Doctors the lynch-pin for marijuana access

Image Credit: Compilation/Jennifer Stahn

June 25, 2013 - 8:03 AM

DOCTORS FIND THE POSITION UNFAIR CONSIDERING LACK OF RESEARCH ON SUBJECT

This is the second of a five-part series on changes in the marijuana industry. Yesterday, we looked at Health Canada's new rules. Now Health Canada lays the keys to a legitimate marijuana industry on the prescription pads of doctors. What's to stop a business from hiring its own doctors simply to write scripts to anyone who wants one? Absolutely nothing. And doctors have a surprising response. Tomorrow: How legal pot farmers intend to react when they become criminals again.

Whether they like it or not, the entire medical marijuana industry hinges, and will continue to hinge, on doctors.

They are the first step in obtaining the golden ticket to pot. But for many doctors, all they really know about the contentious drug is that it’s illegal.

Dr. Shari Claremont, president of the B.C. College of Family Physicians says doctors have been skeptical of Health Canada’s medical marijuana program since its inception in 1999.

“Many family physicians feel we have been put in a really unfair, untenable position by being the ones who are asked to prescribe medical marijuana because we know so little about the drug from a medical perspective,” Claremont says.

The process goes like this: Go to any doctor and tell them why you’re an appropriate candidate for medical marijuana. If the doctor wants to go forward, both the patient and the physician fill out a Health Canada application form and send it in. Under new regulations next April, patients will need a prescription to get their pot, just like every other drug in the pharmacy.

“That’s the last we hear of it,” Claremont says. “I honestly don’t know how they go about getting it (marijuana).”

If the doctor refuses, things can get uncomfortable.

“If the doctor disagrees, that puts the patient and the doctor in an awkward situation,” Claremont says. “This is one of the concerns the college has. It’s awkward to not provide something that our patients want, to have to say no for something they’re asking for. It can have an effect on the doctor/patient relationship.”

Being turned down by one doctor isn’t the end of the world for someone seeking a marijuana license. They can try with a different doctor, although Claremont says they’re less likely to receive the prescription from someone who doesn’t know them. “It may seem to the physician as drug seeking,” Claremont says.

Suspicious or not, one medical marijuana user says paying off Vernon doctors is common practice. After being denied by his own doctor, an Okanagan source who wishes to remain anonymous, says he paid a Vernon physician $500 to get the paperwork signed. He heard about the doctor through the grapevine, and says he is well known for prescribing medical marijuana without asking questions. This line between medical and recreational marijuana is going to get complicated. See more in Part Four of this series on how the two are interconnected.

Claremont says things would be less problematic if there was simply more research on marijuana. Compared to other drugs prescribed by doctors, Claremont says the literature on marijuana is pretty thin. Doctors are responsible for the effects caused by drugs they prescribe so they’re naturally cautious about prescribing it without research backing them up.

“If the patient had a repercussion from that—an accident or overdose, or negative effect—then the doctor who prescribed it is responsible in some way.”

Doctors have been asking the government to fund research on the drug for over a decade.

“The minute the program started, many of the medical organizations, such as the college started to write letters to the government expressing our concerns,” Claremont says. “I don't think the problem is that doctors have anything against people using medical marijuana, they just feel they're in a position where they are asked to prescribe something they know very little about."

It would also help if some of the fear attached to the otherwise illegal drug could be erased.

“Doctors would be more comfortable if the marijuana itself was decriminalized,” Claremont says. “It would take some of the pressure off.”

She says some doctors fear if they agree to sign the Health Canada forms they might get a reputation for being someone who willingly prescribes marijuana.

“I don't think the doctors are comfortable with just having a flood of people they don't know on their doorstep asking for marijuana,” Claremont says, adding it might add undue pressure on practices already filled to the brim.

Under new regulations proposed by Health Canada and scheduled to go into effect in April of 2014, patients would obtain a prescription from a physician and that would be it. No Health Canada license, just doctors. Patients would fill their prescriptions at commercial distribution centers or order products through the mail.

DOCTORS AS GATEWAY

One British Columbian entrepreneur is ready to pave the way for a one-stop-shop service with doctors on staff and some retail items sold on site. Ross Rebagliati wants to capitalize on the looming privatization of the marijuana industry, first opening store fronts that sell cannabis related merchandise, and later becoming a marijuana producer and fanning their product out across Canada.

With doctors on site to write prescriptions, it further blurs the lines between medical and recreational use. What doctor practices medicine in a marijuana shop? Surprisingly, Claremont says that may be the best proposition.

“A few physicians who are particularly interested in treating conditions you would need medical marijuana for could specialize there,” she says, noting chronic pain specialists among others would likely find a niche there. “That might actually take some pressure off the rest of the doctors.”

But that scenario could be a long way off, and family physicians will likely be handling prescriptions for some time yet. Claremont wonders if it would be better for marijuana to be decriminalized.

“I know I wouldn't want to work in a setting I was prescribing something not decriminalized,” she says.