Passing The Joint

It's a bit of a headache for the federal government.  One they'd like to pass to the health professionals.  Is the issue of using marijuana the responsibility of the nation's doctors?  Suppose so, when it is being prescribed medically.  And it is, increasingly, prescribed for patients dealing with pain that is difficult to suppress, or health conditions that respond favourably to marijuana use for people who can find relief no other way that so substantially relieves their symptoms.

For them, the use of medical marijuana presents a boon to their life, a method whereby they are able to live a life that has more quality than before, coping without its use.  The federal government has found itself with a complex situation in monitoring the growth of officially sanctioned weed, with the full knowledge that there are those who feel it would be far more sensible to legalize entirely the growth and free use of marijuana.

For a while it looked as though that might occur.  Marijuana use, after all, has not led to a societal impact that results in the kind of chaos linked to hard drugs and their addictive properties that destroy human lives and fuel crime.  On the other hand, with the legalization of marijuana, a drug of choice for many people who consider it a moderate way to gain pleasure in their leisure time, the criminal cultivation and sale of a forbidden drug would be a thing of the past.

While the former, Liberal-led government appeared to be heading toward possible legalization with the knowledge that this move would be looked at with disfavour by our southern neighbour, the current government has decided otherwise.  And its latest tough-on-crime legislation has done few favours for the marijuana-using crowd; in fact enacting strict rules that might under certain circumstances impose harsh penalties on casual users.

Health Canada is currently preparing to publish proposed new regulations that would alter access to medical marijuana under a program that would establish doctors as the responsible and sole "gatekeepers" to prescribing the drug.  For many doctors this is a hot potato they would prefer not to burn their professional hands on.  They know too little about the drug, its potency and efficacy, other than through hearsay.

And they would prefer not to have that particular 'nail' hammered onto their already onerous responsibilities to society.  CMA president Dr. Anna Reid feels it is unfair to expect medical practitioners to prescribe a drug when information on its safe use and appropriate dosage is unknown, "and that's just not acceptable for us".  She cites emergency rooms and psychiatric wards across the country inundated with people with recurring psychosis.

People hallucinating, losing touch with reality "that is felt by researchers to be actually triggered by marijuana", explained Dr. Reid, an emergency room physician hailing from Yellowknife.  Marijuana, she says, is no longer the same mellow drug it was twenty five years ago when she began practising.  "We know for a fact that marijuana is much stronger now.  These are the kinds of concerns that have physicians very worried about prescribing it, when we don't know what a safe dose is (and) we don't know how to use it."

Through a CMA survey with a response rate of 27%, making it "not necessarily representative of the entire physician population ... but ... a good snapshot of what physicians are thinking in general", over half of responders indicated there was insufficient information on the risks and benefits associated with marijuana use for medical purposes at their disposal.  A significant number claimed they have very few requests from their patients on marijuana use.

And 35% who had been asked about access responded that they never support such requests "while 40% would do so at least some of the time."  And then there were some revealing comments about physician thoughts such as "I have been in the practice long enough to know that there are a lot of 'scammers' out there who would like to be allowed to use marijuana with no personal accountability", and another who considered cannabis an "excellent medication with an undeservedly bad reputation."

"I think it's another difficult thing (for doctors) to assess because of the risk of abuse, misuse and diversion, and it comes on the heels with the problems that we've had with the opioids", said Dr. Reid, unconvinced entirely that the hand-off by Health Canada to the nation's doctors would represent a move in the right direction.