Pubdate: Fri, 13 Jul 2001
Source: Vancouver Sun (CN BC)
Copyright: 2001 The Vancouver Sun
Author: Pamela Fayerman
Bookmark: (Cannabis - Medicinal)


  Medicinal Marijuana Should Be Handled Like Any Other Drug, B.C. Expert Says

Pharmacists across Canada should be preparing to dispense medicinal
marijuana, learning what information to give users about proper doses,
side effects and potential interactions, a pharmacist at the B.C.
Cancer Agency is advising professional colleagues.

Robin O'Brien, who also teaches pharmacy students at the University of
B.C., said she's not necessarily an advocate of medicinal marijuana,
just a pragmatist who believes that since the federal government is
now sanctioning marijuana use for certain ill people, it should hand
over the dispensing duties to professionals who can give patients
"expert counselling."

On July 30, new Health Canada regulations will come into effect to
protect certain patients with chronic or terminal illnesses against
marijuana-related prosecution. Such patients may apply for permission
to grow, possess and use marijuana to relieve symptoms including pain,
nausea and poor appetite.

Once patients have proven they are eligible for marijuana, they have
to grow it themselves or find a designate to do it for them.

"But this unfairly puts the onus on patients to find the drug, a
situation that is lamentable considering some of these patients might
be too frail to grow their own or simply may not live long enough to
harvest their own crop," says the current Pharmacy Practice
professional trade journal, which published O'Brien's lengthy treatise
on the pharmacokinetics, dynamics, clinical effects, toxicity and
other information on marijuana.

O'Brien said it is unrealistic to expect terminally ill people to
suddenly become gardeners and grow their own marijuana. "That's silly
and unworkable. How we can expect people with less than 12 months to
live to grow their own, or to know how to obtain good seeds and buds?"
she said.

Hilary Black, spokeswoman for the Vancouver Compassion Club, a
non-profit organization that sells organically grown marijuana to
registered users, said she agrees the current plan for users to grow
their own pot is ill-advised.

"We don't expect people to make their own penicillin so why would we
expect them to do grow their own cannabis?"

She said she doesn't oppose pharmacists being allowed to dispense
marijuana as long as the government doesn't give them the exclusive
rights to it.

"No one should have the monopoly on distribution and we want to
protect the right of people to access the whole plant and pharmacies
won't be selling that."

Health Canada spokeswoman Roslyn Tremblay said in an interview from
Ottawa Wednesday that the government has not yet figured out how it
will distribute the drug once it is cultivated in a
government-appointed growing operation situated in a former
underground mine in Flin Flon, Man.

But she said pharmacists are not yet being considered as an option
because "we're only talking about something that is at the research

"All the [touted] benefits of marijuana are purely anecdotal at this
point and we intend to spend five years researching it. So it's not a
therapeutic product yet," she said.

Nearly 300 Canadians have been granted permission to use marijuana for
medicinal reasons and next January, when that number is undoubtedly
much higher, the government and its subcontractor, Saskatoon-based
Prairie Plant Systems, will start shipping rolled marijuana cigarettes
made in Flin Flon to such people.

Tremblay said the distribution and shipping details have not yet been
worked out nor has the cost of the drug for those who purchase it from
the government.

"This is very much a new program with growing pains, there are no
plans yet, nothing carved in stone," she said.

Initially, the plant plans on cultivating 185 kg of marijuana in the
first year and 420 kg in the second year. The government is funding
nearly $8 million in research projects and clinical trials. O'Brien
said she and Vancouver palliative care Dr. Romayne Gallagher have a
proposal in mind for one such trial.

Linda Lytle, registrar of the B.C. College of Physicians and Surgeons,
said she thinks it will be some time before people will be able to
walk into a London Drugs or Zeller's pharmacy to buy their medicinal

"But if the federal regulations proceed in the direction they are
moving, I can envision marijuana being added to the list of controlled
drugs and substances, much the same as pain killers like demerol,
codeine and morphine," she said.

The new Health Canada regulations are coming into effect because of a
legal ruling in Ontario that declared Canada's marijuana laws
unconstitutional. The court gave the government until July 31 to
establish a new regulatory process allowing Canadians to use the drug
for medical purposes when conventional treatment has failed.

The regulations apply to people with less than a year to live; those
suffering from AIDS, cancer, multiple sclerosis, spinal cord injuries,
severe arthritis or epilepsy and any others who have been advised by
two medical specialists to use the herbal weed.

Applications must be signed by doctors who indicate the benefits of
using marijuana outweigh the risks, something many doctors have
complained about because there is an abundance of anecdotal evidence,
but less scientific proof of marijuana's therapeutic value.

O'Brien said many oncologists get asked by patients about the drug, so
a decade ago, she began researching what has been reported.

"The cancer information line refers calls here from people who have
tried it and found it to be useful for their nausea. They're tired of
taking pills and find that one or two puffs of marijuana is all that's
needed for relief of their chemotherapy-related nausea," she said.

She used to advise patients at the cancer agency who asked her about
where to get marijuana to ask their kids or grandchildren. But four
years ago, the Vancouver Compassion Club was formed in east Vancouver
and since then, she has referred patients there for more

The non-profit club, at Commercial and 14th Ave., sells organically
grown marijuana to registered users for anywhere from $4 to $10 a
gram. About 1,500 people are current members, after having their
doctors sign forms attesting to their diagnosis and interest in the

O'Brien said she hopes pharmaceutical companies can come up with a
medicinal form of marijuana that doesn't have to be smoked to prevent
users from the tar and risk of lung cancer.

While lung cancer is not as much of a concern for palliative patients,
there are people with chronic diseases, such as multiple sclerosis,
who may want to use the drug over a long period.

"I'd be very happy if someone developed a sublingual form [a pill
which melts under the tongue]," she said.
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MAP posted-by: Terry Liittschwager