Pubdate: Thu, 04 May 2017
Source: Georgia Straight, The (CN BC)
Copyright: 2017 The Georgia Straight
Author: Amanda Siebert


Dr. Caroline MacCallum wants doctors to know that cannabis "isn't the
taboo medicine" they might think it is. Not only has she used it
successfully to treat more than 50 conditions, she has also seen how
it has helped her patients stop using prescription opioids.

MacCallum, a specialist in complex pain and cannabinoid medicine, is
the medical director at Green Leaf Clinic in Langley, where she
assesses patients for their eligibility for Canada's Access to
Cannabis for Medical Purposes Regulations program.

Besides being a former pharmacist who has spoken publicly on the
subject of the plant's medical applications since 2015, MacCallum is
also a clinical instructor in UBC's faculty of medicine and
pharmaceutical sciences. She will share her expertise at the Cannabis
and Hemp Conference and Expo on Sunday (May 7).

At Green Leaf, she prescribes cannabis to treat patients suffering
from arthritis, fibromyalgia, glaucoma, leukemia, multiple sclerosis,
HIV, soft-tissue injuries, lupus, concussions, migraines, and other
autoimmune diseases and conditions related to chronic pain.

A vocal advocate who, along with other physicians, recently wrote to
the College of Physicians and Surgeons of British Columbia to
challenge its stance on medical cannabis, MacCallum wasn't always
aware of its potential for treatment.

"Before Green Leaf, I worked in a number of pain clinics, and I was so
discouraged by how I wasn't getting the results I was hoping for with
my patients," she told the Straight by phone from a conference in Toronto.

"I realized that these drugs don't work for everyone, or every
condition, and I got to a place where I was challenged by my patients
to consider cannabis."

MacCallum started exploring-albeit hesitantly, given the fact that
she'd never learned about the plant in medical school-studies that
supported its viability as medicine.

"I found that there is so much out there about cannabis," she said.
"It was something I wanted to pursue... out of desperation, because
nothing else was working for my patients."

Now an expert in the field, MacCallum is working with a number of
different groups to create hospital policies so when patients are
admitted for care, they're able to use their cannabis in oil form,
on-site. It's just one of the things she is trying to do to help
ensure that cannabis is viewed by medical professionals as legitimate

When prescribing cannabis, MacCallum looks to Canada's licensed
producers (LPs) for products that are appropriate for each patient.

"Because of my pharmacy background and how sick my patients are, I
only work with LPs," she said.

"I feel like it's the most regulated product-not that dispensaries
don't have great product, but there's attention given to things like
heavy metals in the water, pesticides, amounts of tetrahydrocannabinol
[THC] and cannabidiol [CBD], and standardization as a whole," she said.

MacCallum said she prefers to prescribe cannabis to her patients in
oil form but will supplement with flowers meant to be used with a
vaporizer. She doesn't recommend that patients inhale

She isn't only treating pain: often, patients have to deal with
symptom clusters, which can add things like anxiety, depression,
nausea, and poor sleep to preexisting conditions.

To treat these, MacCallum likes to use CBD-heavy oils and strains. She
stresses that THC isn't the only cannabinoid with medical value: some
CBD strains have been shown to help treat the above conditions while
also mitigating some of the euphoria caused by THC, which is something
that she said not all her patients enjoy.

Above and beyond its ability to treat both pain and symptoms,
MacCallum has seen firsthand how cannabis can help her patients
reduce-and, in many cases, eliminate-their reliance on prescription

"I'm able to taper patients off of these drugs and get them less
constipated, less confused, and feeling better," she said, adding that
cannabis also helps in treating the symptoms of opioid withdrawal.

Referencing prepublication results from an extensive survey of
Canadian medical-cannabis patients, MacCallum said many patients are
able to stop using opioids after cannabis is introduced.

A study written by B.C. expert Philippe Lucas and using data from the
survey found that 69 percent of surveyed patients used cannabis as a
replacement for prescription drugs. Among patients who reported
substituting for opioids specifically, 60 percent of opioids being
prescribed were successfully reduced by 100 percent, while 18.4
percent were reduced by 75 percent.

MacCallum said she has seen comparable numbers at Green Leaf, where 90
percent of incoming patients are using opioids. She said one of the
biggest impacts for patients is the reduction in side effects when
cannabis is substituted for opioids.

"You might feel euphoric or foggy at first, but once you're a medical
user, you don't feel that way," she said. "If you have constipation or
confusion with perception because of pharmaceuticals, you never get
used to that. You have that for life."

Despite the success that MacCallum's patients have had, the College of
Physicians and Surgeons continues to tell doctors in B.C. that there
are "few reliable published studies" that discuss the medical benefits
of cannabis. MacCallum, however, said it's the opposite: the college
is the one without the evidence to support its statements.

"I really want the college to hear from more cannabis specialists,
because a lot of us have expertise, and we're willing to give it away
for free," she said.

"If they say it's because of public health, they're missing a huge
opportunity for us to deal with the opioid issues that we're having. I
firmly believe this is the solution to the opioid crisis, and if I
keep yelling loud enough, it will eventually be heard."

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Caroline MacCallum will speak at the Cannabis and Hemp Conference and
Expo, which takes place on Saturday and Sunday (May 6 and 7) at AMS
Student Nest on UBC's Point Grey campus.
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