HempNews

November 1, 2011 – A decade after Canada legalized the medical use of marijuana, most doctors are still refusing to sign the declarations patients need to get legal access to pot — meaning patients in pain risk being jailed if they use a drug that helps them function.

It’s a predicament that threatens to become worse because of proposed changes to how Health Canada regulates access to the drug.

At first glance, it appears the government is easing up on strict rules for obtaining medicinal marijuana. Health Canada has proposed removing itself as the ultimate arbiter in approving or rejecting applications to possess.

Instead, doctors alone would sign off on requests.

But the nation’s largest doctors’ group said the proposals would have the perverse effect of putting even greater pressure on MDs to control access to a largely untested and unregulated substance they know little to nothing about; a drug that hasn’t gone through the normal regulatory review process. Their licensing bodies have told doctors that they are under no obligation to complete a medical declaration under the current regulations and that any one who chooses to do so should “proceed with caution.”

Dr. John Haggie, president of the 75,000-member Canadian Medical Association, said the changes being proposed would essentially off load all responsibility for using and monitoring marijuana to the doctors who sign an authorization — “and they’d be kind out of out there, without any infrastructure around them to assess it, to monitor it and to know if they were doing the right thing.

“I don’t think that’s appropriate or fair,” he said.

Observers said doctors fear doing harm, exposing themselves to legal action and becoming the “go-to” source for people seeking pot not to alter their pain but to alter their consciousness.

Haggie said physicians want fundamental research into some basic questions — is it safe? Who does it work for? Who should not use it? Yet the Conservative government abruptly terminated a medicinal marijuana research program in 2006. According to Health Canada, the government believes clinical research is “best undertaken by the private sector, such as pharmaceutical companies.”

A world leader in cannabis research said the logic defies him.

“I cannot imagine how a government agency can supervise (a marijuana access) program knowing that there is very little data out there — on safety issues in particular — and not try to stimulate research,” said Dr. Mark Ware, head of the Canadian Consortium for the Investigation of Cannabinoids, a non-profit network of more than 150 clinicians and researchers investigating the potential role of cannabinoids in diseases from arthritis to glaucoma.

No drug company wants to evaluate smoked marijuana as a medicine, Ware said, because there’s no money in it for them. Funding agencies have been less than approachable, he added, because there’s little appetite to support studies involving a product that’s often smoked. In clinical parlance, “They don’t see it as a safe, viable drug delivery system,” said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre.

Ware said he wonders how much the government’s disinterest in research might be tied to its tough-on-crime political agenda — “that somehow facilitating research on medicinal cannabis is a way of accepting that it may have some value as a medicine.”

The Montreal doctor, who is helping reform medical school curricula to better educate physicians around pain, received about $2 million under the now-dead medicinal marijuana research program. In a study published in the Canadian Medical Association Journal last year that involved 21 patients with neuropathic pain — a common and dreaded condition that causes electric, stabbing pain — Ware’s group found that smoked cannabis at low doses reduces pain, improves mood and helps sleep, without making people high. All had “refractory” pain, meaning pain that had defied all traditional treatments. No serious or unexpected side effects were reported.

Ware avoids prescribing cannabis to patients with a history of psychosis or schizophrenia, because it’s psychoactive at high doses — and sometimes even therapeutic doses. It can also be dangerous to people with unstable heart disease.

Still, there has never been a proven overdose death caused by marijuana in humans, according to Ontario’s highest court. Ware said that for patients for whom it works, cannabis can achieve about 30 per cent reduction in pain intensity.

But doctors remain wary — their chief concern being: How do I know when a patient is seeking a licence for a legitimate medical purpose and not simply to get legal access to an otherwise illicit drug?

Ware’s consortium has been working hard to educate and support doctors around the use of cannabis. He said data from Health Canada suggest that the average medical user is consuming two grams per day — about four joints when smoked. “It’s just taking that information and getting it into the hands of practising physicians. Then at least they know what the ballpark is.”

Some patients were getting authorizations for far higher amounts, because doctors didn’t know that 30 or 40 grams a day could be outside the “normal” range, he said.

Health Canada said the proposed changes to the program — which would include removing the rights of patients to grow their own supply of marijuana or to appoint designated growers, forcing users to get their pot from a licensed commercial producer instead — would make the program less complicated for seriously ill Canadians.

Paul Lewin begs to differ.

Doctors already are boycotting the program en masse, the Toronto lawyer said. Lewin said medical regulators and insurers sent letters to the government, “saying, ‘Don’t put us in charge, don’t make us a gatekeeper, we don’t know anything about pot, this is a plant product, it’s an unapproved drug.’ ”

Lewin said the court heard stories of how some doctors encouraged their patients to use pot for their pain. The patients would return, reporting that the marijuana was helping, that they were feeling less pain. But when they asked the doctors to sign their forms, “that’s when the mood changes,” Lewin said.

“That’s when they say, ‘Get out. I’m not risking my practice over you.’ ”

Lewin’s client, Matt Mernagh, started growing marijuana when he found it provided some relief from chronic pain and other symptoms of scoliosis, fibromyalgia and epilepsy. But he couldn’t get a licence to grow, because he couldn’t find a doctor to sign his declaration.

Police found Mernagh’s plants in 2008 when they were in his apartment building on an unrelated call. He was charged with production.

Lewin took the case to the Superior Court in Ontario. The court declared the federal medical marijuana program unconstitutional. The case is scheduled to go to the Court of Appeal for Ontario in March.

Lewin said the proposed changes to the marijuana access program are likely to scare off some of the few doctors willing to sign declarations, meaning “more seriously ill, law-abiding Canadians will be wrongfully treated as criminals” and subjected to humiliating arrests, medicine seizures and possibly even jailed, he said.

Ware said doctors need education and guidance. They would need to know whether patients who come seeking a licence for medical pot have been arrested for trafficking or diversion in the past. Abuses of the designated production licenses have occurred and Ware believes they should be phased out. But the consortium of cannabinoid researchers said that it’s not only easier and cheaper for patients to grow their own supply but the act of growing their own “medicine” may be therapeutic in itself. “It gives them a sense of control and ownership of their health and treatments.”

The following information was provided by Health Canada to Postmedia News:

In 2001, 727 doctors supported an application for an authorization to possess marijuana. In 2010, 3,187 doctors signed a declaration. Between Jan. 1 and Oct. 25, 3,803 doctors supported an application for an authorization to possess.

As of Sept. 30, 12,216 people in Canada held authorization to possess marijuana for medical purposes.

Who has authority to approve or reject submissions in the new system?

Under the proposed changes, patients would continue to consult with their physician in order to obtain access to marijuana for medical purposes. Once it has been determined that the use of marijuana for medical purposes is appropriate, the physician would provide the individual with a document. Health Canada is consulting the medical community on the form that this document would take.

Individuals would then send the physician’s document directly to a licensed commercial producer of their choice. The licensed producer would validate the document from the physician by confirming that the physician is licensed to practice medicine in Canada. The licensed producer would register the individual as a customer and would process the order for a specific amount of dried marijuana. Health Canada would maintain an up-to-date list of licensed producers on its website, and work with the medical community to disseminate this information as widely as possible. By By Sharon Kirkey. Source.

September 30th, 2011 – FERNDALE — When his cancer came back for a fifth time, Michael McShane was desperate for treatment outside of traditional medicine.

The last time squamous cell carcinoma left lumpy tumors around his mouth, doctors cut it away and reconstructed his bottom lip by turning out a portion of its inner layer.

“You can only do most facial tricks once,” McShane, 51, said. “I needed another option.”

As a qualifying medical marijuana patient, he tried “Simpson oil” derived from cannabis plants by a Canadian named Rick Simpson. McShane bought some from an Oak Park dispensary that has since closed and puts a few drops every day on his face. Over the course of about 10 weeks, the tumors faded and then seemed to disappear.

His dermatologist, Ali Moiin, M.D., has said McShane isn’t cured but his cancer cells have decreased by about 60 percent.

“You still have some residual ones, but the size has definitely decreased,” Dr. Moiin told a WWJ reporter in late August, adding he thinks the results merit further scientific study.

Moiin didn’t return phone calls for an interview for this story. He isn’t the doctor who signed the physician certification form for McShane, who has another qualifying medical problem.

In all, since the Michigan Medical Marijuana Program started in April 2009, 2,215 of the state’s licensed physicians have certified that a patient suffers from one of the debilitating conditions identified in the act, and that the patient may find therapeutic and palliative relief from the medical use of marijuana. A total of 105,458 patient registry cards have been issued in that time period.

An estimated 55 doctors signed 70 percent of the certification forms, according to one review; most of the others aren’t talking about it publicly.

“I imagine it is a fairly sensitive issue because it is politically charged,” said Colin Ford, director of state and federal government relations for the Michigan State Medical Society.

Physicians are cautious because patient privacy is important, he said.

A forbidden cure?

Privacy isn’t as important to McShane as sharing what he considers his latest triumph over cancer without surgery, radiation, chemotherapy, reconstructive surgery and their side effects.

“The marijuana oil replaced all that and reduced the cancer to almost nothing,” he said. “My forehead and mouth were in bad shape in the spring. All of a sudden one morning it was there — a callous-like growth the size of a half dollar on my forehead. Skin cancer is my regular nemesis.”

McShane is one of a growing number of people extolling the healing properties of Simpson oil for everything from cancer, AIDS, Crohn’s disease, osteoporosis, arthritis, and diabetes to psoriasis, hemorrhoids and warts. They call it a “forbidden cure,” saying the oil that can be used topically or ingested isn’t given enough credit because it would cut into medical and pharmaceutical profits.

“I’ve struggled with cancer for over 20 years and probably have spent over $1 million on conventional treatment,” McShane said, adding he was insured until his payments increased to $1,400 a month.

“I can’t believe what just wiping Simpson oil on my skin did for me. I spent a couple hundred dollars versus $100,000.”

Qualifying conditions

McShane is one of 3,119 patients certified in the state through Aug. 31 for using medical marijuana to treat cancer and its side effects.

“Severe and chronic pain is the most common box checked as a medical condition,” said Celeste Clarkson, manager of the Michigan Medical Marijuana Program, which is administered through the Department of Licensing and Regulatory Affairs.

The number of medical marijuana patients certified by doctors for severe and chronic pain totaled 99,304 through the end of August, when the latest figures were tallied.

The second most common box checked is muscle spasms for 31,779 registered patients, followed by severe nausea for 13,617 patients and then cancer for 3,119 patients.

In all, the state act defines 14 chronic or debilitating diseases, medical conditions, and side effects from treatments that qualify, including glaucoma, HIV/AIDS, hepatitis C, amyotrophic lateral sclerosis, Chrohn’s disease, agitation of Alzheimer’s disease, nail patella, Cachexia or wasting syndrome, and seizures.

The MMP has 21,000 applications are pending. The staff was increased from three at the onset to 25 employees. They have 15 days to approve or deny an application and then five calendar days to issue the medical marijuana card. It is taking months for patients to get their cards.

“We’re inundated,” Clarkson said. “The volume of applications is constant. We average 400-600 a day. We’ve received as many as just shy of 2,000 in one day. That was in March. Right now we’re issuing registration cards for new applications received in May.”

‘Now this is a mom’

Christiana Offerman, 36, of Sterling Heights is certified to use medical marijuana for severe and chronic pain. Fifteen years ago she was diagnosed with fibromyalgia, a disorder that causes widespread muscle and bone pain, fatigue and sleep and mood problems.

Offerman had been taking prescriptions of Vicodin as needed for pain, almost the highest dosage allowed of Neurontin for burning and stabbing pain, muscle relaxers, sleeping pills, and Ativan for the anxiety and depression caused by the stress of living with a painful incurable disorder.

The side effects of painkillers and muscle relaxers made it tough for the working mom to meet the needs of her two teenage children and respite care clients.

“I was lethargic and in bed, unable to respond,” Offerman said. “I was unbalanced, uncoordinated and very groggy. I wasn’t part of my kids’ lives.”

After she became a registered medical marijuana patient in late 2009, Offerman said she started using topical cannabis oil for nerve pains in her arm and burning pains in her back. She also smokes marijuana for “all-over body relief.” She said she has stopped taking five prescriptions, including Vicodin, Neurontin, Ativan and sleeping pills.

“It was relieving, liberating,” Offerman said. “I make dinner at dinner time. I go to school conferences, football games and dances. I’ve gotten to know my kids better. They are so happy. Now this is a mom.”

Changing attitudes

Offerman started outing herself as a medical marijuana patient in spring 2010 to educate the public.

“At first I didn’t tell people because I was ashamed,” she said. “My son is in marching band. I work for a health agency. There was a stigma, but contrary to popular opinions, we’re not all tie-dyed hippies who want to get high all day. We’re doctors, lawyers, moms and dads.”

Offerman said when people find out she uses medical marijuana they are curious and ask a lot of questions. Her employer has no problem with it.

“In their eyes, it’s not a drug; it’s a medical option,” she said. “As long as I have a card on file, it’s good with them. I have told my primary care physician, too. She couldn’t sign my paper work because she’s affiliated with a medical group, but she knows what prescription drugs I don’t need anymore and that I don’t get my blood drawn every six months anymore.”

Offerman and McShane said they are trying to change attitudes about medical marijuana one person at a time.

“I want to make it socially acceptable, something that warrants respect,” McShane said. “It’s here for a reason. God made it and we can turn it into something absolutely beautiful.”

Now that the dispensary where he got Simpson oil has closed, McShane is learning how to make it himself. He said he is a “conservative” caregiver for himself and four patients, keeping three plants in various growth stages so he can harvest some marijuana every couple weeks.

A caregiver can grow up to 12 plants for a qualifying patient and can assist up to five patients.

“I play by the rules,” McShane said. “I’m not cheating the electrical guy or anyone. I’m the caregiver model and I’m curing cancer on the side.” Source.