March 24, 2015

The College of Physicians and Surgeons of Ontario Marijuana Policy

So this flitted by my Twitter feed and I read it and it bugged me and I started writing a Facebook status update about it but it got ridiculous so I’m posting it here.

physicians must specify on every prescription the quantity of dried marijuana to be dispensed to the patient as well as the percentage of THC it must contain.” Wow that is ignorant. As an example, I’ve been semi-sick every day for the last 2 weeks while smoking a strain that was 20% THC, today I switch to a different strain that only has 13% THC and I’ve felt the best I have in a long time. THC is only one factor and not necessarily the most important one.

The College also recommends that physicians who prescribe dried marijuana first require patients to sign a written treatment agreement.21 This agreement must contain, at minimum, a statement from the patient that they: will not seek dried marijuana from another physician or any other source; will only use dried marijuana as prescribed; will store their dried marijuana in a safe and secure manner; and will not sell or give away their dried marijuana. It is recommended that the treatment agreement contain a statement that if the agreement is breached, the physician may decide not to continue prescribing dried marijuana to the patient.” Oh okay, then we need to do that with vicodin, hydrocodone, tramadol, fentanyl, codeine, hydromorph etc etc etc then too because all of the above are far more abused, dangerous and for a lot of people, as chemically addictive and therefore hard to kick as heroin because that’s basically what most of those are.

The MMPR authorize both physicians and nurse practitioners to prescribe dried marijuana for medical purposes; however, to date the College of Nurses of Ontario has not permitted their members to prescribe.” This I was lukewarm on until I started clicking around…

From the CPSO policy page, I found this link, which was literally listed as how to deal with your patient when they disagree with you...which is, I guess, to feed them totally biased and even fabricated information from an article with a ridiculous conclusion?

The maximum recommended dose is 1 inhalation 4 times per day (approximately 400 mg per day) of dried cannabis containing 9% delta-9-tetrahydrocannabinol (level III evidence). Physicians should avoid referring patients to “cannabinoid” clinics (level III evidence).” The former sentence only proves that cannabinoid clinics are CLEARLY needed since most Ontario doctors *I* know, don’t have time to cram and become weed experts in time to properly meet the demands of what is estimated by our very own government to end up being be a HUGE market in the very near future. I don’t really blame some doctors for not wanting to be the gatekeepers of this, but the article I linked is garbage, if only because the studies they used were small samples for short periods of time. Every patient is different and there is lots of trial & error in the beginning because this is an herb with many variables, not a pharmaceutical. I literally thought the idea of a cannabinoid clinic was nothing but a money grab until I read this. Knowledgeable nurse practitioners working in cannabinoid clinics actually sounds like a good thing!

I could go through this article paragraph by paragraph, liiiiiike….”Cannabinoids have important acute and chronic cognitive effects (level II evidence). Acutely, smoked cannabis can cause perceptual distortions, cognitive impairment, and euphoria.8 [So what? So can hydromorph.] Chronic cannabis use is associated with persistent neuropsychological deficits, even after a period of abstinence.15 As long-term studies have been observational, causality cannot be definitively established. Nonetheless [this is an eraser word, like “but” – everything that comes after it is moot], these studies indicate that cannabis can have clinically important adverse effects; therefore, longterm prescribing should be undertaken with caution.“….but use critical thinking skills and listen to the language I highlighted. Oh, and “cannabis use disorder”, which they so eloquently shortened to “CUD”, is not actually a real disorder. Even their own footnoted sources do not mention the term “CUD” or use the word “disorder” in their titles and don’t you think if there were an honest to god DISORDER, like bipolar, like schizophrenia, that could be legit tied to weed and coined first, it would damn well be in the title of one of their supporting articles? At least ONE? As it stands in this article, that “disorder” is as good as completely made up. They offer zero support or proof and then they compare this “disorder” to studies on opioid addiction which is serious and requires very specific treatment, whereas if “CUD”, which has no listed criteria for diagnosis, is suspected you must stop use of marijuana immediately even…if….it’s…..helping.  Then they try and compare “CUD” to opioid addiction, which is just…why would you even think they are remotely the same? Who wrote this shit?

Research has demonstrated that pain patients who are addicted to prescription opioids experience marked improvements in pain, mood, and function when they discontinue
opioids and receive addiction treatment.23 While research on CUD and pain is lacking, we would expect similarly positive outcomes in pain patients who are successfully treated for CUD.” Like, why even include this? This isn’t even relevant or factual information. “We would expect”, uh, yeah…you would be wrong. Pineapples and bananas.

Further, our suggested maximum dose (400 mg per day) is lower than the average dose smoked by medical cannabis users (1 to 3 g per day).” Uh yeah, there’s a fucking reason for that. Everyone. Is. Differ. Ent. Yeah if you’re a 70 year old lady with arthritis pain and you’ve never had cannabis before, that’s a good place to START not MAXIMUM.

Anyway, like I said, it’s dumb. The actual arguments I would use against prescribing medical marijuana were glossed over in favour of the rest of that shit that made no sense. The agenda was so glaring, it was like watching a bad, cheap commercial that relied on a bad, cheap joke. Ugh.

Posted at 7:33 pm in: Cannabis , Health , Spring , Vaporizing

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