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)

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

FILE – Perry Bellegarde, National Chief of the Assembly of First Nations, takes part in an event on Parliament Hill in Ottawa on Tuesday, July 7, 2020. THE CANADIAN PRESS/Sean Kilpatrick
Indigenous Peoples Day must be a ‘call to action’, says Assembly of First Nations chief

Discovery of children at Kamloops residential school site must lead to change, Perry Bellegarde says

This undated file photo provided by Ernie Carswell & Partners shows the home featured in the opening and closing scenes of The Brady Bunch in Los Angeles. Do you know the occupation of Mike Brady, the father in this show about a blended family? (Anthony Barcelo/Ernie Carswell & Partners via AP, File)
QUIZ: A celebration of dad on Father’s Day

How much do you know about famous fathers?

North Westside residents can dispose of their unwanted bulky items between June 30 and July 14, 2021. (File photo)
North Westside residents can soon get rid of unwanted bulky items

Large household items can be disposed of at North Westside Transfer Station June 30 to July 14

Starting in 2022, the Columbia Shuswap Regional District is extending dog control to the entire Electoral Area D area. (Stock photo)
Dog control bylaw passes in Shuswap area despite ‘threatening’ emails

CSRD board extending full dog control to Electoral Area D; director calls for respectful discussion

The new Civic Memorial Park will incorporate pieces of the 80-year-old arena it replaces. (Artists rendering)
Pieces of Civic Arena reclaimed for new Vernon park

City centre space to incorporate wood from the historic arena

Marco Mendicino, Minister of Immigration, Refugees and Citizenship during a press conference in Ottawa on Thursday, May 13, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada to welcome 45,000 refugees this year, says immigration minister

Canada plans to increase persons admitted from 23,500 to 45,000 and expedite permanent residency applications

Tokyo 2020 President Seiko Hashimoto and IOC President Thomas Bach, on a screen, speak during a five=party online meeting at Harumi Island Triton Square Tower Y in Tokyo Monday, June 21, 2021. The Tokyo Olympics will allow some local fans to attend when the games open in just over a month, Tokyo organizing committee officials and the IOC said on Monday. (Rodrigo Reyes Marin/Pool Photo via AP)
Tokyo Olympics to allow Japanese fans only, with strict limits

Organizers set a limit of 50% capacity — up to a maximum of 10,000 fans

The border crossing into the United States is seen during the COVID-19 pandemic in Lacolle, Que. on February 12, 2021. THE CANADIAN PRESS/Paul Chiasson
Border quarantine to soon lift for fully vaccinated Canadians

Eligible travellers must still take multiple COVID-19 tests

The Pierre family, an Indigenous family, once lived in what is now downtown Summerland. Today, Pierre Drive is named in honour of the family. (Photo courtesy of the Summerland Museum)
Pierre family played role in Summerland’s history

Downtown Summerland was once Penticton Indian Reserve #3

A portion of the George Road wildfire burns near Lytton, B.C. in this Friday, June 18, 2021 handout photo. THE CANADIAN PRESS/HO, BC Wildfire Service *MANDATORY CREDIT*
Blaze near Lytton spread across steep terrain, says BC Wildfire Service

Fire began Wednesday and is suspected to be human-caused, but remains under investigation

Jaimee Peters photo of a Willow Midwives helping with a birth. Willow closed its doors March 31 because of a shortage of midwives. (Contributed)
South Okanagan’s only midwifery to re-open this summer

Willow Community Midwives was forced to close because of a shortage of midwives

Blair Lebsack, owner of RGE RD restaurant, poses for a portrait in the dining room, in Edmonton, Friday, June 18, 2021. Canadian restaurants are having to find ways to deal with the rising cost of food. THE CANADIAN PRESS/Jason Franson
Canadian restaurateurs grapple with rising food costs, menu prices expected to rise

Restaurants are a low margin industry, so there’s not a lot of room to work in additional costs

Gord with a mom and her young son outside Pathways which was defunded on May 31. (Facebook)
Gord Portman with a mom and her child outside of Pathways. The sign says it all about the difference Pathways has made in people’s lives. They were defunded by Interior Health on May 31.
Penticton man takes the plunge for the recovery house that helped save his life

Gord Portman said Discovery House and Pathways have been everything in his 1 year sobriety

Most Read