Pubdate: Sat, 25 May 2002
Source: Winnipeg Free Press (CN MB)
Copyright: 2002 Winnipeg Free Press
Page: A1
Author: Alexandra Paul


Medical Marijuana Better 'Worn' Than Smoked: Doctors

The country's top pain specialists predict doctors will some day prescribe 
marijuana to control chronic pain.

But physicians won't allow patients to smoke it. Instead, pain sufferers 
would wear it or inhale it.

Doctors foresee a day when they will prescribe the active ingredients of 
marijuana, or a marijuana-like chemical, in a spray to be inhaled, or as a 
rub or patch to be absorbed through the skin.

"Because of the concern with smoking, alternatives... are required before 
long-term use of cannabinoids (marijuana drug derivatives) can be 
recommended," said Winnipeg anesthetist and pain control expert Dr. Ian 
Sutton. Pot smoke is as dangerous as cigarettes, he said. "Most physicians 
won't get involved with smoking, and with campaigns against smoking, why 
would you advocate it?" Sutton said.

As an aerosol or a patch, marijuana is just as good as smoking pot, without 
the health risks, say doctors, who yesterday urged the federal government 
to loosen controls to allow long-term studies of medical marijuana.

Only two limited studies do have the green light -- one in Montreal and 
another in Halifax. The topic was a highlight of the second of a three-day 
Canadian Pain Society Conference that has drawn 350 specialists from 
Canada, the United States, Australia, Sri Lanka and Nigeria. Last summer, 
Ottawa amended federal drug laws to allow a limited number of patients 
suffering from conditions such as multiple sclerosis, HIV, cancer and 
Crohn's disease to obtain a special exemption to smoke marijuana to relieve 
their conditions.

Chronic pain patients who smoke marijuana for medicinal purposes reacted 
with derision to the cautious position the doctors are taking.

Patients say smoking works and there's no reason to complicate an effective 
drug because of politics.

Andy Caisse, 33, one of 255 Canadians with federal clearance to smoke 
marijuana, says he's tried marijuana in other forms, but only smoking 
controls his multiple sclerosis. Dave Tetreault, 33, who suffers from 
Crohn's disease, a painful inflammatory bowel disease, agreed.

Both men belong to the Manitoba Compassion Club, which advocates the 
medical use of marijuana, and both claim to smoke four to five joints a day.

Tetreault smokes illegally -- he has no document from his doctor allowing 
him to smoke marijuana -- and he believes doctors are being fussy by 
opposing the legalization of a street drug.

"The comparison between cigarette smoke and marijuana, that's just an 
excuse. If their hearts were really in it, there would be none of these 
delaying tactics," Tetreault said. The future of marijuana in pain control 
is more of a political issue than a medical debate, doctors admit.

The Canadian Medical Association and the Canadian Medical Protective 
Association are both on record as being opposed to prescription marijuana 
on the grounds that federal legislation, as it is currently written, leaves 
individual doctors legally responsible for patients' abuse of the drug. 
"The whole issue of the CMPA, they look after malpractice (insurance) and 
they're saying, if we don't know about this drug, don't prescribe it. If 
something happens, you're going to get into trouble," said another 
specialist, Dr. John Clark, a pain management specialist at Dalhousie 
University in Halifax.

"The whole issue is very political," Clark said.
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