SMA News Digest (Summer 2014): V54, I2 | Page 19

HEALTH CARE medical marijuana and how the new legislation affects your practice By Dallas Carpenter On April 1, 2014, changes to Health Canada’s Marihuana Medical Access Program come into effect. The new program, Marihuana for Medical Purposes Regulations, involves changes to the authorization, production, and distribution of marijuana for medical use that will impact health providers and patients. Under the old rules, the physician’s role was to provide a patient with an assessment form which the patient would pass on to Health Canada. Health Canada would then decide if the patient was eligible to receive marijuana. A patient would be able to receive marijuana from a licenced provider or grow an approved quantity on their own. The new rules require a prescription from a physician for the use of marijuana. Once prescribed, the patient must take the prescription to an approved grower to dispense the prescribed amount of the substance. Health Canada’s role has been reduced to licencing growers, while the role of physicians has been increased to the role of “gatekeepers.” The Saskatchewan Medical Association shares the position of the Canadian Medical Association that “there is insufficient scientific evidence available to support the use of marijuana for clinical purposes,” and that “there is insufficient evidence on clinical risks and benefits, including the proper dosage of marijuana to be used and on the potential interactions between this drug and other medications.” The College of Physicians and Surgeons of Saskatchewan (CPSS) has set standards for therapy involving the use of medical marijuana, although the CPSS has also expressed concerns about physicians prescribing a substance that has little clinical information available. As Bryan Salte, Associate Registrar and Legal Counsel for CPSS explained at the May Representative Assembly, “We think it’s important to say that this is something that is an unproven therapy, it’s something that we’re not certain of, but nonetheless, no- body should feel they are compelled to prescribe marijuana if they are not comfortable doing it.” A physician choosing to prescribe marijuana must be the physician treating the condition the marijuana is prescribed to treat. The physician must keep extensive records and conduct a physical examination before authorizing the use of marijuana, and must obtain statements from the patient that they will use marijuana only in the dosage prescribed and ѡ