Pubdate: Sat, 09 Aug 2014
Source: Victoria Times-Colonist (CN BC)
Copyright: 2014 Times Colonist
Contact: http://www2.canada.com/victoriatimescolonist/letters.html
Website: http://www.timescolonist.com/
Details: http://www.mapinc.org/media/481
Page: A 10

DON'T PRETEND POT IS HARMLESS

If medical marijuana is a step toward legalization, just make it 
legal - or at least decriminalize it - and don't dump it all on 
doctors. Making physicians the gatekeepers of legal marijuana is not 
fair to doctors and is not conducive to public health.

The problem is that marijuana has been prescribed by the courts, not 
by health-care professionals.

"Dried marijuana is not an approved drug or medicine in Canada," says 
the Health Canada website. "The Government of Canada does not endorse 
the use of marijuana, but the courts have required reasonable access 
to a legal source of marijuana when authorized by a physician."

Many physicians are reluctant to take on that responsibility.

"We have Health Canada telling us that marijuana is not a medicine, 
we have our malpractice insurance company telling us to be very 
cautious because nobody is taking responsibility for the safety of 
it," says Dr. Chris Simpson, a Queen's University cardiologist and 
incoming president of the Canadian Medical Association.

Simpson doesn't dismiss marijuana - he says "many compelling 
anecdotes" indicate that marijuana can help patients with HIV, 
hard-to-treat seizures and other conditions. But, he adds, "we have 
people out there saying marijuana can cure cancer, which seems quite 
improbable."

"Somewhere in between those two extremes is the truth, and I think we 
need to find the truth, and the way to do that is with the 
appropriate research."

Testifying before a parliamentary health committee in May, Dr. Meldon 
Kahan, medical director of the substance-use service at Women's 
College Hospital in Toronto, detailed a long list of harmful effects 
from cannabis use. They included impairments in attention, increased 
anxieties, psychosis and cancer.

"Widespread cannabis prescribing by physicians will increase the 
social and psychiatric harms of cannabis," Kahan said, calling for 
the development of evidence-based guidelines for prescribing smoked marijuana.

"Guidelines will give physicians solid grounds on which to make 
prescribing decisions. Physicians are facing a deluge of requests to 
prescribe cannabis, and guidelines will give them the support they 
need to refuse to prescribe cannabis when medically unnecessary or unsafe."

Because Health Canada allows marijuana to be prescribed by 
physicians, that enhances the public perception that marijuana is not 
only harmless, but therapeutic.

"The evidence suggests otherwise," Kahan said. "Smoked cannabis has 
negligible therapeutic benefits."

Would marijuana pass the scrutiny of the University of B.C.'s 
Therapeutics Initiative, established to examine the effectiveness of 
prescription drugs? It uses solid evidence and rigorous scientific 
research, and it has saved lives. Marijuana should undergo the same 
scrutiny as to its potential benefits and harms.

But medical marijuana is not treated the same as other drugs. Science 
has little to do with it.

"The current means of 'prescribing' violates all of the usual 
practices of medicine," wrote Maryland psychiatrists Dinah Miller and 
Anette Hanson in a 2012 Baltimore Sun commentary. "What other 
medication do we authorize for a year, with no stipulation as to 
frequency, dose or certainty that there has been a positive response 
without side effects?"

If marijuana can relieve the agony of someone with severe chronic 
pain or terminal cancer, who would withhold it? But let's face it, 
the biggest demand for pot is as a recreational drug, like alcohol 
and tobacco. It should be handled the same, with regulations as to 
its production and distribution. We should not clog our courts and 
jails with pot-smokers.

By all means, investigate its potential for good, but let's not 
pretend it does no harm.
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MAP posted-by: Jay Bergstrom