Pubdate: Fri, 16 Feb 2018
Source: Edmonton Journal (CN AB)
Copyright: 2018 The Edmonton Journal
Author: Colette Derworiz
Page: A1


A new medical guideline suggests family doctors should think twice
before prescribing medical marijuana to their patients.

The Simplified Guideline for Prescribing Medical Cannabinoids in
Primary Care, published Thursday in the medical journal Canadian
Family Physician, says there is limited evidence to support the
reported benefits of medical marijuana for many conditions.

It adds that any benefit could be balanced, or even outweighed, by the
potential harm.

"While enthusiasm for medical marijuana is very strong among some
people, good, quality research has not caught up," project leader Mike
Allan, director of evidence-based medicine at the University of
Alberta, said in a news release.

The guideline was created by a committee of 10 researchers after an
indepth review of clinical trials. It was peer reviewed by 40 others,
including doctors, pharmacists, nurses and patients.

They looked at medical marijuana for muscle tightness and stiffness,
treatment of pain and nausea and vomiting, as well as at its side effects.

The committee found acceptable research for use of medical marijuana
for some conditions, including nerve pain, palliative cancer pain,
muscle stiffness related to multiple sclerosis or spinal cord injury
and nausea and vomiting from chemotherapy.

Allan said the benefits were generally minor.

"Medical cannabinoids should normally only be considered in the small
handful of conditions with adequate evidence, and only after a patient
has tried a number of standard therapies," he said.

The researchers suggested pharmaceuticals derived from cannabis be
tried before smoked marijuana to control dosage.

The committee also found that side effects - including sedation,
dizziness and confusion - were common and consistent.

Jonathan Zaid, the executive director of patient-advocacy group
Canadians for Fair Access to Medical Marijuana, said it's always good
to have a review of the research.

"There have been many who have reviewed this same evidence and found
different outcomes," he said. "It's important to consider all
available options."

He suggested medical cannabis is working for more than 200,000

"The government's own recent cannabis survey found that 97 per cent of
people who said they use cannabis for medical purposes found they were
finding effective symptom management," he said.

"So, I think it's important to balance both the clinical as well as
the anecdotal and real-life experience of people."

Allan said they put together the guideline for doctors to consider
when they discuss treatment options with their patients.

"If you have a patient who is benefiting from nothing else, then this
potentially is helpful for them," he said. "There are patients out
there who do fit that criteria."

Either way, he said additional research is required for health-care
providers to help patients make the best decisions.

"It could change how we approach the issue and help guide our
recommendations," said Allan.

The guideline, which isn't mandated, will be distributed to about
30,000 doctors across Canada.
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MAP posted-by: Matt