Marijuana for Medical Purposes
The College’s Position Alleged medical benefits of smoked marijuana up until now are still unproven and are based on anecdotal information. Very few published studies are available on the benefits of marijuana in its smoked form. Marijuana smoke has almost 200 active ingredients, any of which may be responsible for a variety of effects. Tetrahydrocannabinol (THC), one of the dominant ingredients of marijuana, has been available for many years in tablet form and is used as an anti-nauseant, mainly in treating the side effects of chemotherapy. Many uncertainties remain about the effects, both beneficial and harmful, of smoked marijuana. The content and amount of active ingredients in marijuana vary significantly, depending on the origin and method of production of the substance. The lack of availability of credible scientific information on the indications for smoked marijuana's medicinal use, together with the absence of information on the risks and benefits of this substance, make it questionable, if not dangerous, for physicians to prescribe this agent for their patients. Little is known about the interaction of this agent with other drugs and medications. Its analgesic effects alone are reported to be no better than codeine. What is known is that THC potentiates the analgesic action of narcotics many-fold. That fact alone requires that it be used very cautiously and may indicate a potential for harm. Marijuana is also known to create dependency or to be addictive for a significant number of its users. Physicians are advised that they should not prescribe any drug for their patients without knowing the risks, benefits, potential complications and drug interactions associated with the use of that agent. Currently, that would certainly include marijuana in its smoked form, where it may cause significant harm. Furthermore, physicians may be the subject of accusations or suggestions of negligence, including liability if a prescribed drug, including prescribed marijuana, produces unforeseen negative effects. While some specific patients may benefit or claim benefit from smoked marijuana, only physicians who are fully familiar with this agent and its potential medicinal use or uses, should consider prescribing it or writing in support of it being provided to their patient. The regulations for prescribing marijuana recently published by Health Canada, do not take into account the requirement for physicians to follow evidence-based protocols and guidelines in providing care for their patients. Smoked marijuana has not been the subject of the investigative protocols and the pre-public release requirements required for all new drugs. Medical Marijuana Update Pursuant to the Medical Marijuana Access Regulations, SOR/2001-227 (“the Regulations”), marijuana may be prescribed to patients fulfilling the criteria set out in the Regulations. The medical benefits of marijuana have been subject to much debate. To assist members in considering patient requests for medical marijuana and in making an informed decision, the College has conducted a review of the current research literature on the risks and benefits of medical marijuana. The results of this review are available to members for review in person at the College Library, at 400-858 Beatty Street, Vancouver, BC, or online through the College website at www.cpsbc.ca. While the College’s position in this matter remains unchanged, the College, through its Library Service, is providing members with access to appropriate reference material to guide them in making informed decisions on the risks and benefits of medical marijuana as they seek to provide appropriate evidence-based care to their patients.
Resource Manual – Marijuana for Medical Purposes
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For more information on medical uses of marijuana, go to: o Sites of Interest American Medical Association: Featured CSA report: Medical Marijuana (A-01) http://www.ama-assn.org/ama/pub/category/print/13625.html Institute of Medicine (USA): Marijuana and medicine: assessing the science base http://books.nap.edu/html/marimed/ Canadian Medical Protective Association: What to do when your patients apply for a license to possess marijuana for medical purposes http://www.cmpa-acpm.ca/cmpapd03/cmpa_docs/english/resource_files/ infosheets/common/2001/pdf/info_sheet_2001-10a-e.pdf Canadian Pharmacists Association: Position Statement on Medical Marijuana http://www.pharmacists.ca/content/about_cpha/who_we_are/policy_positio n/pdf/MedicalMarijuanaStatement-Final.pdf o Legislation and Regulations Governing the Use of Medical Marijuana in Canada Medical Use of Marijuana http://www.hc-sc.gc.ca/dhp-mps/marihuana/index_e.html Medical Marijuana Access Regulations http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hecssesc/pdf/marihuana/marihuana-reg_e.pdf Latest amendments to the Marijuana Medical Access Regulations http://canadagazette.gc.ca/partII/2005/20050629/pdf/g2-13913.pdf Other amendments to the Regulations http://www.hc-sc.gc.ca/dhp-mps/marihuana/law-loi/acts-reg-loi_e.html Information for Health Care Professionals http://www.hc-sc.gc.ca/dhp-mps/marihuana/howcomment/medpract/infoprof/index_rev_e.html
For a list of suggested articles about the current state of knowledge related to the medicinal use of marijuana, members may login to the College Library section of the website for full-text articles.
Resource Manual – Marijuana for Medical Purposes
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