Pubdate: Sat, 24 Feb 2018
Source: Medicine Hat News (CN AB)
Copyright: 2018 Alberta Newspaper Group, Inc.
Author: Gillian Slade
Page: A5


It is hard to pinpoint reasons for a large increase in the number of
physicians authorizing the use of medical marijuana, but a local pain
specialist has some theories.

"Cannabinoids are showing great promise as medicines, especially in
the myriad of non specific conditions like anxiety, insomnia, fatigue,
mild to moderate pain, unhappiness, recurrent stress and dysphoria
conditions which pharmacotherapy has offered little and doctors are
ill equipped to treat," said Dr. Gaylord Wardell, anesthesiologist and
pain specialist, Sante Surgi, Medicine Hat. "Patients are dissatisfied
with their doctors and their drugs."

In 2016 there were 329 physicians authorizing medical marijuana for
about 5,300 patients, according to data from the Alberta College of
Physicians and Surgeons.

By April 2017 there were 500 physicians authorizing medical marijuana
to about 10,000 patients.

By May 2017, there were 527 physicians authorizing medical marijuana
to 21,803 patients.

Those numbers need some explanation because patients are authorized to
receive medical marijuana for only one year at a time. That means the
number of patients and the number of doctors is fluctuating
constantly, said Kelly Eby, spokesperson for Alberta College of
Physicians and Surgeons.

It is difficult to determine whether the increasing numbers are an
indication of physicians switching patients to medical marijuana
instead of a prescription for opioids.

"The new rules for opioid prescribing did not come in until April
2017, so while it's possible the increase in MMP (medical marijuana
authorization) is related to reduced opioid prescribing, there's no
direct proof." said Eby. "The increase in MMP authorizations could
simply be because it's been legal for several years now and physicians
feel more comfortable authorizing it for their patients."

The new rules included additional steps for physicians to follow
before prescribing an opioid.

However, in January 2017, a local doctor, speaking on condition of
anonymity, told the News the college was already monitoring physicians
prescribing opioids, and that some were "terrified" of prescribing
opioids for that reason.

Dr. Donovan Nunweiler, Southlands Medical Clinic, says he does not
feel pressured by patients to prescribe medical marijuana.

"I have encountered patients who have found a medical benefit and
others who have been disappointed," said Nunweiler. "It is not a magic
cure for all. I suspect there will be pharmaceutical research with
cannaniboids in the future."

Nunweiler is concerned about the number of people using marijuana, in
particular, during pregnancy.

Wardell says cannabis/marijuana is no panacea, but provided organized
crime is kept out, it is far safer than other recreationals such as
tobacco, alcohol and other medicinals such as aspirin-like drugs,
antidepressants, antipsychotics, anticonvulsants, benzodiazepines,
sleeping pills and legal opioids.

Ordinary people may have the final say anyway.

When marijuana becomes legal on the open market patients will use it
and will reject those doctors who oppose it without valid scientific
medical justification, said Wardell.

"Despite their worst efforts, the College of Family Physicians, the
Royal College, the Canadian Medical Association, the Canadian Medical
Protective Association and the provincial licensing bodies for doctors
will not be able to make cannabis go away," said Wardell.

Cannabis has been used as medicine for three thousand years and
doctors should think twice before they vilify a plant with a long
history of value to mankind, Wardell said.
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