Pubdate: Tue, 11 Nov 2014
Source: Montreal Gazette (CN QU)
Copyright: 2014 Postmedia Network Inc.
Contact:  http://www.montrealgazette.com/
Details: http://www.mapinc.org/media/274
Author: Charlie Fidelman
Page: A1

MONTREAL POT CLINIC OPENS TO PATIENTS

Montreal family physician Michael Dworkind first saw enormous 
benefits of marijuana in patients with human immunodeficiency virus 
infection and acquired immune deficiency syndrome. They were 
suffering from nausea, weight loss, inflammation, moodiness, insomnia 
and a host of aches.

"I could see the devastation," recalled Dworkind, who specializes in 
palliative care at the Jewish General Hospital, yet some suddenly got 
their appetite back and improved their overall health.

"'Well, doctor,' they said, 'I had a toke,' " Dworkind said. Turns 
out that what worked with HIV/AIDs also improved the lives of 
seriously ill cancer patients.

"I had 80-year-olds using cannabinoids in vaporizers because they 
didn't want to get high," Dworkind said of chemical compounds 
secreted by marijuana flowers that provide relief for an array of symptoms.

After quietly giving recommendations for pot since 2000 when patients 
began clamouring for marijuana for compassion care, Dworkind is now 
the medical director of Quebec's first specialty clinic focusing on 
the medical use of marijuana.

Located in a bright renovated building in The Village on Amherst St., 
Sante Cannabis officially opens its doors Tuesday. Dressed casually 
in jeans, and a stethoscope draped over a black sweater, Dworkind is 
one of two physicians seeing patients unofficially every Monday at 
the clinic for the last three months. Three other physicians have 
signed on, and in February, the clinic will have five doctors to 
evaluate patients and prescribe cannabis.

It is not a panacea, Dworkind says, but it works for the right patient.

The clinic's opening took Quebec's professional order of physicians 
by surprise. Why the rush? demanded Dr. Yves Robert, College des 
medecins du Quebec secretary, who learned of the opening when a 
reporter called. Why the hurry, he asked, when the College is 
actively working on developing a protocol to allow physicians to 
participate in creating a drug monitoring program and database for 
research purposes.

Clinic officials say they had to move to close a gap created in April 
when Health Canada gave doctors permission to prescribe marijuana for 
therapeutic reasons but Quebec said not so fast, it would provide its 
own guidelines for prescription under a research framework.

Unfortunately, there has been some delay with the Quebec guidelines, 
Robert said, that are expected to go into effect next January.

"We're trying to work as fast as possible," he said, shifting the 
blame onto Health Canada for enacting new federal regulations without 
putting in transition measures for 40,000 medical marijuana users 
across the country. "For us, it's a matter of quality of practice."

That's where the new clinic comes in, officials said. Sante Cannabis 
clinic, a play on words on Sante Canada, will enrol patients and use 
similar guidelines that are expected to merge with the College 
framework in January, an option that doesn't sit well with Robert, 
who says he is worried about patient confidentiality and data safety.

"Who will see the data? How will privacy be protected?" he asked. 
It's not clear whether the College will sanction doctors prescribing 
marijuana outside of its research framework.

The clinic is the brain child of business and life partners Erin 
Prosk and Adam Greenblatt, who until recently ran the Medical 
Cannabis Access Society that provided edible cannabis products for 
nearly 2,000 Quebec patients. The Society billed itself as a 
"dispensary" rather than a compassion club, Greenblatt says, because 
patients have a right to medication. The same principle applies in 
the new clinic, which will hold cooking workshops and help patients 
find the right strain of medical-grade marijuana for their particular 
condition.

Greenblatt and Prosk dipped into a private trust fund, about 
$100,000, to start the clinic, and say they receive absolutely no 
funds from marijuana growers.

Not just anyone can walk through its doors asking for marijuana.

Patients must have a physician referral or eligible conditions, 
including multiple sclerosis, spinal cord injury, spinal cord 
disease, cancer, AIDS or HIV infection, severe arthritis, epilepsy 
and palliative care. Research has shown that the body has a natural 
"endocannabinoid system," said Dworkind, an associate professor of 
family medicine at the Jewish, a McGill University teaching hospital. 
And that system includes specific receptors mostly in the brain, he 
said, that regulate a variety of physiological processes from 
appetite to pain-sensation.

"It can block impulses that say 'ouch' to the brain," he said. "And 
it modifies how you respond to the pain, with few side effects.

"We're looking at quality of life," Dworkind says. But there's a 
terrible injustice because "by the time patients gets to us, they are 
desperate. They are suffering."

Robert Boulanger, 73, said he couldn't wait for the medical 
authorities to line up the research protocol and he didn't want to 
buy pot off the streets, so he sought medical grade marijuana by 
contacting the clinic.

"I saw the doctor, and they helped with the complicated paperwork - 
you wouldn't believe how much paper," said Boulanger, who smokes a 
little bit every day "just enough to calm the pain." Boulanger says 
he can now walk without shooting pain in his feet, a condition caused 
by medication to treat HIV acquired during the 1990s.

The clinic currently has about 100 patients.
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MAP posted-by: Jay Bergstrom