Doctors Backtracking on Cannabis Prescriptions?
One step forward and two steps back as Canadian Medical Association says they would rather member doctors did NOT prescribe cannabis after full legalization in October.
Success, they say, isn’t a straight line. That’s particularly true when it comes to cannabis legalization efforts. The latest news is that the Canadian Medical Association wants the country to ease off its medical cannabis laws to exclude doctors following recreational legalization on Oct. 17, 2018. It’s yet another sign that no amount of public support and forward momentum will make access to cannabis a sure thing.
The logic behind the CMA’s thinking goes like this: Many doctors feel uncomfortable making suggestions to their patients about cannabis usage. Once doctors are no longer gatekeepers that stand between suffering people and access to help, doctors shouldn’t be put in the position of advising patients on how to effectively use a substance that they don’t understand all that well.
Some members of the organization point to the lack of “sufficient evidence” of cannabis’ effects as reason enough for medical professionals to be wary. Others, no doubt, feel uncomfortable re-classifying a substance they grew up thinking was harmful. Other doctors have taken a more Libertarian bent, arguing that patients do not need to consult primary care providers before taking other kinds of over-the-counter remedies, like Advil or Benadryl, so why should cannabis be treated differently?
Those are all legitimate concerns, but they also completely ignore the complexity of the issue and fail to address the benefits of having a knowledgable physician prescribing cannabis.
If doctors cede their ground as medical professionals, where else should people look? Aren’t physicians supposed to help educate the general population about the current state of medical research—to guide their patients toward making educated decisions? If doctors deny their positions now, won’t they risk losing the trust of patients who desperately need guidance while also pushing cannabis—a plant that has very real effects on the human body and brain—into the realm of alternative medicine, essentially damning it to quackery?
To be sure, the full potential of cannabis is not understood. There are reams of evidence in the form of peer-reviewed studies showing correlations between cannabis use and pain relief, cancer abatement, mood enhancement, and aiding in management of auto-immune disorders. But, these studies are all relatively new and have yet to be repeated ad nauseum. And, while much is known about cannabis, there are real gaps in our understanding of the intricacies of cannabis interactions with the endocannabinoid system.
But medicine has never been an exact science. How many times have prescription drugs come onto the market only to be removed for causing severe side effects? According to the FDAs website, it happens all the time. In 2018 alone, recalls were issued for a very popular blood pressure medication called Valsartan because it contained a carcinogen that caused liver damage. Then there’s an antibiotic called Daptomycin used for life-threatening bacterial infections that causes infusion reactions, birth-control pills that were packaged out of order, a heart pump(!) and many more. And those are just the medications. A list that includes dietary supplements and herbal remedies would be much, much longer.
Clearly, doctors have felt comfortable prescribing other medications that have had unknown side effects (or severe, life-threatening side effects). And, while cannabis’ full powers may not be well understood, the potential drawbacks are certainly well documented. We know what THC and CBD can do to the body. The risk of problems is much less than newer, synthetic drugs. The worst-case scenario is that a patient may not feel good for a brief time; there’s zero chance of someone overdosing and dying from cannabis.
What’s more, doctors frequently prescribe over-the-counter medicine. Telling a patient to “take a couple Tylenol” if they feel pain is valid medical guidance that doctors provide on an everyday basis. Cannabis shouldn’t be treated differently just because of its legal status.
As to a doctors’ feelings of unease, well, there are ways around that. First, as doctors learn more about cannabis, they will become more comfortable with it. Legalization brings with it the promise of greater acceptance, which can in turn change minds. And doctors do not have to offer opinions—they’re free to refer patients to other doctors or hand out pamphlets of explanation.
The bottom line is that medical cannabis laws have real value to patients by expanding treatment options. They also hold value to drug manufacturers, whose research can help determine the track of cannabis medicine. And finally, the laws hold value for society by lessening the stigma for people who need medical assistance, but have been ill-served by other available options.
For all these reasons, medical cannabis laws are important and deserve to be protected.