Pubdate: Mon, 12 Dec 2011 Source: Montreal Gazette (CN QU) Copyright: 2011 Canwest Publishing Inc. Contact: http://www.canada.com/montrealgazette/letters.html Website: http://www.montrealgazette.com/ Details: http://www.mapinc.org/media/274 Author: Glen McGregor, Postmedia News; Ottawa Citizen EXPLOSION IN CLAIMS OF SEVERE ARTHRITIS Now 40 Per Cent of Applications for Marijuana Treatment Seen by Health Canada, a Jump of 2,400 Per Cent From 2008 to 2010 The federal government has seen a staggering increase in the number of requests for medical marijuana authorizations from applicants claiming they have severe arthritis to legally obtain the drug. Applications to Health Canada based on severe arthritis claims jumped 2,400 per cent between 2008 and 2010, far outstripping the number of claims for cancer, HIV/AIDS and other serious diseases, an Ottawa Citizen analysis has found. The spike in arthritis claims was part of an overall rise in applications over the past three years, as more private clinics specializing in marijuana began referring patients to pot-friendly doctors willing to sign their forms. Arthritis was listed as the reason for 40 per cent of all applications under the Marihuana Medical Access Regulations received so far in 2011. Severe arthritis is one of the Category 1 illnesses that require patients to obtain the signature of just a single doctor under Health Canada rules. Cancer, multiple sclerosis, HIV/AIDS infections and spinal cord injuries and disease and are also listed in Category 1, but often have more obvious visible symptoms than arthritis. Patients with other Category 2 illnesses such as hepatitis, glaucoma or ulcerative colitis must go through the additional step of getting a specialist to sign their applications, a process that can take many months and does not always succeed. "I think a lot of people are applying under arthritis even if they may have a different condition," says Scott Gilbert, who runs the Hamilton Medical Marijuana Centre. "They are going with whatever is the easier one to get approved on." Although a patient might otherwise qualify for authorization based on a Category 2 illness such as fibromyalgia or Crohn's disease, a savvy doctor familiar with the medical marijuana program might ask if the patient also has arthritis, too. Health Canada is conducting a review and plans to overhaul the way the program works, in part by transferring more authority to doctors. The department says it is required to approve applications that have been signed by a doctor and meet the conditions of the program. It has noticed the sharp increase in marijuana applications but doesn't know why, exactly, the numbers are rising so sharply. "Increasing awareness of the program among patient groups and treating physicians is likely a key contributing factor," said Health Canada spokesman Gary Holub. The department is also aware of the increase in arthritis claims, Holub said. "The risk of abuse exists within the current system. That's why changes are being proposed that will balance the legitimate needs of patients, while reducing the risk of abuse." Patients often complain that the refusal of doctors to approve their applications is the greatest obstacle to entering the program. But the surging number of applications suggest they are finding other ways to get approved. Many privately run clinics are sprouting up across the country, with in-house physicians to sign the 33-page Health Canada application form or provide referrals to doctors who are willing. The Do No Harm Clinic in Kelowna, B.C., for example, has helped process applications for more than 500 patients over the past two years. It serves patients who have been unable to find a doctor to sign their forms and will provide a physician to consult with patients anywhere in the country over the Internet. A doctor who works at the clinic agreed to speak to the Citizen about his practice on the condition he not be named, as he does not want to be deluged with requests from potential patients. "Medical marijuana is not a prescription," he said. "I don't have to touch the patient to see they have cancer." But he said he will not list severe arthritis or other illness on the application unless the patient can produce documentation of the disease provided by a specialist. "We would make sure you've seen a specialist," he said. He acknowledged, however, that some other Canadian marijuana clinics are moving to what he calls the California model, where a patient walks in off the street and gets a doctor to sign the forms on the spot. "That kind of thing goes on," he says, but he notes patients can do the same thing if they present with back pain to get a prescription for Oxycodone, a powerful and addictive pharmaceutical painkiller. The doctor volunteers his services, but the clinic charges $400 to help patients complete the Health Canada application form. Gilbert's clinic in Hamilton works a bit differently, prescreening patients with cancer, HIV and other conditions and, where suitable, sending them to doctors in the community known to be comfortable prescribing marijuana. An increasing number of private clinics and services are working within the system to arrange approval under Health Canada's rules - some charging processing fees. For $450 plus tax, the Medical Cannabis Resource Centre in downtown Vancouver will hook a patient up with a doctor on Skype to confirm identity. Like the Do No Harm Clinic, the centre still requires a statement of diagnosis of a pre-existing condition from another doctor. These clinics are trying to work around the problems in Health Canada's rules to get marijuana to patients who need it, says Rielle Capler of the Canadian Association of Medical Cannabis Dispensaries. "Whether they're entrepreneurs or well-meaning physicians, they're stepping in to fill these gaps," she said. Capler says she's concerned about clinics asking large fees from patients who are often too sick to work and living on fixed incomes. "There are some that have been charging $500. But this is what it has come to." - ------------------------------- [sidebar] HOW CANADA'S MEDICAL MARIJUANA SYSTEM WORKS Since 2001, Canada has allowed patients with serious illnesses to apply for authorization to possess and, in some cases, grow marijuana. The rules are called the Marihuana Medical Access Regulations (MMAR). Who can apply? Under the MMAR, people who are classified as Category 1 can apply to relieve symptoms of these diseases: - --Cancer - --Multiple sclerosis - --HIV/AIDS infection - --Spinal cord injury or disease - --Severe form of arthritis - --Seizures caused by epilepsy Category 1 patients need their doctor to fill out a form recommending their treatment with medical marijuana. Then their application must be approved. Category 2 patients have one or more debilitating symptoms of another illness not covered in Category 1. They require a specialist to attest that conventional treatments have failed or are not appropriate to relieve their symptoms. Types of authorizations - - - A patient can be author-ized to possess marijuana produced for Health Canada by Prairie Plant Systems. The typical amount allowed varies from between one and five grams. It is sold for $5 plus taxes per gram. - - - A patient can be authorized to possess marijuana they have grown themselves. They can purchase a package of 30 seeds for $20 plus taxes. - - - A patient can be authorized to possess marijuana grown by a person they designate as their producer. A designated grower can produce marijuana for a maximum of two patients. Proposed changes Health Canada has been consulting over proposed changes to the MMAR. The new regulations have not been finalized and it is unclear when these changes would come into force. Also unclear is whether patients already authorized under MMAR would be allowed to continue to operate under the old regulations. The changes would: - - - Eliminate the categories of conditions or symptoms - - - Eliminate the require-ment to have Health Canada approve the applications. Doctors alone would determine who gets medical marijuana. - - - End the provisions that allow patients to grow their own marijuana or designate a grower. Instead, Health Canada would license approved commercial suppliers. Ottawa Citizen - --- MAP posted-by: Richard R Smith Jr.