Life-changing leaf

Medical marijuana user says doctors discouraged from prescribing; new clinic hopes to alleviate wariness

Louis Power lpower@thetelegram.com
Published on February 7, 2016

As the country moves towards legalizing marijuana for recreational use, patients in Newfoundland and Labrador are still having trouble accessing the herb for medical use.

It’s not because of the fact that no licensed producers grow marijuana in the province; doctors here may be hesitant because the College of Physicians and Surgeons of Newfoundland and Labrador appears to discourage them from having anything to do with it.

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Jeff Piercey of Portugal Cove-St. Philip’s is among the few patients in Newfoundland and Labrador who’ve been able to get hold of medical marijuana. He said it wasn’t easy to find a doctor in this province who would prescribe it. He lives with a chronic pain condition caused by a degenerative disc, and went to multiple doctors on his quest for pain relief.

“The only reason I found someone who would prescribe for me was I knew somebody who knew somebody who knew a doctor. It was very, very difficult – it was about a year and a half process,” he said.

“I went from narcotic to narcotic, and they either didn’t help with the pain or the side-effects were too extreme, and I didn’t want to put that into my body.”

Last January, Piercey finally got a prescription filled for medical marijuana, and he said the leaf changed his life.

“Before I started using medical marijuana, when my chronic pain condition started, I was not able to be a dad. I was not able to be a husband. And now I can be a father to my two kids. It’s given me my life back,” he said.

 

College’s concerns

Piercey has spoken with others in search of medical marijuana who face similar resistance. He said he learned that physicians in Newfoundland and Labrador are being advised not to start prescribing it.

In “Advisory to the Profession and Interim Guidelines — Marihuana for Medical Purposes,” published in March 2014 ( https://www.cpsnl.ca/default.asp?com=Policies&m=340&y=&id=98 ), the College says it has relayed concerns to Health Canada about federal regulations, and they have not been sufficiently addressed.

“The College believes that physicians should not be expected to facilitate patient access to a substance, for medical purposes, for which there is no body of evidence of clinical efficacy or safety,” reads the text, which can be found on the College’s website.

“As well, medical standards and guidelines for prescribing of marihuana, addressing issues such as standardized dosage or quality control, are lacking. The amount of active ingredients in marihuana varies significantly, depending on the origin and method of production of the substance. Also, many uncertainties remain about the effects, whether considered beneficial or harmful, of marihuana use.

“In light of these concerns, the College believes physicians will be at increased risk of allegations of negligence and malpractice if they facilitate an individual’s access to marihuana for medical purposes, as compared to the prescribing of drugs and treatments for which there is a recognized scientific body of evidence of clinical efficacy or safety.”

The College also “strongly discourages” doctors from dispensing medical marijuana to patients.

These interim guidelines are not hard-and-fast regulations. The College says it believes it would be premature to publish standards of practice, “as this could be interpreted as the College supporting or legitimizing this practice,” and notes that it is monitoring the approaches of Canadian medical regulators.

This province’s College is not alone in its reluctance to embrace marijuana for medical purposes.

The College of Physicians and Surgeons of Saskatchewan, for example, had this to say in its regulatory bylaws published in 2014: ( http://www.cps.sk.ca/Documents/Legislation/Legislation/RegulatoryBylaws.pdf ) “The College of Physicians and Surgeons supports the evidence- based practice of medicine, and believes that physicians should not be asked to prescribe or dispense substances or treatments for which there is little or no evidence of clinical efficacy or safety. The College of Physicians and Surgeons believes that there have not been sufficient scientific or clinical assessments to provide a body of evidence as to the efficacy and safety of marihuana for medical purposes.”

But like Newfoundland and Labrador’s College, it acknowledges that the Marihuana for Medical Purposes Regulations ( http://www.laws-lois.justice.gc.ca/eng/regulations/SOR-2013-119/ ) authorizes physicians to provide a medical document allowing the patient to obtain medical marijuana. It also lays out the minimum guidelines for those who wish to do so.

In other provinces, such as Ontario, physicians are given guidelines, but neither encouraged or discouraged from the practice.

 

Access in N.L.

Last year, New Brunswick-based Marijuana for Trauma set up an office in St. John’s to help local patients access medical marijuana. The organization is run by veterans, and focuses mainly on helping other veterans with post-traumatic stress disorder, though it has worked with civilians as well.

MFT founder Fabian Henry told The Telegram this past summer that it hadn’t been able to find a single local doctor to prescribe medical marijuana, and it had to rely on a clinic in Ontario to obtain prescriptions.

Cannabinoid Medical Clinic (CMC), another organization that helps patients access medical marijuana and other prescription cannabinoids (medication based on the marijuana molecules THC and CBD), is opening a St. John’s clinic later this month which will be staffed by at least one physician.

Dr. Danial Schecter, CMC’s co-founder and executive director, spoke with The Telegram about the clinic and why he feels it’s needed here.

“It’s my understanding that there are certain areas that have been traditionally underserviced, and we do know that St. John’s specifically ... has very few physicians who are comfortable with this,” he said.

Several patients from St. John’s have reached out to see if the organization would see them via video call.

“It’s not the best way to practice medicine, so instead of doing health care over Skype, we’ve decided to open an actual clinic where patients can come and see us,” Schecter said.

Like the organization’s four other clinics (in Barrie, Ont., Toronto, Ottawa and Halifax), clients will need a referral from their family doctor to see a physician at the St. John’s CMC location. There, they will be assessed, and if deemed a good candidate, prescribed either medical marijuana or another prescription cannabinoids (medication based on the marijuana molecules THC and CBD).

Medical marijuana is mailed to users from one of 25 licensed producers on the mainland, and other cannabinoid medication such as tablets can be sought from local pharmacies.

“Doctors are increasingly understanding that cannabinoids, as a class of medication, can be very effective in helping patients in a number of different conditions including chronic pain, post-traumatic stress disorder, and even gastrointestinal disorders,” said Schecter.

But he knows some physicians are still hesitant to fill a prescription for the herb. In such a case, he said, CMC will be happy to talk to them about cannabinoid therapies

WEBLINKS

http://cmclinic.ca/

http://mftgroup.ca/

http://www.cpsnl.ca/default.asp?com=Policies&m=340&y=&id=98