Pubdate: Sun, 31 Mar 2002 Source: Ajax/Pickering News Advertiser (CN ON) Copyright: 2002 Metroland Printing, Publishing, & Distributing, LTD Contact: http://www.durhamregion.com/ Details: http://www.mapinc.org/media/2104 Column: Health & Fitness - The Doctor Game Author: W. Gifford-Jones, M.D. Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada) DOCTORS SHOULD PRESCRIBE MARIJUANA TO THOSE WHO NEED IT I've been a medical journalist for 27 years. It's made me a terrible skeptic, but for good reasons. I've seen too many distortions of the truth in medicine. I've seen too many colleagues sit on the fence rather than take a stand on controversial issues. I've seen too many fight the use of painkillers when they could ease the agony of dying cancer patients. Above all else, I've seen too often a complete void of common sense. Now I'm seeing it again, patients who need marijuana to ease their suffering but can't obtain it. In July 2001, the federal government legalized the use of marijuana for terminally ill patients and from patients suffering from cancer, multiple sclerosis, spinal cord injury, AIDS, severe forms of arthritis and epilepsy. Marijuana alleviates severe nausea, persistent muscle spasm and seizures associated with these diseases. Marijuana can also be prescribed for other diseases when conventional medication failed. My initial reaction was, "Hallelujah." The government had finally taken a reasonable stance. But it didn't make the purchase of medical marijuana easy. It's not like picking up your prescription from your local pharmacy. Patient first must find a physician who will write a letter stating that marijuana is needed because conventional medication has failed. They must then write about themselves and their medical condition. They also have to indicate if they wish to grow their own supply or obtain it from a licensed dealer. This information, along with 2 passport-sized photographs, must be sent to Health Canada's Office of Cannabis Medical Access. But it appears the government has legalized a medication it doesn't possess. Sources tell me Health Canada is growing some in an abandoned mine which won't be available for a year. In the mean time patients have to get their marijuana from authorized "compassion clubs" (there are about 20 in Canada) which also require a Doctors letter. And huge parts of this country are without clubs. Even in good health this would be a tough assignment. But if you're nauseated or vomiting due to aids or chemotherapy, this process becomes a nightmare. The first major obstacle is obtaining a doctors letter. Since first initiating a study on this problem I've been contacted by numerous patients who can't find a family doctor or a specialist to sign on the dotted line. Physicians argue more research is needed to test the safety of marijuana. Yet a report from the Harvard Medical School says "one of marijuana's greatest advantages is its relative safety." Critics forget our so-called 'safe' drugs often cause drug reactions and sometimes death. Most drugs have a list as long as your arm of possible drug reactions. But to my knowledge, no one has ever died from an overdose of marijuana. Tests show that the ratio of marijuana needed to overdose to the point of intoxication is 40,000 to 1. By comparison, for alcohol it's 5 to 1 to 10 to 1! Opponents always mention 'the slippery slope theory,' that people will go from marijuana to a variety of illegal drugs. But this is a legal, political and law enforcement problem, not a medical one. Besides, patient suffering from these diseases are seldom 'slippery slope customers.' I can understand no doctor wants his office loaded with people seeking marijuana unjustifiably. But surely this shouldn't be a problem. It's easy to document which patients are receiving chemotherapy or suffer from multiple sclerosis or AIDS. Yet. I could not find a major cancer center in Toronto or neurologist who was prescribing marijuana. This issue reminds me of the battle I fought in the 1980s to get heroin legalized for terminal cancer patients. The facts of its benefits were documented. But I was fought all the way by the Canadian Cancer Society, cancer specialists, pharmacists, and the RCMP. There opposition was all due to political, moral and religious reasons. Like marijuana, heroin was not considered a 'nice drug.' Yet the British had been using it for 90 years to treat cancer patients, women in labor, heart attacks, and burned children with excellent results. I don't condone smoking marijuana for pleasure just as I'm appalled to see so many people still smoking tobacco. But I can't understand how any doctor could refuse to write a letter for those suffering from the terrible complications of AIDS and other diseases when marijuana can offer comfort. And surely there should be an easier way for patients to eventually obtain marijuana. The best route, I believe, would be a doctor's prescription to be filled at a pharmacy.