Editorial: Don’t pretend pot is harmless

If medical marijuana is a step toward legalization, just make it legal — or at least decriminalize it — and don’t dump it all on doctors. Making physicians the gatekeepers of legal marijuana is not fair to doctors and is not conducive to public health.

The problem is that marijuana has been prescribed by the courts, not by health-care professionals.

“Dried marijuana is not an approved drug or medicine in Canada,” says the Health Canada website. “The Government of Canada does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a physician.” Many physicians are reluctant to take on that responsibility.

“We have Health Canada telling us that marijuana is not a medicine, we have our malpractice insurance company telling us to be very cautious because nobody is taking responsibility for the safety of it,” says Dr. Chris Simpson, a Queen’s University cardiologist and incoming president of the Canadian Medical Association.

Simpson doesn’t dismiss marijuana — he says “many compelling anecdotes” indicate that marijuana can help patients with HIV, hard-to-treat seizures and other conditions. But, he adds, “we have people out there saying marijuana can cure cancer, which seems quite improbable.”

“Somewhere in between those two extremes is the truth, and I think we need to find the truth, and the way to do that is with the appropriate research.” Testifying before a parliamentary health committee in May, Dr. Meldon Kahan, medical director of the substance-use service at Women’s College Hospital in Toronto, detailed a long list of harmful effects from cannabis use. They included impairments in attention, increased anxieties, psychosis and cancer.

“Widespread cannabis prescribing by physicians will increase the social and psychiatric harms of cannabis,” Kahan said, calling for the development of evidence-based guidelines for prescribing smoked marijuana.

“Guidelines will give physicians solid grounds on which to make prescribing decisions. Physicians are facing a deluge of requests to prescribe cannabis, and guidelines will give them the support they need to refuse to prescribe cannabis when medically unnecessary or unsafe.”

Because Health Canada allows marijuana to be prescribed by physicians, that enhances the public perception that marijuana is not only harmless, but therapeutic.

“The evidence suggests otherwise,” Kahan said. “Smoked cannabis has negligible therapeutic benefits.” Would marijuana pass the scrutiny of the University of B.C.’s Therapeutics Initiative, established to examine the effectiveness of prescription drugs? It uses solid evidence and rigorous scientific research, and it has saved lives. Marijuana should undergo the same scrutiny as to its potential benefits and harms.

But medical marijuana is not treated the same as other drugs. Science has little to do with it.

“The current means of ‘prescribing’ violates all of the usual practices of medicine,” wrote Maryland psychiatrists Dinah Miller and Anette Hanson in a 2012 Baltimore Sun commentary. “What other medication do we authorize for a year, with no stipulation as to frequency, dose or certainty that there has been a positive response without side effects?”

If marijuana can relieve the agony of someone with severe chronic pain or terminal cancer, who would withhold it? But let’s face it, the biggest demand for pot is as a recreational drug, like alcohol and tobacco. It should be handled the same, with regulations as to its production and distribution. We should not clog our courts and jails with pot-smokers.

By all means, investigate its potential for good, but let’s not pretend it does no harm.

Source: http://www.timescolonist.com/opinion/editorials/editorial-don-t-pretend-pot-is-harmless-1.1304417#sthash.8ubjqn0w.dpuf 9th August 2014

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