Objections to medical cannabis ‘dead wrong’
College’s information outdated, says James Moir.
The Alberta College of Family Physicians (ACFP) recently published a statement reflecting their stance on medical cannabis, basically stating there is insufficient evidence to recommend it, and that adverse effects outweigh any benefits.
As a physician working in Edmonton’s only legitimate “physician-and-nurse-run” cannabinoid medical clinic, I must object strongly to this stance. I have an MD from the University of Alberta, with five years’ subspecialty training in anesthesiology and pain medicine, and have over 20 years clinical experience in this area. I have five years’ experience in perioperative medicine and extra training in cannabinoid medicine, which allows me to prescribe medical cannabis and work in the clinic, where I have been for the better part of a year.
The ACFP’s statement is simply dead wrong, and appears to be based on outdated information, and at least partially based on the ignorance and stigma associated with cannabinoid medicine, which pervades the lay public and medical profession alike.
There is a misconception that medical cannabis is “smoking pot,”and that “pot is pot.” Nothing could be further from the truth.
It is now known that humans produce natural cannabinoids that interact with receptors throughout the body.
The details of why we have this system and what it does naturally are still being unravelled, but it is becoming apparent that it is an important physiological system, intimately involved in perception, learning, regulation of nerve function, immunity and the inflammatory response.
There is solid evidence that these compounds are effective in chronic pain and muscle spasticity associated with diseases such as multiple sclerosis, Parkinson’s disease, spinal cord injuries, certain forms of epilepsy, wasting associated with chronic illness such as cancer, or AIDS, nausea associated with chemotherapy, and chronic anxiety states.
The adverse affects cited by the ACFP are misleading and inaccurate.
It is stated that these effects are common, and include anxiety, hallucinations, exacerbations of schizophrenia, and chronic bronchitis and COPD.
These effects can and do occur, but are by no means common. It is now known they are caused by THC, one of the many ingredients in cannabis, and only in very high doses. THC is the one cannabinoid that causes the marijuana high, and “street” cannabis contains very high levels of THC.
Medicinal cannabis contains nowhere near these THC levels, and the majority of clinical benefits can be obtained with no THC at all.
Addiction is a very complex subject, but suffice it to say that it is a separate physical brain disease, and people who have it are no more likely to use cannabis as their drug of choice than another drug, such as alcohol. While cannabis can potentially cause mild physical dependence, it is very uncommon. Cannabis withdrawal is much more of a concern for people using cannabis recreationally, not medically.
As with any medication, there are some people in whom cannabis is contraindicated such as schizophrenics, or people with a history of psychosis.
It is not prescribed to patients with these conditions.
Inhaling smoke of any kind is unhealthy. That is why smoking cannabis is never recommended in medicinal cannabis therapy.
There are now other options, such as vaporization, and oral ingestion in a variety of forms.
With people dying daily of opiate overdose and complications, medical cannabis presents a powerful weapon in the war on opiates.
At the cannabinoid clinic where I work, we have successfully weaned many patients with chronic pain and inflammatory conditions off opiates entirely, or drastically reduced their daily intake to safer levels. As an experienced physician, I will categorically state that the medicinal ingredients in cannabis are the safest known to medicine.
As a physician, I consider myself a scientist, and would never prescribe or endorse any therapy for which I did not feel there was adequate evidence.
I have seen no effort on the part of the press or professional associations such as the ACFP to critically and honestly examine this issue.
And that truly is a shame.