder, a personal or strong family history of cannabis use disorder, cardiovascular or respiratory disease and is pregnant, planning to become pregnant or is breast feeding.

Patients who have medical authorization for cannabis from a doctor may access cannabis by registering with a licensed producer, at least 130 of which exist across the country, or by registering with Health Canada to produce a limited amount for their own purposes or by designating someone to grow it for them.

Canada began providing limited legal access to dried marijuana starting in 1999, before patients could possess it with a doctor’s authorization for medical purposes starting in 2001.

As of June, more than 330,000 Canadians were registered with Health Canada-approved licensed producers as users of medical marijuana.

Dr. Mike Allan, director of programs and practice support at the College of Family Physicians of Canada, will moderate the debate between Ware and Kahan.

Allan said patients should consider the potential side effects of cannabis, the same as with any other “natural” drug they may take.

“Many will claim that because they’re natural they’re adverse-event free but that’s just not the case. There are a lot of natural products that have adverse events and cannabinoids are one of them.”

Money generated from cannabis should go toward research to better understand its potential benefits and harms, he said.

Camille Bains, The Canadian Press


Like us on Facebook and follow us on Twitter.

Just Posted

Gardening: George and the family berry plan

Pitt Meadows family’s farm roots go back to 1925.

Letter: Premier has ‘no clue’ on PR

Or Horgan is deliberately hiding his intentions.

Air ambulance called to scene after report of shots fired in Abbotsford

Incident Monday afternoon in the area of Ross and Simpson roads

B.C. Legions in need of young members to continue aiding veterans into the future

Lest we forget what thousands of men and women did to fight for Canada’s freedoms – but without new membership, many Legion chapters face dwindling numbers

Clear skies for Fraser Blues Remembrance Day flyby

It was the first time the formation team flew over the Maple Ridge and Pitt Meadows Remembrance Day ceremonies

Calgary 2026 leader expects close vote in Winter Games plebiscite

Residents to choose in a non-binding vote on Tuesday whether they want city to bid on 2026 Olympics

VIDEO: Newcomer kids see first Canadian snowfall

Children arrived in Canada with their mother and two siblings last week from Eritrea

Feds dropped ball with WWI anniversary tributes: historians

Wrote one historian: ‘Other than the Vimy Ridge celebration … I think they have done a very bad job’

Sides ‘far apart’ in Canada Post talks despite mediation, says union

The lack of a breakthrough means rotating strikes will resume Tuesday

Feds’ appeal of solitary confinement decision in B.C. to be heard

Judge ruled in January that indefinite such confinement is unconstitutional, causes permanent harm

Touching note left on Lower Mainland veteran’s windshield

A veteran is hoping the writers of a note know how much he was touched by their kind words.

B.C. health care payroll tax approved, takes effect Jan. 1

Employers calculating cost, including property taxes increases

Nunavut urges new plan to deal with too many polar bears

Territory recommends a proposal that contradicts much of conventional scientific thinking

Most Read