Pubdate: Tue, 29 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

DOCTORS DISPUTE CMA TAKE ON POT USERS

President's Views On Medical Use Unfair, Some Say

Some doctors are raising concerns that the national body representing
them has outdated views on medical marijuana that are creating
barriers for patients who could benefit from the herb.

Dr. Louis Hugo Francescutti, president of the Canadian Medical
Association, recently told the Citizen there isn't enough medical
evidence to support medical marijuana use, and that people who seek
the drug in doctors' offices are just looking for "dope."

Dr. Marcia Gillman, a physician who specializes in palliative care at
Montreal's Jewish General Hospital, said Monday that Francescutti has
a duty to be well-informed, which is "clearly not the case here."

"With his statements, he's managed to stigmatize and marginalize users
of medical cannabis, portraying them as stoners just looking to get
high," she said. "Besides perpetuating negative stereotypes, it serves
to deter physicians from prescribing to the very patients who could
benefit from cannabis."

Gillman said the CMA and provincial medical colleges have not
encouraged doctors to educate themselves about cannabis. "I don't
quite understand this," she said, since marijuana has "very promising
therapeutic value."

She said cannabis has helped patients of hers - including a
72-year-old Catholic priest - deal with symptoms such as pain, nausea,
appetite issues, anxiety and sleep problems.

A patient has never threatened her or made demands for marijuana, she
said - the kind of situation suggested by Francescutti. Gillman added
patients are often "sheepish, apologetic and almost embarrassed" to
bring cannabis up as a treatment option, she said, because of its reputation.

"This isn't the face of a so-called 'doped-up nation,'" she said,
alluding to another Francescutti comment. "These are everyday people
seeking relief from their suffering."

Though clinical trials are lacking, there is plenty of pre-clinical
and anecdotal evidence that marijuana helps patients for whom
first-line and second-line treatments aren't effective, said Dr.
Danial Schecter, who runs a clinic in Toronto that assesses referred
patients for cannabis prescriptions.

"Whenever a new and novel therapy comes on to the market, there's
always going to be resistance from the established medical community,"
said Schecter.

"We're trying to treat marijuana as much like any other type of
medicine as possible," he said. "A lot of patients out there who are
potential candidates for it are having difficulty accessing this."

He said about 10 per cent of doctors are comfortable prescribing
marijuana; 10 per cent are against it; and 80 per cent are interested
but lack the education they need to make an informed decision.

Some doctors may be concerned that they are jumping on a "marijuana
bandwagon," he said, in light of mistakes made in the past: For
example, the liberal prescription of OxyContin, an addictive opioid
drug.

"The medical establishment is a bit scared we're going to make the
same mistakes," he said.

Still, a lot of research has already been done on marijuana, said
Philippe Lucas, who conducts research on cannabis therapy for the
Center for Addictions Research of British Columbia. He sits on the
board of the Canadian Drug Policy Coalition and is a vice-president at
one of Canada's licensed medical marijuana producers, Tilray.

"It's the most studied herb in history," he said. "This is an
incredibly active research area."

More than 33,000 peer-reviewed articles have been published about
marijuana, he said, and his company is starting an "aggressive
research strategy." Still, more research needs to be done, he said.

According to Lucas, marijuana could be a good alternative to opioid
drugs such as OxyContin for those with chronic pain.

"There's a big difference between the stance of the CMA and the
reality on the street," said Lucas. "More and more physicians are
willing to consider cannabis as an additional tool in their toolbelt.
We need to move away from policies and statements that are based on
fear and misinformation."  
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MAP posted-by: Jo-D