Docs warming to marijuana, though no definite reason why
By Gillian Slade on February 24, 2018.
gslade@medicinehatnews.com @MHNGillianSlade It is hard to pinpoint reasons for a large increase in the number of physicians authorizing the use of medical marijuana, but a local pain specialist has some theories. “Cannabinoids are showing great promise as medicines, especially in the myriad of non specific conditions like anxiety, insomnia, fatigue, mild to moderate pain, unhappiness, recurrent stress and dysphoria conditions which pharmacotherapy has offered little and doctors are ill equipped to treat,” said Dr. Gaylord Wardell, anesthesiologist and pain specialist, Sante Surgi, Medicine Hat. “Patients are dissatisfied with their doctors and their drugs.” In 2016 there were 329 physicians authorizing medical marijuana for about 5,300 patients, according to data from the Alberta College of Physicians and Surgeons. By April 2017 there were 500 physicians authorizing medical marijuana to about 10,000 patients. By May 2017, there were 527 physicians authorizing medical marijuana to 21,803 patients. Those numbers need some explanation because patients are authorized to receive medical marijuana for only one year at a time. That means the number of patients and the number of doctors is fluctuating constantly, said Kelly Eby, spokesperson for Alberta College of Physicians and Surgeons. It is difficult to determine whether the increasing numbers are an indication of physicians switching patients to medical marijuana instead of a prescription for opioids. “The new rules for opioid prescribing did not come in until April 2017, so while it’s possible the increase in MMP (medical marijuana authorization) is related to reduced opioid prescribing, there’s no direct proof.” said Eby. “The increase in MMP authorizations could simply be because it’s been legal for several years now and physicians feel more comfortable authorizing it for their patients.” The new rules included additional steps for physicians to follow before prescribing an opioid. However, in January 2017, a local doctor, speaking on condition of anonymity, told the News the college was already monitoring physicians prescribing opioids, and that some were “terrified” of prescribing opioids for that reason. Dr. Donovan Nunweiler, Southlands Medical Clinic, says he does not feel pressured by patients to prescribe medical marijuana. “I have encountered patients who have found a medical benefit and others who have been disappointed,” said Nunweiler. “It is not a magic cure for all. I suspect there will be pharmaceutical research with cannaniboids in the future.” Nunweiler is concerned about the number of people using marijuana, in particular, during pregnancy. Wardell says cannabis/marijuana is no panacea, but provided organized crime is kept out, it is far safer than other recreationals such as tobacco, alcohol and other medicinals such as aspirin-like drugs, antidepressants, antipsychotics, anticonvulsants, benzodiazepines, sleeping pills and legal opioids. Ordinary people may have the final say anyway. When marijuana becomes legal on the open market patients will use it and will reject those doctors who oppose it without valid scientific medical justification, said Wardell. “Despite their worst efforts, the College of Family Physicians, the Royal College, the Canadian Medical Association, the Canadian Medical Protective Association and the provincial licensing bodies for doctors will not be able to make cannabis go away,” said Wardell. Cannabis has been used as medicine for three thousand years and doctors should think twice before they vilify a plant with a long history of value to mankind, Wardell said. 20
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