Janet E. Joy, Stanley J. Watson, Jun Borras, Sebastian Scholl , John A. Benson, Wendy Wolford
01 January 1999
The medical use of marijuana is surrounded by a cloud of social, political, and religious controversy, which obscures the facts that should be considered in the debate. This book summarizes what we know about marijuana from evidence-based medicine--the harm it may do and the relief it may bring to patients. The book helps the reader understand not only what science has to say about medical marijuana but also the logic behind the scientific conclusions.
Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with prescription pain medications.
When no alternative treatment to cannabis exists and buying the drug in a pharmacy is too expensive, home cultivation can take place, the Cologne Administrative Court decided. The hearing, which was first brought two weeks ago, centred on five middle-aged men who were prescribed the drug by doctors when all other treatments failed. The court rejected two of the five cases, but said the other three should be allowed to grow their own cannabis. It said applications to grow the drug should be reviewed on a "case-by-case" basis. (See also: Schmerztherapie:Gericht erlaubt Schwerkranken Cannabis-Anbau)
The Tories omnibus crime legislation casts a shadow on the future of the medical marijuana program. The toughening of drug trafficking laws means that anyone caught sharing or selling marijuana will face mandatory jail sentences. No longer will judges have the discretion to waive a sentence for pot providers who offer the product to help the sick. If charged and convicted of trafficking, they will do jail time - at least six months. (See also: Ten Years of Medical Marijuana in Canada)
Research into medicinal marijuana is undergoing a surge of interest, with more evidence emerging not only of its ability to ease human suffering, but also of its apparent safety. Some say cannabis may be less toxic to humans than over-the-counter pain relievers. Scientifically controlled experiments have concluded that smoked cannabis can provide moderate relief from chronic, severe non-cancer pain — including HIV-related nerve pain and post-traumatic neuropathy, a condition that can follow an injury or medical procedure. Both are notoriously resistant to conventional treatments. (See also: Ten Years of Medical Marijuana in Canada)
Data obtained by the Ottawa Citizen through the Access to Information Act put a face to the typical medical marijuana patient for the first time, 10 years after the federal government — under pressure from a series of legal rulings — was forced to start allowing seriously ill Canadians to apply to use the drug. As Health Canada moves to overhaul the rules governing medical marijuana, its own numbers show sharp disparities in the accessibility and use of the drug across the country as patients scramble to find doctors willing to prescribe. (See also: Ten Years of Medical Marijuana in Canada)
The federal government's plan to revamp Canada's medical marijuana program and address court-raised constitutional concerns seems half-baked. The proposed changes ignore a recent B.C. Supreme Court ruling and do little to properly address some of the most contentious issues. In particular, Ottawa intends to continue to permit only dried marijuana to be produced, sold and distributed to medical patients who will use a new document issued by doctors to buy pot from commercial producers. That decision flies in the face of Justice Robert Johnson's ruling in April that patients could make cannabis-infused oils, drink it in their tea or bake it into brownies and cookies, not just smoke it.
More than 15,000 people are licensed to grow medical marijuana in Canada, but Health Canada has no record of staff ever inspecting any of the growers. Health Canada implemented its medical marijuana access regulations in 2001. Under the program, people with "grave and debilitating illnesses" can be granted legal access to marijuana for medicinal purposes. People seeking a permit apply in writing to Health Canada, with a supporting document from a medical practitioner. (See also: Medical marijuana growth rules to change)
The Conservative government's new medicinal pot system may lead some patients to illicitly grow their pot outdoors. Under proposed changes taking effect next year, personal-use production licences will be eliminated, making it illegal for patients to cultivate their own marijuana. Only commercial producers will be licensed in the new system. The new Marihuana for Medical Purposes Regulations estimates the current $1.80-a-gram cost for marijuana will rise to $8.80 a gram when the program takes effect. (See also: Medical marijuana users protest at Winnipeg MP's office)
Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette’s syndrome and the authors recommend more research.
Health Canada began two days of closed-door talks Wednesday about changes to the controversial medical marijuana law that has faced legal challenges and criticism for being ineffective. But even as meetings get underway in Ottawa, there are concerns Health Canada is on the wrong track with a law that asks doctors to ignore a sworn obligation to protect patients’ health, while forcing patients to go to great lengths to obtain a drug that many say eases their pain.
A decade after Canada legalized the medical use of marijuana, most doctors are still refusing to sign the declarations patients need to get legal access to pot - meaning patients in pain risk being jailed if they use a drug that helps them function. It's a predicament that threatens to become worse because of proposed changes to how Health Canada regulates access to the drug.
Canada’s ban on marijuana was effectively upheld when Ontario’s top court struck down the country’s laws related to medicinal pot much to the chagrin of activist groups. In overturning a lower court ruling, the Court of Appeal ruled the trial judge had made numerous errors in striking down the country’s medical pot laws. The Appeal Court found the judge was wrong to interpret an earlier ruling as creating a constitutional right to use medical marijuana. Doctors are allowed to exempt patients from the ban on marijuana, but many physicians refuse to prescribe on the grounds its benefits are not scientifically proven.
Starting next year, thousands of medical marijuana users will have to dig up their gardens and start buying only from suppliers approved and licensed by Ottawa. Health Canada announced the changes in June. Starting Oct. 1, licences will no longer be issued to people who wish to grow their own medical marijuana. As of April 2014, the practice will be outlawed. Anyone using medical marijuana will need to get it from a licensed medical supplier. (See also: Conservative government launching billion-dollar free market)
In 2001, Canada became the first country to adopt a formal system to regulate the medicinal use of marijuana — the Marijuana Medical Access Regulations. The policy allowed people suffering from terminal illnesses or severe conditions such as epilepsy, AIDS, multiple sclerosis and cancer to use the drug if it eased their symptoms. Some people would be able to grow marijuana themselves under strict guidelines.