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 1
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/hecs-
sesc/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/how-
comment/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 2