Pubdate: Thu, 24 Jul 2014 Source: Ottawa Citizen (CN ON) Copyright: 2014 Postmedia Network Inc. Contact: http://www.canada.com/ottawacitizen/letters.html Website: http://www.ottawacitizen.com/ Details: http://www.mapinc.org/media/326 Author: Marie-Danielle Smith Page: A1 MEDICAL POT PRODUCERS WOOING HESITANT DOCTORS Practice Has Head of Cma 'Quite Frightened' Some doctors feel intimidated not only by marijuana company reps, but by patients themselves. Representatives of licensed medical marijuana companies are being sent to doctors' offices as part of the push to get hesitant physicians to prescribe the drug more often. It's a development that has dismayed Dr. Louis Hugo Francescutti, the president of the Canadian Medical Association, who says that a largely unproven treatment is now being thrust upon doctors, leaving them caught between at least some patients looking to score drugs and the vendors looking to peddle them. "I'm actually quite frightened," he said. Francescutti said some of Canada's 13 licensed marijuana producers are operating in the same way that pharmaceutical companies do. "They've got product they have to move. "So they've hired the best advertising firms," he said. "Now, they've got very professional, well-dressed men and women knocking on doctors' offices." That's a problem for Francescutti, at least in part, because he doesn't think medical marijuana has put through stringent enough testing. Frankly, he said, there is a lack of medical evidence that marijuana products are effective. "There would have to be a clinical trial for its effect on depression, for its effect on joint pain. You'd have to have probably a thousand trials that would have to be repeated," he said. "If marijuana is so magical, then how come the trials aren't out there?" Francescutti acknowledged that one of the reasons those trials may not have been done previously could have been a lack of funding: "That could be part of it." Tweed, Canada's first publicly traded medical marijuana producer, has hired three "academic detailers" to visit doctors' offices. Mark Zekulin, executive vice-president of the Smiths Falls-based company, said they are "out there hitting the pavement, introducing who we are." He said doctors get a lot of visits from many different pharmaceutical companies, but "We're a little different." He said most doctors are receptive and interested in learning more. Tweed's director of business and medical development, Chris Murray, said there is a lot of apprehension from doctors in terms of the "hard sell from pharma reps." "We are not out there putting a hard sell on medical marijuana," said Zekulin. "There is information out there, and we're not making it up. It's to make doctors aware of that information. How they want to integrate it into their practice is up to them." Neil Closner, CEO of MedReleaf, a Markham, Ont.-based licensed marijuana producer, said his company does not hire sales reps, though representatives attend conferences and events that physicians attend. "I don't feel that this is something we want to be pushing on physicians," he said. However, Dr. Alykhan Abdulla, president of the Academy of Medicine Ottawa, which represents Ottawa physicians at all levels of government, said he believes more than 90 per cent of physicians would be hesitant to prescribe medical marijuana. "The average family doctor has never learned how to prescribe medical marijuana. It's not taught in medical school," said Abdulla, who said he has prescribed the herb. He said companies are not only sending representatives to lobby doctors but also making calls, writing emails and sending faxes. He receives two or three of these every week. "These people have an agenda, they want to sell it, they want to make money," said Abdulla. "They're not pushy. They're professional people. . They're trying their best, but it's the wrong way to approach it." When it comes to clinical trials, MedReleaf alone has 20 clinical trials underway. It also draws data from a partner company, Tikun Olam, which has treated thousands of patients under Israel's medical marijuana system. After seeing that data, many doctors "end up walking away converted," said CEO Closner. Tweed is not developing formal trials, but is building a database based on the chemical contents of its various marijuana strains and feedback from patients and doctors. But Francescutti said the industry as it stands now has "got nothing to do with medicinal properties. It's got everything to do with people wanting to smoke dope." He said that the court system was "conned" into thinking that marijuana has significant health benefits. It was the courts that said patients should be given access, and it was then Health Canada that "dumped" this responsibility onto doctors, he said. It's akin to "legalized dope-pushing," he said. Francescutti said his position on medical marijuana has resulted in hateful, threatening emails. "This is a fringe element," he said, adding some doctors feel intimidated not only by marijuana company reps, but by patients themselves. Francescutti described a scenario with a male patient, 6-foot-2 and 250 pounds, approaching a "tiny, little female" doctor who had recently immigrated to the country. "He says to you, 'I want marijuana,'" said Francescutti. "Do you think you'd feel intimidated?" He said he received a call from "a physician exactly like that," who told him she was terrified. "She said, 'Here's this big man in my office threatening me that if I didn't give marijuana to him there would be consequences,'" said Francescutti. "What started out as a cute little story about marijuana is turning into a frickin' nightmare," he said. "We just need one doctor to get killed over this, then it would make a great movie. I hope it's not me. I hope it's not any doctor. Or reporter." Barring extensive clinical study, "Maybe the best thing that could happen is Trudeau gets elected and he legalizes it," said Francescutti. He said he doesn't think that would be the right thing, but it would take the problem out of doctors' hands. "We'd have a doped-up nation," he said. "We'd probably have an increase in the sales of chips, so I guess I'd buy some stocks in chips and nachos. That's about the only good that would come of this." - --- MAP posted-by: Jay Bergstrom