OMA president's comments, apology raise questions about stigma around marijuana: CBC

Really respect those who can recognize when they have made a mistake and take quick action to make it right.

Strongly agree with Dr. Verbora’s perspective that the President of the Ontario Medical Association was circulating information that was accurate, to the best of her knowledge, and respect the fact that she took swift action to correct herself when her colleagues brought newer, more accurate information to her attention.

In this CBC article, Dr. Verbora says the medical community is reluctant to engage with newer research about marijuana:  

"Cannabis is so stigmatized and that's just because in the medical community, the way we talk about it, the way we educate on it, we only talk about the harms and we don't talk about the benefits."    

TTC subway operator barred while using medicinal cannabis: CBC

This is yet another example of the shocking, dangerous and unfortunately, not surprising, double-standard that exists between medical cannabis and traditional pharmaceuticals.

If organizations want to err on the side of caution for safety-sensitive positions until there is a more accurate way of testing cannabis impairment, than that seems sensible to me. What does not make sense, however, is forcing a TTC driver off of her medical cannabis to keep her job but allowing her to continue driving while taking impairing opioids, which she describes as leaving her feeling "groggy, forgetful and feeling like a zombie." Not to mention their high addiction potential.

Not only that, but this patient was prescribed CBD oil, which only contains trace amounts of THC and is considered non-impairing. Based on the evidence available, how can anyone believe that going back on opioids is a safer choice?

Read full article from the CBC here.

Ontario Human Rights Commission releases updated policy ahead of cannabis legalization: Global News

From today’s Global News: Employers are required to do what they can to accommodate medical marijuana users as well as those addicted to pot but that doesn’t give employees carte blanche to show up at work stoned, Ontario’s Human Rights Commission said on Thursday.

In its updated policy guidance ahead of next week’s legalization of recreational weed, the commission says employers can expect workers to be sober at work, particularly in safety-sensitive jobs.

“Accommodation does not necessarily require employers to permit cannabis impairment on the job,” the document states. “The duty to accommodate ends if the person cannot ultimately perform the essential duties of the job after accommodation has been tried and exhausted, or if undue hardship would result.”

Ultimately, the commission said, the looming change in the law has no impact when it comes to human rights.

Phasing out medical cannabis would leave pediatric patients in the lurch, CBC

I read the CBC column, “Phasing out medical cannabis would leave pediatric patients in the lurch,” with interest this weekend.

 In short, the fact that the Canadian Medical Association has floated the idea of eliminating the medical cannabis access system is a very serious potential outcome to recreational cannabis legalization that most Canadians are unaware of. Not only could this have dire effects for children, as Dr. MacCallum and Dr. Valleriani outline in their article, but also for the thousands of geriatric and palliative patients living in long-term care. While these elderly patients wouldn’t be restricted by the minimum age limit that pediatric patients face, access to quality-of life-improving medication would be severely restricted if the rules were to change. In short, this is a public health issue that people need to know more about as it could potentially affect some of our most vulnerable patients including children and the elderly.

 

 

 

Research: Cannabis and the Health and Performance of the Elite Athlete, Clinical Journal of Sport Medicine (September 2018)

ABSTRACT

Objective: Cannabis (marijuana) is undergoing extensive regulatory review in many global jurisdictions for medical and nonmedical access. Cannabis has potential impact on the health of athletes as well as on performance in both training and in competition. The aim of this general review is to identify and highlight the challenges in interpreting information with respect to elite athletic performance, and to point to important research areas that need to be addressed.

Data Sources: A nonsystematic literature review was conducted using Medline and PubMed for articles related to cannabis/marijuana use and sports/athletic performance; abstracts were reviewed by lead author and key themes identified and explored.

Main Results: Cannabis may be primarily inhaled or ingested orally for a range of medical and nonmedical reasons; evidence for efficacy is limited but promising for chronic pain management. Although evidence for serious harms from cannabis use on health of athletes is limited, one should be cognizant of the potential for abuse and mental health issues. Although the prevalence of cannabis use among elite athletes is not well-known, use is associated with certain high-risk sports. There is no evidence for cannabis use as a performance-enhancing drug.

Conclusions: Medical and nonmedical cannabis use among athletes reflects changing societal and cultural norms and experiences. Although cannabis use is more prevalent in some athletes engaged in high-risk sports, there is no direct evidence of performance-enhancing effects in athletes. The potential beneficial effects of cannabis as part of a pain management protocol, including reducing concussion-related symptoms, deserve further attention.

Read full journal article here.

Authors:

Ware, Mark A., MBBS, MSc*; Jensen, Dennis, PhD†,‡,§; Barrette, Amy, MSc¶; Vernec, Alan, MD, Dip Sport Med‖; Derman, Wayne, MBChB, PhD**,††

Not all research is created equal: Cannabis and chronic pain

Not all research is created equal. A new study published in The Lancet medical journal suggests that cannabis is not effective at treating chronic, non-cancer pain. This study is flawed on a number of levels.

Take a look at what I, and other physicians treating patients with cannabinoid medicine across North America, have to say in the article here.

From a clinical perspective, I have successfully treated hundreds of patients with non-cancer, chronic pain with cannabis therapy. It does not work for everyone and it is not a panacea, but for many, many patients it can be life-changing and is the only medicine that works to relieve their pain.

However, until we have more prospective, randomized controlled trials that can prove causality, we will continue to go around in circles with the cannabis as medicine debate. To legitimize cannabis as medicine and improve access for patients around the world who could benefit, more quality research is imperative.

U.S. Senate committee slams marijuana's federal classification, saying Schedule I blocks research: Forbes

Forbes reporter, Tom Angell reports: "A key U.S. Senate committee says that marijuana's current federal classification blocks scientific research on its effects -- something that legalization advocates have long argued." 

Canadians, and indeed patients from around the world, cannot underestimate the impact that the U.S. classification of marijuana has on the pace of advancement within the field of cannabinoid medicine. 

Angell explains: "Schedule I is the most restrictive category under federal law, and is supposed to be reserved for drugs with a high potential for abuse and no medical value. Researchers wishing to study substances classified there must overcome procedural hurdles that don't exist for other drugs."

"The committee's criticism of Schedule 1 roadblocks to marijuana research provides more momentum to the effort to reclassify cannabis under federal law." 

Read full article here.

FDA approves first ever drug comprised of an active ingredient derived from marijuana

On June 25, 2018, the U.S. Food and Drug Administration (FDA) made history by granting approval for the first drug comprised of an active ingredient derived from marijuana, to treat rare, severe forms of epilepsy.

This impact of this decision on the advancement of cannabinoid medicine cannot be understated. Currently, marijuana is listed as a Schedule 1 drug in the U.S., which is defined as drugs with no currently accepted medical use and a high potential for abuse. Schedule 1 drugs currently include Heroine, LSD, Ecstasy and Marijuana, among others. The scheduling of marijuana in the U.S. has undoubtedly hindered research and development into cannabis as medicine and so the FDA's approval of Epidiolex - an oral solution made from cannabidiol (CBD) - could have a profound impact on the advancement and acceptance of cannabinoid medicine.

Read the FDA's full statement here.

 

 

Trust medical marijuana, N.J.'s top health official asks doctors and medical students: NJ.com

NJ.com reports: New Jersey's top doctor Tuesday encouraged physicians and medical students to embrace cannabis as another tool to help their patients, despite acknowledging that rigorous scientific research is lacking.

Here are a few highlights of his message but be sure to click on the full story to read the full article and watch a video from the day's event:

  • "At the end of the day, this is about patients. The Department of Health is pushing this because...many times it is the best therapy you can give them."
  • "I want this to be in physicians' and other providers' heads as a therapeutic option -- not something separate, not sort of in a different category like alternative medicine. This really is reaching a level of relevance and importance to patients,"

Cannabis versus Cancer: Scientific American

Scientific American reports: "Countless scientific studies have shown that medical cannabis offers palliative care benefits, including appetite stimulationpain relief and more. But early research indicates that cannabinoids can do so much more. Data is showing that medical marijuana has antitumor effects and may one day be used as a cancer treatment, not just as a drug to ease symptoms of the disease." Full article.