THE MARIJUANA CONUNDRUM

In the management of chronic non-malignant pain (CNMP), we really
have very few drug options. Aside from the opioids, there is
methadone, which is limited by the need for a special licence to
prescribe it in Canada (but not in the U.S.). Or a GP can sign a
Health Canada form (the last one I saw was a half-inch thick) for a
patient to possess or grow marijuana for medical use if the patient
is going to die in the next six months. The processing of the form
takes nine months.

For multiple sclerosis or severe rheumatoid arthritis, a specialist
with an FRCP or an FRCS can sign a form for the medical use of
marijuana. I have yet to be able to find two specialists in this
field who will see a patient within a year and who will sign a form.

Complicating the issue even more is that the Canadian Medical
Protective Association will not cover any problems related to
physicians prescribing cannabis. Recent Canadian Medical Association
changes now state a physician no longer must recommend the daily dose
of marijuana, the form or root of administration, but instead the
total amount to be administered. The patient has to sign a form
releasing the physician from liability.

Never in the history of my medical career have I come across such
confusing, frightening and obstructive legislation, guidelines and
fear-mongering statements. Who is going to prescribe a medication
that the CMPA will not defend you against?

The final irony is that the world is awash with marijuana. It would
be quicker for a patient to buy it off the street if it was effective
for their pain. To confuse the matter even more, I believe the
current legislation is so obstructive it denies the right of the
patient in need of obtaining the medication legally and in a
reasonable time legally.

Dr. Alan Russell

Brampton, Ont.