Pubdate: Mon, 14 Mar 2016
Source: Sudbury Star (CN ON)
Copyright: 2016 Osprey Media
Contact: http://www.thesudburystar.com/letters
Website: http://www.thesudburystar.com
Details: http://www.mapinc.org/media/608
Author: Jim Moodie
Page: A1

MEDICAL MARIJUANA CLINIC COMING

Along with the potholes that are emerging this spring will be a new 
clinic that specializes in medical pot.

Ronan Levy, director of Canadian Cannabis Clinics, said an exact site 
for the clinic remains to be confirmed, but it will likely be 
downtown and could be operational in a few weeks.

"We are looking at a few locations," he said. "We try to position 
ourselves close to other medical centres because even though the 
patient is our ultimate customer, so to speak, really the people we 
need to develop relationships with are the local physicians."

The goal is to be open within a month, said Levy. "Once we get a 
location finalized and a lease signed, we can be up and running in a 
couple of weeks," he said. "We don't have any specialized equipment, 
so getting the doors open can be a quick process."

The Sudbury clinic will be 13th one in Ontario for the company, which 
is the country's largest operator of clinics specializing in medical cannabis.

Levy said the organization has been welcomed in other centres of 
comparable size to Sudbury, such as Kingston and London, Ont., 
although there is always some skepticism among the public about a 
marijuana dispensary that needs to be allayed.

"There is a stigma associated with it, unfair as it may be," he said. 
"People still have perceptions about it and we're doing our best to 
fight those perceptions and help people understand that cannabis, in 
this context, is used as medicine, and should be afforded the same 
respect and deference as any other area of medicine."

The organization has occasionally experienced resistance from 
landlords who are "concerned that a cannabis clinic will attract the 
wrong type of crowd," he admitted. "But once we've set up in 
locations, even landlords that have been hesitant to lease us space 
quickly find that there's nothing about our operation that is at all 
problematic."

Patients tend to be "middle-aged or older people" who are genuinely 
sick, he said. "When you walk by, if you didn't know it was a 
cannabis clinic, there would truly be nothing to distinguish our 
clinic from any other medical clinic."

Medical marijuana has been legal in Canada since 2001, and new 
regulations implemented in 2014 have made it easier for patients to 
access the substance for medicinal use.

Doctors can issue medical documents -- essentially a prescription -- 
authorizing patients to purchase medical marijuana from one of 29 
licensed producers in Canada.

Levy stressed that no marijuana will be kept on the premises of the 
new clinic planned for Sudbury. Instead, patients who are prescribed 
a dose will receive the medication through the mail.

And it's far from case than anyone can just stroll in and sign up for 
a bag of pot.

"People tend to think that when a cannabis clinic opens, it's a 
ticket for legal access to recreational cannabis, but that's not true 
at all," said Levy. "There are no walk-ins, and we put a lot of 
effort and time into screening a patient."

Patients will only be seen if they are referred by a physician, or 
self-refer with a signed consent form that allows the clinic to speak 
with their doctor and access their medical records.

Levy said ideally, a local physician can be found to work at the 
clinic, but if that arrangement isn't possible immediately, the 
clinic can still go ahead with one of two other arrangements.

"One option is to do locums (temporary physician placements), where 
even if it's not a local doctor, that doctor will come and spend a 
day a week in Sudbury and see a bunch of patients in a row," said 
Levy. "Or the other option, which is probably what we'll start with 
in Sudbury, is telemedicine."

In the latter case, the clinic would have a receptionist, a nurse and 
an international medical graduate, or IMG -- someone who is a 
qualified doctor in another country, but isn't able to practise here 
yet -- who can perform a basic physical, he said.

"Then the IMG would present the case to the doctor, who will be 
available through the Ontario telemedicine network, which is kind of 
like a Ministry of Health-certified version of Skype."

Levy said he's confident a local physician can be recruited to work 
at the clinic -- his organization employs 25 doctors already at its 
various locations -- but it's not always possible to find someone 
until the clinic itself exists.

"It's a bit of a chicken and egg scenario," he said.

Levy said there is a common misconception that a patient seeking 
medical marijuana assessment will be charged to access this form of 
care. "Some did pay a fee initially," he said. "But we have never 
charged fees; it's all covered through OHIP."

The only out-of-pocket expense for a patient seen through Canadian 
Cannabis Clinics is for the cannabis itself. "The cost for that is $7 
a gram, on average, and the typical prescription is a gram or less a 
day," he said. "It's not like you're walking out with bags and bags 
of cannabis."

The two main components of marijuana are tetrahydrocannabinol (THC) 
and cannabidiol (CBD), noted Levy.

The former is what gives people a high, but it can also can ease 
pain, stimulate an appetite and relieve nausea and spasms.

CBD does not have a psychoactive effect but "has neuroprotective, 
anti-inflammatory, anti-anxiety, anti-epileptic and anti-psychotic 
properties," according to the Canadian Cannabis Clinics website.

Levy said THC is typically capped at 12 per cent when prescribed to 
patients, and "anecdotally patients seem to find that equal 
proportions of THC and CBD are effective."

A patient could receive a grade of marijuana that has a THC content 
up to 30 per cent, he said, but "generally patients are encouraged to 
start low, and go slow."

Patients are also being increasingly encouraged to "vape" medicinal 
pot rather than smoke it, as you can still inhale the active 
components through vaporization while avoiding by products of burning 
plant matter.
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MAP posted-by: Jay Bergstrom