Pubdate: Mon, 08 Feb 2016
Source: Telegram, The (CN NF)
Copyright: 2016 The Telegram
Author: Louis Power
Page: A1


Medical marijuana user says doctors discouraged from prescribing; new
clinic hopes to alleviate concerns

As the country moves towards legalizing marijuana for recreational
use, patients in Newfoundland and Labrador are still having trouble
accessing the herb for medical use.

It's not because of the fact that no licensed producers grow marijuana
in the province; doctors here may be hesitant because the College of
Physicians and Surgeons of Newfoundland and Labrador appears to
discourage them from having anything to do with it.

Jeff Piercey of Portugal Cove-St. Philip's is among the few patients
in Newfoundland and Labrador who've been able to get hold of medical
marijuana. He said it wasn't easy to find a doctor in this province
who would prescribe it. He lives with a chronic pain condition caused
by a degenerative disc, and went to multiple doctors on his quest for
pain relief.

"The only reason I found someone who would prescribe for me was I knew
somebody who knew somebody who knew a doctor. It was very, very
difficult - it was about a year and a half process," he said.

"I went from narcotic to narcotic, and they either didn't help with
the pain or the side-effects were too extreme, and I didn't want to
put that into my body."

Last January, Piercey finally got a prescription filled for medical
marijuana, and he said the leaf changed his life.

"Before I started using medical marijuana, when my chronic pain
condition started, I was not able to be a dad. I was not able to be a
husband. And now I can be a father to my two kids. It's given me my
life back," he said.

College's concerns

Piercey has spoken with others in search of medical marijuana who face
similar resistance. He said he learned that physicians in Newfoundland
and Labrador are being advised not to start prescribing it.

In "Advisory to the Profession and Interim Guidelines - Marihuana for
Medical Purposes," published in March 2014 
the College says it has relayed concerns to Health Canada about
federal regulations, and they have not been sufficiently addressed.

"The College believes that physicians should not be expected to
facilitate patient access to a substance, for medical purposes, for
which there is no body of evidence of clinical efficacy or safety,"
reads the text, which can be found on the College's website.

"As well, medical standards and guidelines for prescribing of
marihuana, addressing issues such as standardized dosage or quality
control, are lacking. The amount of active ingredients in marihuana
varies significantly, depending on the origin and method of production
of the substance. Also, many uncertainties remain about the effects,
whether considered beneficial or harmful, of marihuana use.

"In light of these concerns, the College believes physicians will be
at increased risk of allegations of negligence and malpractice if they
facilitate an individual's access to marihuana for medical purposes,
as compared to the prescribing of drugs and treatments for which there
is a recognized scientific body of evidence of clinical efficacy or

The College also "strongly discourages" doctors from dispensing
medical marijuana to patients. These interim guidelines are not
hard-and-fast regulations. The College says it believes it would be
premature to publish standards of practice, "as this could be
interpreted as the College supporting or legitimizing this practice,"
and notes that it is monitoring the approaches of Canadian medical

This province's College is not alone in its reluctance to embrace
marijuana for medical purposes.

The College of Physicians and Surgeons of Saskatchewan, for example,
had this to say in its regulatory bylaws published in 2014
"The College of Physicians and Surgeons supports the evidence-based
practice of medicine, and believes that physicians should not be asked
to prescribe or dispense substances or treatments for which there is
little or no evidence of clinical efficacy or safety. The College of
Physicians and Surgeons believes that there have not been sufficient
scientific or clinical assessments to provide a body of evidence as to
the efficacy and safety of marihuana for medical purposes."

But like Newfoundland and Labrador's College, it acknowledges that the
Marihuana for Medical Purposes Regulations authorizes physicians to
provide a medical document allowing the patient to obtain medical
marijuana. It also lays out the minimum guidelines for those who wish
to do so.

In other provinces, such as Ontario, physicians are given guidelines,
but neither encouraged or discouraged from the practice.

Access in N.L.

Last year, New Brunswick based Marijuana for Trauma set up an office
in St. John's to help local patients access medical marijuana. The
organization is run by veterans, and focuses mainly on helping other
veterans with post-traumatic stress disorder, though it has worked
with civilians as well.

MFT founder Fabian Henry told The Telegram this past summer that it
hadn't been able to find a single local doctor to prescribe medical
marijuana, and it had to rely on a clinic in Ontario to obtain

Cannabinoid Medical Clinic (CMC), another organization that helps
patients access medical marijuana and other prescription cannabinoids
(medication based on the marijuana molecules THC and CBD), is opening
a St. John's clinic later this month which will be staffed by at least
one physician.

Dr. Danial Schecter, CMC's cofounder and executive director, spoke
with The Telegram about the clinic and why he feels it's needed here.

"It's my understanding that there are certain areas that have been
traditionally underserviced, and we do know that St. John's
specifically ... has very few physicians who are comfortable with
this," he said.

Several patients from St. John's have reached out to see if the
organization would see them via video call.

"It's not the best way to practice medicine, so instead of doing
health care over Skype, we've decided to open an actual clinic where
patients can come and see us," Schecter said.

Like the organization's four other clinics (in Barrie, Ont., Toronto,
Ottawa and Halifax), clients will need a referral from their family
doctor to see a physician at the St. John's CMC location. There, they
will be assessed, and if deemed a good candidate, prescribed either
medical marijuana or another prescription cannabinoids (medication
based on the marijuana molecules THC and CBD).

Medical marijuana is mailed to users from one of 25 licensed producers
on the mainland, and other cannabinoid medication such as tablets can
be sought from local pharmacies.

"Doctors are increasingly understanding that cannabinoids, as a class
of medication, can be very effective in helping patients in a number
of different conditions including chronic pain, post-traumatic stress
disorder, and even gastrointestinal disorders," said Schecter.

But he knows some physicians are still hesitant to fill a prescription
for the herb. In such a case, he said, CMC will be happy to talk to
them about cannabinoid therapies.
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MAP posted-by: Matt