Pubdate: Mon, 21 Jul 2003 Source: Globe and Mail (Canada) Page: A12 Copyright: 2003, The Globe and Mail Company Contact: http://www.globeandmail.ca/ Details: http://www.mapinc.org/media/168 Author: Dean Beeby, Canadian Press Cited: David Hadorn's "Use of Cannabis Medicines in Clinical Practice" http://www.davidhadorn.com/cannabis/CM-guideline.htm Health Canada Office of Cannabis Medical Access http://www.hc-sc.gc.ca/hecs-sesc/ocma/index.htm Bookmarks: http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada) http://www.mapinc.org/topics/Health+Canada (Health Canada) HEALTH CANADA READIES RELEASE OF DOPE MANUAL Draft Version of Document Shows Patients to Receive Warnings Against Marijuana Use Health Canada is set to release a user's manual this week for a drug it has long opposed: marijuana. The unprecedented move has been triggered by the courts, which compelled Health Canada this month to begin distributing government-certified marijuana to a group of patients who take the substance to alleviate symptoms. The department must also release a manual on how to use its dope -- but a draft version of the document shows patients will get little practical advice about ingesting marijuana and lots of warnings against using it at all. "Administration by smoking is not recommended," says the 59-page document, which is modelled on drug product monographs, standard for approved medicines. The March 30 draft document specifically advises against administering marijuana to children under 16 or to those 65 years or older because the potential for harm is likely to outweigh benefits. Nursing and pregnant women are also urged to steer clear. The document warns of potential panic attacks, psychosis and convulsions in some cases. "If disturbing psychiatric symptoms occur at the prescribed dosage, the patient should be closely observed in a quiet environment and supportive measures, including reassurance, should be used." Users are also advised that traces of marijuana remain in the urine for weeks and may turn up in drug tests carried out by employers or police. Apart from brief sections citing scientific studies on taking marijuana orally -- baked in a cookie, for example -- or rectally as a suppository, the manual offers no techniques to avoid smoking. Experienced, health-conscious users have long turned to tinctures and vaporizers as alternatives to smoking dope. A doctor based in Berkeley, Calif., who uses marijuana to treat patients, posted his own user's manual on the Internet, providing detailed advice on non-smoked forms of ingestion. "For both efficiency and health reasons, I recommend to all my patients that they set a goal of taking all (or almost all) of their cannabis medicines in non-smoked forms, mostly using edibles and drinkables, 'topping off' as necessary with vaporization," David Hadorn wrote on his Web site (http://www.davidhadorn.com/cannabis/CM-guideline.htm). Tinctures can be produced by soaking marijuana leaves and buds in alcohol, which extracts the active ingredient. Drops of the tincture can then be used in cooking or under the tongue. Health Canada does not approve the use of marijuana, saying clinical studies are needed first to demonstrate whether it is effective as a medicine. However, court decisions have forced it to allow select patients to use marijuana on a compassionate basis. Suzanne Desjardins, a Health Canada scientist who helped produce the manual, said the dried marijuana that Health Canada will distribute through doctors to some of the 582 approved medical users will have a standard dose of 10 per cent THC. The cost will be $5 a gram, much less than on the street. The material, grown under contract by Prairie Plant Systems in Flin Flon, Man., and available in 30-gram bags, was originally intended only for clinical trials. Direct distribution to patients, however, could be cut off within weeks as the federal government mounts a court challenge of the order requiring it to be a supplier. The Health Canada user's manual, which will be sent to doctors and posted on the Internet this week, will be accompanied by a two-page information sheet for patients written in layman's language, Ms. Desjardins said. None of the Prairie Plant Systems marijuana can be distributed until the document is made available, she said. - --- MAP posted-by: Richard Lake