TORONTO -- Two medical groups weighed in Monday on the issue of medical marijuana, with the College of Family Physicians issuing guidelines to its members about which patients should and should not get prescriptions and the Arthritis Society calling for research to help doctors make those decisions.
College CEO Dr. Francine Lemire said the lack of research into cannabis has left many family doctors unsure about which patients could benefit from medical-grade weed and what dose should be prescribed.
"We're aware that there is demand out there by patients for dried cannabis for medical purposes," Lemire said from Ottawa. "We're aware of the relative lack of evidence, good solid evidence, for when to authorize or not to authorize (its use).
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Marijuana plant strains are held in jars as MediJean lab manager Abdul Ahad works in the research and tissue culture development lab at the medical marijuana facility in Richmond, B.C., on Friday March 21, 2014. (THE CANADIAN PRESS/Darryl Dyck)
"And we felt that it was important for us to share what evidence there is with physicians and to support them in how to prescribe."
The college's recommendations, which are spelled out on the organization's website, say there is no research evidence supporting the use of cannabis for low back pain or fibromyalgia, but it could be considered for nerve-damage pain caused by such conditions as multiple sclerosis, metastatic cancer, shingles, diabetic neuropathy and severe injury.
But even in the case of such pain-causing conditions, doctors should consider using medical pot only after trying standard medications and therapies, including pharmaceutical cannabinoids, the document says.
"Authorizations for dried cannabis should only be considered for patients with neuropathic pain that has failed to respond to standard treatments."
Before prescribing, the college advises doctors to conduct a pain assessment, assess patients for anxiety and mood disorders, and screen them for existing substance use disorders.
The guidelines say patients under 25, those with substance abuse, cardiovascular or respiratory disease, and women who are pregnant, planning to become pregnant or breastfeeding should not be prescribed medical marijuana.
When its use is considered appropriate, the family doctor should regularly monitor the patient's response to treatment and discontinue authorization for its use if the smokable herb is clearly ineffective or causing harm, the college said.
College of Family Physicians: Guidelines on prescribing medical marijuana
Read more: http://www.ctvnews.ca/health/calls-for-more-research-as-family-mds-given-advice-on-medical-marijuana-1.2029820#ixzz3El2SAFp7 |
