Yesterday, the Hon. Leona Aglukak announced that the Government of Canada was moving to a new system of production and distribution of marijuana for medicinal purposes. There are currently 26,000 users of medicinal marijuana in Canada and for them and their doctors these changes will be difficult to manage. The changes proposed will mean that those who currently grow marijuana in their homes legally for personal medical use will no longer be able to do so. Instead, they will take the equivalent of a prescription to one of a list of identified producers who will then sell them the marijuana they require.

As a psychiatrist, I have concerns that the principal research on marijuana to date concerns its impact as a drug of abuse. There are numerous accounts of benefit in situations where a patient is suffering from chronic pain, in particular during a terminal illness, but many anecdotes are not evidence. Unfortunately, despite the fact that the Government of Canada’s medicinal marijuana program is 10 years old, there has still not been sufficient research to provide a physician with the information needed to understand the dosing, efficacy, side effects and drug interactions of this pharmacological product that we are asked to prescribe. What assurance or counselling can we provide a patient with respect to the use of marijuana for medical purposes? How is a dose of marijuana determined?

Why is this drug different from all other drugs? The Government has not required the usual process for approval of marijuana for medicianl use. Why are patients and doctors expected to accommodate the risks associated with the production and distribution of marijuana in the absence of sufficient research to allow us to prescribe this substance with confidence? My concern is that the government’s new policy effectively abandons 26,000 patients who have come to depend on marijuana for relief and says to doctors, “If you want to prescribe marijuana, accept the risks.” The government’s previous model of production and distribution was not ideal but at least they accepted some responsibilty in a difficult circumstance.

Now, the government is suggesting that doctors should have even more responsibility in this process. Under the old system, many doctors were uncomfortable recommending medicinal marijuana. The increased risks of this new system will  leave many more patients without access to the medicinal marijuana they are using. Sabrina Fabien, a reporter with Radio-Canada in Halifax, asked me if I thought the government was trying to reduce the use of medicinal marijuana. Now that’s a good question!

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