Pubdate: Mon, 12 May 2014
Source: Regina Leader-Post (CN SN)
Copyright: 2014 The Leader-Post Ltd.
Author: Pamela Cowan


Prescribing Medical Marijuana

If a doctor prescribes marijuana to a patient and that person is 
involved in a motor vehicle accident and seriously injures someone, 
is the physician liable?

Dr. Geeta Achyuthan, a Regina physician, raised the question at the 
recent representative assembly of the Saskatchewan Medical 
Association in Regina.

When doctors prescribe marijuana, it's critical they warn their 
patients not to drive until they know what impact the substance will 
have on them, said Bryan Salte, associate registrar and legal counsel 
for the Saskatchewan College of Physicians and Surgeons.

"Recognizing the fact that it is a legally authorized substance and 
you are legally authorized to prescribe it, I don't know how you 
could be held liable if the patient uses it inappropriately," Salte 
said. Achyuthan is not the only doctor who is hazy about the 
ramifications of prescribing marijuana.

During his presentation to SMA representatives, Salte read a 
statement from the College of Family Physicians of Canada: "Asking 
physicians to prescribe drugs that have not been clinically tested 
runs contrary to their training and ethics. Marijuana is a complex 
substance with strains that vary greatly in power and effect, but we 
have no information on potency, dosage or how it interacts with other 

Another unknown is the outcome of a legal challenge that is playing 
out in the courts.

Federal Court Judge Michael Manson ruled March 21 that anyone who was 
already authorized to possess marijuana could continue to grow their 
own or have another person grow for them.

The judge granted an application from medical marijuana patients 
asking for a temporary injunction to preserve the status quo until 
their constitutional challenge of the new system could be heard.

The court was primarily concerned with the evidence that marijuana 
would be unaffordable under the new system for many patients. That 
decision is under appeal, Salte said.

In the meantime, the college has set standards about marijuana 
prescribing and those bylaws are now in effect.

The college's bylaw states there has not been sufficient scientific 
or clinical assessment to provide evidence about the safety and 
efficacy of marijuana for medical purposes, so physicians must be 
cautious about prescribing.

Before doctors can prescribe marijuana, they must review the 
patient's medical history, physically examine the patient and review 
information pertaining to the condition for which the use of 
marijuana is authorized.

Patients must sign treatment agreements that say they won't get 
marijuana from other sources, that they have been advised of the 
risks and benefits associated with marijuana and they are aware that 
marijuana is something of an untested therapy at the moment, Salte said.

The patient's record must include other treatments that have been 
attempted, their effect and the doctor's opinion that the patient is 
likely to receive therapeutic or palliative benefit from marijuana use.

A doctor who prescribes marijuana to a patient must be treating that 
person for the condition he or she is authorized to use pot.

For example, a doctor who prescribes marijuana for a patient with 
multiple sclerosis must be the treating physician for MS, Salte said.

"They can't be a storefront operation whose job it is to then 
prescribe marijuana and have no further contact with the patient," he said.

Nor can doctors simultaneously prescribe and sell marijuana.

"If you choose to invest in a legal grow-op, then you can't be a 
prescriber of marijuana," Salte said.

Saskatchewan doctors are required to keep a record of all medical 
marijuana prescriptions.

The information must include the patient's name, health services 
number and date of birth; the quantity and duration for which 
marijuana was prescribed; the medical condition for which the pot was 
prescribed and the name of the licensed producer from which the 
marijuana will be obtained, if known.

A summary of the prescriptions must be submitted to the college once 
a year or, if doctors prescribe pot to more than 20 patients, every six months.
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MAP posted-by: Jay Bergstrom