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POLICY: MEDICAL MARIJUANA

The College of Physicians and Surgeons of Saskatchewan recognizes the necessity of the Federal Government to respond to the direction of the Ontario Court of Appeal in Parker v Regina in providing regulations governing the possession and production of marijuana for medical purposes.

The College supports evidence-based medicine. In the absence of scientific information that provides the grounds to support the medical use of marijuana for the conditions set out in the regulations is evidence-based, the College of Physicians and Surgeons of Saskatchewan is uncertain of the safety and efficacy of the medical use of marijuana.

The College would advise that physicians should not prescribe any drug for their patients without knowing the risks, benefits, potential complications, and drug interactions associated with this agent.

Physicians who decide to assist with the application process and prescribe marijuana should be aware that the College would expect adequate documentation to acknowledge that the patient has been informed that the study on this agent is incomplete, and that the long-term complications associated with chronic use are unknown. The College would also expect documentation clearly stating the reasons(s) for the decision to use this agent, and an inventory of drugs and procedures previously tried, and the reason(s) for their failure or inadequacy. Documentation should also include the risks, benefits, potential complications, drug interactions, and the plan for treatment and follow-up.

Under the Medical Marijuana Act, Regulations A, "a 'medical practitioner' is a person who is authorized under the laws of the province to practice medicine in that province and who is not named in a notice given under sections 8 or 59 of the Narcotic Control Regulations". A medical practitioner may support the application for a Category 1 condition. A "medical practitioner" for the purposes of completing this application is either a general practitioner or a specialist who specializes in the area of the medical condition, for example, an oncologist in the area of cancer treatment, a rheumatologist for severe arthritis, neurologist for spinal cord disease or epilepsy. A "specialist" means a medical practitioner who is recognized as a specialist by the medical licensing authority of the province in which the practitioner is authorized to practice medicine.

A medical practitioner may support the application for a Category 2 condition. An assessment of the case by a specialist is required if the medical practitioner is not already a specialist. The medical practitioner, if not a specialist, must declare that (1) the applicant's case has been assessed by a specialist; (2) the specialist's area of specialization is relevant to the treatment of the applicant's medical condition; (3) that the specialist concurs that the conventional treatments for the symptom are ineffective or medically inappropriate for the treatment of the applicant; and, (4) the specialist is aware that marijuana is being considered as an alternative treatment for the applicant.

The College would encourage physicians to access the Medical Use of Marijuana site at Health Canada to obtain a description of the medical conditions and symptoms for Categories 1 and 2, copies of the application forms, and for further information as necessary. Alternately, physicians may wish to contact the Marijuana Medical Access Division, Drug Strategy and Controlled Substances Program, AL: 3503B, Ottawa ON K1A 1B9.

Council, September 2005