Medical marijuana use without safety proof worries doctors
Fed up with government-monopoly health care, many voted with their feet. The CMAJ authors (Robert L. Phillips, Jr., Stephen Petterson, George E. Fryer, Jr. and Walter Rosser) conclude that about 12,000 Canadian-educated physicians are now living in the United States. As the authors point out, “this is the equivalent of having two average-sized Canadian medical schools [out of a total of just 17] dedicated to producing physicians for the United States,” every year for 25 years. While there has always been some emigration of Canadian doctors, it is notable that the trend picked up momentum in the 10 years immediately following the passage of the CHA in 1984. The study’s authors do not make this connection, but it is easy to see from their graphs the dramatic spike in physician departures from the mid-1980s to the mid-1990s as governments gained more and more control over primary and specialized care. Not only were doctors’ limited in the way they practiced medicine, but they also came to be seen by governments as the enemy of controlled health-care budgets. Rather than being seen as income- generators, as they are in U.S. hospitals and clinics — the more patients doctors can attract, the more money they bring in — Canada’s health bureaucrats began treating doctors as cost centres. Fewer doctors meant fewer tests would be ordered, fewer beds in hospitals filled, fewer surgeries performed and fewer billings to medicare. Control the number of physicians and governments believed they could control their health expenditures.
Starting April 1, medical marijuana users in Canada will no longer be able to grow their own. Instead, they’ll have to get pot from producers licensed by Health Canada. When the change was announced in June, Health Canada said the number of people authorized to use marijuana for medical reasons grew from less than 500 in 2001 to more than 30,000. The department will no longer be a supplier, and it says the change will provide access to quality-controlled marijuana for medical purposes that is produced under secure and sanitary conditions. Mark Gobuty, CEO of Peace Naturals in Clearview Township, south of Collingwood, Ont., is proud of his medical cannabis facility, where some plants are half way through their flowering cycle. The products will be dried out and then sold to clients. “There’s still a lot of giggle factor,” Gobuty acknowledged. He said doctors can sign a letter for patients to get a small amount of marijuana and then get feedback from the patient and the company. At Peace Naturals, the ultimate goal is to come up with standardized medications from different plant varieties for specific ailments, such as pain, nausea or insomnia, said Darryl Hudson, the company’s chief of research. While a doctor’s prescription states an exact amount of drug to be taken at exact times for an exact length, the new system gives physicians permission to say they think it’s OK for a specific patient to use marijuana, said Dr. Louis Francescutti, president of the Canadian Medical Association. “We’re asking them to prescribe a product that really has not been tested as rigorously as any other product that’s out there and basically writing it with your eyes blindfolded and assuming all the risks that go with it.” Francescutti also has concerns about marijuana’s potential dangers,especially when there are other proven medications for controlling pain and nausea available. When doctors prescribe other medications, they know the benefits and side-effects. But physicians receive little if any training about marijuana. “I can tell you as an emergency physician, I will not be prescribing any marijuana simply because I don’t feel safe that I know exactly what I’m prescribing,” Francescutti said. Regulatory colleges and medical liability experts are also advising physicians to tread gently until the medicinal benefits of marijuana are clearly shown.