Pubdate: Tue, 15 Nov 2005
Source: Medical Post (Canada)
Copyright: 2005 The Medical Post
Contact:  http://www.medicalpost.com/
Details: http://www.mapinc.org/media/3180
Author: Dr. Alan Russell

THE MARIJUANA CONUNDRUM

In the management of chronic non-malignant pain (CNMP), we really 
have very few drug options. Aside from the opioids, there is 
methadone, which is limited by the need for a special licence to 
prescribe it in Canada (but not in the U.S.). Or a GP can sign a 
Health Canada form (the last one I saw was a half-inch thick) for a 
patient to possess or grow marijuana for medical use if the patient 
is going to die in the next six months. The processing of the form 
takes nine months.

For multiple sclerosis or severe rheumatoid arthritis, a specialist 
with an FRCP or an FRCS can sign a form for the medical use of 
marijuana. I have yet to be able to find two specialists in this 
field who will see a patient within a year and who will sign a form.

Complicating the issue even more is that the Canadian Medical 
Protective Association will not cover any problems related to 
physicians prescribing cannabis. Recent Canadian Medical Association 
changes now state a physician no longer must recommend the daily dose 
of marijuana, the form or root of administration, but instead the 
total amount to be administered. The patient has to sign a form 
releasing the physician from liability.

Never in the history of my medical career have I come across such 
confusing, frightening and obstructive legislation, guidelines and 
fear-mongering statements. Who is going to prescribe a medication 
that the CMPA will not defend you against?

The final irony is that the world is awash with marijuana. It would 
be quicker for a patient to buy it off the street if it was effective 
for their pain. To confuse the matter even more, I believe the 
current legislation is so obstructive it denies the right of the 
patient in need of obtaining the medication legally and in a 
reasonable time legally.

Dr. Alan Russell

Brampton, Ont.
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MAP posted-by: Beth Wehrman