A decade after Canada legalized the medical use of marijuana, most doctors are still refusing to sign the declarations patients need to get legal access to pot — meaning patients in pain risk being jailed if they use a drug that helps them function.
It’s a predicament that threatens to become worse because of proposed changes to how Health Canada regulates access to the drug.
At first glance, it appears the government is easing up on strict rules for obtaining medicinal marijuana. Health Canada has proposed removing itself as the ultimate arbiter in approving or rejecting applications to possess.
Instead, doctors alone would sign off on requests.
But the nation’s largest doctors’ group said the proposals would have the perverse effect of putting even greater pressure on MDs to control access to a largely untested and unregulated substance they know little to nothing about; a drug that hasn’t gone through the normal regulatory review process. Their licensing bodies have told doctors that they are under no obligation to complete a medical declaration under the current regulations and that any one who chooses to do so should “proceed with caution.”
Dr. John Haggie, president of the 75,000-member Canadian Medical Association, said the changes being proposed would essentially off load all responsibility for using and monitoring marijuana to the doctors who sign an authorization — “and they’d be kind out of out there, without any infrastructure around them to assess it, to monitor it and to know if they were doing the right thing.
“I don’t think that’s appropriate or fair,” he said.
Observers said doctors fear doing harm, exposing themselves to legal action and becoming the “go-to” source for people seeking pot not to alter their pain but to alter their consciousness.
Haggie said physicians want fundamental research into some basic questions — is it safe? Who does it work for? Who should not use it? Yet the Conservative government abruptly terminated a medicinal marijuana research program in 2006. According to Health Canada, the government believes clinical research is “best undertaken by the private sector, such as pharmaceutical companies.”
A world leader in cannabis research said the logic defies him.
“I cannot imagine how a government agency can supervise (a marijuana access) program knowing that there is very little data out there — on safety issues in particular — and not try to stimulate research,” said Dr. Mark Ware, head of the Canadian Consortium for the Investigation of Cannabinoids, a non-profit network of more than 150 clinicians and researchers investigating the potential role of cannabinoids in diseases from arthritis to glaucoma.
No drug company wants to evaluate smoked marijuana as a medicine, Ware said, because there’s no money in it for them. Funding agencies have been less than approachable, he added, because there’s little appetite to support studies involving a product that’s often smoked. In clinical parlance, “They don’t see it as a safe, viable drug delivery system,” said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre.
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