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