Dear Herb: I am feeling excited to try using medical marijuana to support or potentially replace some medications I am currently using. The side effects of my current meds can sometimes be worse than what I'm using them to treat.
I talked to my family doctor but he refused to prescribe it to me. I want to do it legally and also want to have some medical supervision, preferably from my own physician who knows me well.
Do doctors have to be willing to prescribe medical marijuana to their patients, or should I just find another doctor? Will that change when recreational weed is legalized? — Gonna Request A Safer Script
Dear Grass: I've got good news and bad news for you, G.R.A.S.S.
First, the bad news: your family doctor is by no means required to authorize cannabis for you. (When it comes to cannabis, Health Canada and various medical organizations prefer the term authorize instead of prescribe, since the government doesn't classify cannabis as an approved therapeutic product like pharmaceutical drugs that carry an official Drug Identification Number.)
For the most part, the professional organizations that represent Canadian medical professionals have been skeptical about the medical benefits of cannabis.
Take, for example, this 2014 guide to the subject from the College of Family Physicians of Canada. The government's requirement for a medical authorization to access the legal medical cannabis program, wrote the College, "puts family physicians in a difficult position: we are asked to authorize our patients' access to a product with little evidence to support its use, and in the absence of regulatory oversight and approval."Advertisement
In a recent, in-depth feature on The Leaf, Canadian Medical Association VP Dr. Jeff Blackmer said, "probably the majority of physicians aren't comfortable authorizing this substance."
So it's not just your family doctor, G.R.A.S.S. — lots of physicians in Canada are hesitant to authorize cannabis for their patients, and like I said, they're not required to do so if it goes against their clinical judgment. If your doctor's not willing to help you out with this, you'll need to find someone else.
To that end, the good news: there are plenty of doctors in Canada who are more open to the idea of using cannabis for medical purposes. In fact, according to Health Canada's cannabis market data, a total of 11,058 medical practitioners in Canada have provided a medical document for a client who registered with a licensed cannabis producer as of December, 2017.
How do you find one of those cannabis-friendly physicians? Well, lucky for you, Canada now has a whole slew of clinics where potential medical marijuana users can consult with doctors who are well-versed in cannabis. (The rise of these clinics, in my opinion, is definitely related to the fact that so many doctors aren't willing to consider cannabis for their patients.)
The cannabis website Lift maintains a fairly extensive list of these clinics, searchable by area. I can't recommend a specific clinic for you to visit, but here are some basic guidelines to help you find one that's reputable:
- If the clinic is also a dispensary or has cannabis available on site, it's definitely not legal.
- The clinic should be billing your provincial health system for the appointment, not you. If the clinic wants to charge you a fee to consult with a doctor, steer clear.
- Some clinics collect patients' medical data for for-profit research or resale. That's not necessarily a bad thing, but you should be aware of this.
- If a clinic's doctor does authorize you to use medical cannabis, the clinic will help you sign up directly with a licensed cannabis producer that will deliver the cannabis by mail. The clinic ought to let you choose from among any of the producers authorized for sale in Canada, instead of just limiting you to a few.
- Ask whether the clinic receives referral fees or "educational grants" from licensed producers for signing up clients. Again, this doesn't have to be a deal breaker, but it's worth knowing.
Even though the physicians at these clinics may be more open to authorizing cannabis than your average white coat, they still have no obligation to authorize your medical cannabis use if they don't think it's a good idea for your specific case. Expect to answer questions about your medical history and past cannabis use.
In fact, physicians at a reputable cannabis clinic won't just write a medical cannabis authorization for everyone who walks in the door, said James O'Hara, the new president and CEO of advocacy group Canadians for Fair Access to Medical Marijuana.
"I would look for a clinic who isn't just going to willy-nilly give it out, that they're really going to assess my own particular needs," said O'Hara.
That doesn't just mean assessing only a patient's medical symptoms, but also assessing their situation more broadly, said O'Hara. For example, clinics should be willing to help patients find a dosage form that's appropriate for their situation. Or, a patient with limited financial means would benefit from a clinic that's willing to help them find a licensed producer with a compassionate pricing program, he said.
Finally, you asked whether this situation will change after legalization. Right now, it looks like the government intends to keep the existing medical cannabis system in place, and review it within five years of legalization.
Good luck, G.R.A.S.S!
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