No pot for anyone under 25 among B.C. doctors’ new rules for medicinal marijuana

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      The professional organization that regulates the conduct of B.C. doctors is cracking down on how patients access medicinal marijuana, and some MDs in the province are not happy about it.

      In a telephone interview, Dr. Ian Mitchell, a Kamloops-based physician and clinical associate professor at UBC, described the new rules as “excessive” and “beyond Health Canada requirements”.

      “This is very restrictive and a big change from the past,” he told the Georgia Straight. “These new regulations make it almost impossible for anybody to comply with them.”

      The revised policies come in the form of a recent College of Physicians and Surgeons of B.C. “professional standards and guidelines” memo. The March 2015 document concerns how doctors should issue what Health Canada calls a “medical document” (as opposed to a prescription) that patients require to order marijuana from federally authorized suppliers.

      It states that cannabis is “not appropriate” for patients under the age of 25; for those who have a history of psychosis, a cannabis disorder, or a substance-use disorder; or for anybody with a cardiovascular or respiratory disease.

      The document is an official college “standard”, according to the regulator’s website, which means it reflects “relevant legal requirements” that are enforced under the province’s Health Professions Act.

      It goes on to state that a physician should not complete a patient’s medical document for marijuana unless they have a “longitudinal relationship” with that individual or are in contact with a physician who has such a relationship. Finally, it forbids doctors from charging patients for the completion of the medical document.

      In a telephone interview, Dr. Galt Wilson, senior deputy registrar for the college, said the memo obtained by the Straight has since been recalled and is being revised to incorporate members’ input. But Wilson stressed that the college is dissatisfied with the status quo, and he defended several of the memo’s specific provisions.

      “We’ve turned up examples of what we consider substandard medical care associated with marijuana authorization,” he told the Straight. “So we wanted to put the word out that we expect the same high standard of care for this situation as we do for every other medical service.”

      According to Wilson, a set of more specific guidelines was required because the potential health benefits of marijuana have yet to be sufficiently researched.

      He said that chief among the college’s concerns is the increasing number of physicians who are charging patients for the completion of Health Canada’s required medical document. Wilson argued that this has created a potential conflict of interest, where doctors have a cash incentive to find a reason to recommend marijuana. Wilson explained that the college has therefore ordered doctors to treat the medical document as a prescription, for which they are not permitted to charge a separate fee.

      “What we’ve seen is some pretty superficial assessments,” he said. “And we’ve seen really concerning examples of what we regard as a conflict of interest.”

      Wilson stressed that in revising standards around marijuana, the College of Physicians and Surgeons of B.C. is taking cues from the College of Family Physicians of Canada, which issued a 28-page report on the matter in September 2014.

      The new rules will apply to more than 25,000 British Columbians who are authorized to purchase medicinal marijuana from Ottawa-approved suppliers. They could also impact Vancouver residents who purchase cannabis products from the city’s estimated 65 storefront dispensaries. Although those businesses operate illegally, some require clients to hold proper Health Canada authorization to possess marijuana.

      Doctors across the country are debating the B.C. college’s new rules. That’s evident in a package of emails obtained by the Straight that were sent between some 70 Canadian physicians who have formed a group called Practitioners for Medicinal Cannabis (PMC). Many messages argue that the new standards are overly stringent. One email, for example, suggests that the college is “endangering the public by indirectly obstructing access”. Others express similar sentiments.

      Dr. Arnold Shoichet is a board member for the Vancouver-based Medicinal Cannabis Resource Centre and a founding PMC member. In a telephone interview, he described the dominant reaction to the college’s move on marijuana as “distress”.

      “Many of the participants within the PMC have verbalized their concerns about the way the college is choosing to address its responsibilities,” Shoichet said. “Their restrictions are, in a sense, tying the hands of the medical practitioners who are supportive and willing to get involved.”

      In separate interviews, Shoichet and Mitchell took issue with the college’s order that physicians treat Health Canada’s medical document as a prescription. They argued the form is significantly more complicated and time-consuming than any prescription and should, therefore, be subject to a fee at the discretion of physicians.

      Shoichet added that B.C. isn’t the only province whose medical regulatory agency has moved against marijuana. The Ontario College’s policy on cannabis includes similar provisions, he noted.

      “Regulatory authorities across the country seem to be doing the same thing,” Shoichet observed. “Why are they doing that?”

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      Comments

      27 Comments

      Jon Q. Publik

      Apr 22, 2015 at 10:14am

      Why does everyone want to harsh my mellow, man. Seriously, do these doctors even understand how readily available access to marijuana is in this province?

      MatthewE

      Apr 22, 2015 at 10:53am

      Given that cannabis is more often than not a substitute for alcohol and other psychoactive substances, including prescription painkillers, anti-depressants, anti-psychotics, tranquilizers and sedatives with much higher addiction potential and much worse benefit/risk profiles, doctors should be anxious to recommend it.

      Given the prevalence and history of cannabis in Canada, any doctor who claims ignorance of the effects, side-effects and drug-interactions is arguably negligent.

      If nothing else, doctors should be able to proclaim with some certainty that their patient's health would benefit from not fearing having their door kicked in by a SWAT team and having their dog shot.

      Token

      Apr 22, 2015 at 11:08am

      either it's a prescription, or its a medical document. It can't be both. It should be considered a prescription now that it's not a multi page "document" and so patients can write it off on their taxes. How can they limit age on medication? Have they not seen Sanjay Gupta 3 episodes about medical marijuana that shows even young children benefit from cannabis? AND asthma patients? They benefit too. They're gonna be disallowed? What a joke. It's easier to get opiates than cannabis. Let's get Trudeau in October 2015 and put an end to all this crap with full legalization for adults.

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      Kemo

      Apr 22, 2015 at 11:11am

      So it's ok for these "doctors" to prescribe Dexedrine-Dextroamphetamine (pharmaceutical amphetamine) to children that are 6 years old for ADHD, without knowing how it even works? It has caused 20+ cases of sudden death since 2006. Marijuana has caused ZERO deaths in 2000+ years of use... Alcohol which kills millions is available to 19 year olds and readily accessible to minors as young as 13... but ya, stop adults from using an herb that's been shown to reduce drug and alcohol abuse, violent crimes and has medicinal properties that far outperform most of the pharmaceutical poison these doctors are paid to push on their patients. This is downright criminal and I can't believe the blatant hypocrisy that the college of old religious outdated cronies is trying to impose. Maybe you should focus on harm reduction of the "killer" drugs you already prescribe to citizens of all ages.

      Don T Beugard

      Apr 22, 2015 at 12:38pm

      The CMA has proven that mainstream doctors are not people of science but rather willing stooges of big pharma.
      Many of the recent mass shootings around the continent are showing a common denominator;
      Anti-depressants.

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      Not Impressed

      Apr 22, 2015 at 1:28pm

      I don't understand the philosophy that because some doctors may be prescribing seriously strong meds that it makes it perfectly acceptable to prescribe pot. If you are concerned about the effects of one group then you should be concerned about the other.

      I also don't see people who take anti-depressants and anti-pyschotics celebrating on the stairs of the art gallery and encouraging others to start taking them. This is why I think that pot is definitely overprescribed and it's time that the government starts regulating dispensaries. For a society that seems to be becoming more aware of over-medicating I'm shocked at how few seem to care that pot is being so readily prescribed.

      The age limitation is the first sensible step I've seen so far from the medical community. Hopefully, in time, people will stop thinking about pot as a harmless bit of recreation and see it for the health risk it truly is.

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      Beatnuck

      Apr 22, 2015 at 5:00pm

      For a society that seems to be becoming more aware of over medicating I'm shocked at how few seem to care that alcohol is so readily available.

      (Sounds kinda silly when you replace "pot" with "alcohol", eh?)

      Anandamide

      Apr 22, 2015 at 7:25pm

      Kids have endocannabinoid systems just like adults do. What's happening to all those kids in Colorado and California suffering from intractable paediatric epilepsy? Cannabis extract is proving to be a wonder drug for them. They are seeing up to a 100% reduction in seizures (up to 300 per day before cannabis), they're relearning the ability to walk, talk, eat etc. Cannabis is a far safer medicine than hardcore prescription drugs. Why shouldn't families have the right to decide to chose a safer medicine for their kids? There are ZERO direct deaths caused by cannabis. EVER! In thousands of years of use.

      Charlotte Figi and Zaki Jackson: 6 and 10, Colorado
      99 to 100% seizure reduction.
      https://www.youtube.com/watch?v=BH5yzEu3JGQ

      Jaden David: Age 7, California

      https://www.youtube.com/watch?v=OAkQdz8Fvcc

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      tracy thompson

      Apr 22, 2015 at 7:40pm

      just another instance in which the "professional governing body" and it's members care more about covering their asses than caring for their patients. i believe most GP's are ignorant in regard to the health benefits of cannabis and are simply toeing the line and playing safe by "erring on the side of caution"

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