Pubdate: Fri, 18 Apr 2014
Source: Montreal Gazette (CN QU)
Copyright: 2014 Postmedia Network Inc.
Contact:  http://www.montrealgazette.com/
Details: http://www.mapinc.org/media/274
Author: Marcia Gillman
Note: Marcia Gillman is a physician at the Jewish General Hospital, 
specializing in palliative medicine.)
Page: A17
Bookmark: http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada)

IS MEDICAL MARIJUANA EFFECTIVE?

It Works Well in Palliative Care, and the College Des Medecins Du 
Quebec Should Show More of an Open Mind Toward It

The College Des Medecins Du Quebec Is Too Negative About Medical Marijuana

The College des medecins du Quebec (CMQ), with its statement issued 
April 1 regarding medical marijuana (cannabis), insists on 
disseminating misinformation, which only serves to deter physicians 
from prescribing to patients who could benefit.

As a palliative-care physician specializing in the symptom management 
of patients living with (and eventually dying from) incurable 
cancers, I have been prescribing medical cannabis with very good 
results. In some instances, it has allowed my patients to reduce 
their need for opioids, thus reducing the potentially serious side 
effects of narcotic medications. In addition to managing pain, 
medical marijuana has helped alleviate other troubling symptoms in my 
patient population, such as anxiety, insomnia, nausea and lack of appetite.

Let me examine some of the statements made by Dr. Yves Robert, 
secretary of the CMQ, in defending its position:

1. "Medical marijuana is not a recognized treatment." Perhaps not 
"officially" recognized, but to state that there is no evidence of 
medical therapeutic benefit is to ignore thousands of published 
studies in recent decades (not to mention tens of thousands of 
compelling anecdotal cases) that have collected a respectable and 
impressive amount of data attesting to the very promising therapeutic 
uses, as well as highlighting the high safety profile and exceedingly 
low toxicity of cannabis.

2. "There are no clear indications for medical cannabis." Wrong. The 
medical literature (and patient experience) supports an array of 
indications for a variety of ailments. Spasticity in multiple 
sclerosis, control of seizures in epilepsy, control of tremor in 
Parkinson's disease, pain management in both malignant and chronic 
non-malignant diseases, chemotherapy-induced nausea and vomiting, 
management of chronic anxiety and post-traumatic stress disorder - to 
name just a few. The list goes on.

3. "Medical cannabis causes addiction." This is both misleading and 
overstated. As suggested by an Institute of Medicine report back in 
1999, approximately nine per cent of general cannabis users may 
become dependent (as defined by DSM criteria). Compare this with 
dependency (addiction) risks of 32 per cent for tobacco, 23 per cent 
for heroin, 17 per cent for cocaine and 15 per cent for alcohol. It 
strikes me as hypocritical to deny patients easy access to medical 
cannabis while tobacco and alcohol are freely available, 
unquestionably harmful, and pose a much greater addiction risk. The 
simple truth is that the vast majority of patients can give up their 
cannabis with no ill effects, other than the return of symptoms for 
which they were originally taking the drug.

4. "The side effects of smoking (marijuana) are still present, just 
like nicotine and cigarettes."Once again, the CMQ has not done its 
homework. Patients need not smoke their marijuana. Other delivery 
systems are available, such as vaporizing, or ingesting the cannabis 
extracts in the form of oils, tinctures or edibles.

5. "There are no real scientific data showing safety." It's well 
supported in the scientific and medical literature that with very few 
exceptions, cannabis is highly safe and remarkably low in toxicity - 
much safer, in fact, than aspirin or anti-inflammatories. Apart from 
those with a history of schizophrenia or unstable heart disease, 
cannabis can be safely prescribed. Not one lethal overdose from 
marijuana has ever been reported. Cannabis is without doubt safer 
than most, if not all, of the medications I regularly prescribe to my 
very sick patient population. Nonetheless, the CMQ guidelines 
restrict cannabis to a rather small and specific subset of patients, 
prescribed only as a very last resort (if at all), assuming all else 
has failed, and even then, with a great deal of caution.

I am deeply saddened and frustrated that the CMQ insists on putting 
up barriers to a safe, effective and relatively inexpensive medical 
therapy, despite the new Health Canada regulations intended to 
provide Canadians with easier access to medical cannabis.

In the midst of all the buzz (excuse the pun) surrounding Health 
Canada's new "Marihuana for Medical Purposes Regulations," the CMQ's 
stance comes across as deliberately ill-informed and backward-thinking.

Quebec patients deserve better.
- ---
MAP posted-by: Jay Bergstrom