The new grey market: As older users warm up to cannabis, pot companies want to learn more: Financial Post

Cannabis companies hoping to expand the medical market will have to overcome the conservatism towards cannabis amongst medical associations — both the Ontario Medical Association and the Canadian Medical Association support the dismantling of the medical cannabis regime altogether, arguing that with legalization, there remains no need for medical professionals to serve a “gatekeeper role.”

This kind of opposition, said Pearson, is what makes is so difficult to obtain funding to really understand how cannabis can improve the lives of seniors. “I treat seniors in a long-term care setting and I’m weaning down their use of anti-psychotics and opioids. To just say leave it up to themselves, that means you’re saying they should self-medicate, which is absurd.” Read full article here.

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."    

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.

Is there a double-standard when it comes to off-label pharmaceuticals and medical cannabis?

In Canada, all prescription pharmaceuticals (“drugs”) must be approved for sale by Health Canada. When Health Canada approves a drug for sale the approval stipulates, among other things; the population for whom the drug can be prescribed, the indication(s) 
the drug can treat, and the dosage(s) that can be administered. The use of an approved drug beyond the criteria set out in the product’s approval is referred to as “off-label” use. 

1 in 9 drugs are used off label: 99.2% of gabapentin is used off label and 75% of pediatric medications are used off label. According to a Health Canada report (below), 79% of off-label prescriptions were not supported by strong scientific evidence. (Strong evidence was described as at least one randomized, controlled clinical trial {RCT}.) Yet, when it comes to medical uses for cannabis, the same rules do not apply and the standards for evidence are so much more rigorous. As a physician seeing the positive impacts of cannabinoid therapy on my patients every day, I really question this double-standard — especially given cannabis’ excellent safety profile. 

Check out the Senate of Canada Standing Senate Committee on Social Affairs Science and Technology on Prescription Pharmaceuticals in Canada - Off Label Use.

Medical cannabis shouldn't be subject to tax: Ottawa Citizen

You’ve heard me talk about the cost burden of medical marijuana before; it’s an issue that’s very important to me as a doctor focused on patient and family-centred care.

When the federal government released its 2018 budget, it came as a surprise to many that it was planning to add a new excise tax on medical cannabis. Excise tax is usually reserved for products deemed to have a high social cost, such as tobacco or alcohol. However, a budget branded with the motto, “giving every Canadian a real and fair chance at success,” has seemed to overlook Canadian families already struggling with affordability and access to medical cannabis. 

In this article, Jenna Valleriani, does an excellent job exploring why medical cannabis, if authorized by a health-care provider for medical purposes, should be treated any different than most prescription medicines. 

If this issue is important to you, I encourage you to reach out to your local government representatives and make your voice heard. 

Yours in good health - Blake

Full article here.