Pubdate: Fri, 05 Jun 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Mike Hager
Page: S1

POT 'FREE-FOR-ALL' MUST END, DOCTOR SAYS

Head of B.C.'s medical association says Ottawa is failing physicians
by not setting rules for discussing medical marijuana with patients

The head of B.C.'s medical association says the federal government is
failing Canada's doctors by not providing meaningful guidelines on how
to talk to their patients about medical marijuana prescriptions in the
absence of reliable clinical studies.

Bill Cavers says doctors across Canada are being bombarded with
information on medical marijuana by the same companies producing the
drug, a clear conflict of interest. Health Canada, which does not
endorse medical marijuana's use, should stop the practice, said Dr.
Cavers, who wants an independent process to better educate medical
professionals about the benefits and dangers of the drug.

Dr. Cavers, president of Doctors of BC, which represents the
province's 12,000 physicians, said the way the new system of medical
marijuana regulation continues to roll out "is a free-for-all."

"Here we have providers who have a vested interest in promoting the
product being the ones to potentially train professionals in how to
provide that product," Dr. Cavers said. "That's analogous to a
pharmaceutical company training me in the use of their product.

"While it may provide me information, it's not unbiased."

Last year, the federal government overhauled its system of small
licensed growers supplying themselves and other patients in favour of
commercial scale producers that can sell directly to people prescribed
the drug.

The Canadian Medical Association has consistently opposed the new
regime because its doctors are now forced to assess their patient's
treatment needs and prescribe set dosages, while under the old system
they merely needed to verify that a patient had claimed they were
benefiting from medicinal pot.

While doctors can prescribe pot like it is a pharmaceutical drug,
there is a dearth of clinical evidence on the efficacy of the plant's
touted benefits and many simply don't know enough about it to
recommend it to patients. This is complicated by Health Canada
refusing to approve marijuana as a drug or medicine, but being
compelled to regulate it by the courts, which have ruled that
Canadians must have reasonable access to medical cannabis.

Brian Kierans, a 30-year-old TV industry worker in Toronto, said his
general practitioner was too uncomfortable with the new system to give
him a prescription for his irritable bowel syndrome and instead signed
a legal medical document clearing him to get a supply of cannabis at
an illegal dispensary. He eventually secured a prescription from a
doctor at a specialized medical marijuana clinic and now has bought
from three licensed producers.

"The system that's set up is set up to be as complicated as possible
and, unfortunately, we're all just caught in it," Mr. Kierans said.
"And we're all just trying to do our best."

Dr. Cavers said his association wants Health Canada to offer doctors
simpler, much broader data and guidelines on medicinal cannabis. A
Health Canada representative was unavailable to comment late Thursday,
but pointed to the guide the department published for doctors last
year.

The department stated it is actively looking into allegations of
industry-wide kickback fees to doctors, clinics and patient groups for
access to clients that were levelled earlier this week by Tilray, one
of the largest licensed producers. But Dr. Cavers said Health Canada
should also look into the ways doctors are learning about medicinal
marijuana.

About a decade ago, the Canadian pharmaceutical industry faced
stricter guidelines on how drug company representatives could contact
medical professionals, Dr. Cavers said. That forced those drug
companies to support conferences and events that invite professionals
to discuss topics "that are pertinent to the drugs that they provide,"
he added. Much of the information provided by growers could be very
valuable, but it isn't from an unbiased source, he said.

Greg Engel, CEO of Tilray, said in an interview with The Globe and
Mail last week that his company's representatives will exhibit at
about 10 health care conferences this year. At those conferences,
physicians looking for more information about the system can follow up
with Tilray representatives, he said. Tilray also offers two online
programs for medical professionals to educate themselves on the
nuances of the medical marijuana system.

Tilray broke away from the industry's main lobby group to form its own
and establish a code of ethics prohibiting paying any kickbacks. That
policy also states that its members ensure "transparency in the
presentation of research and study results."
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