Regina Leader-Post

Medical associatio­n shouldn’t ignore cannabis

Physicians need training, guidance on medical pot, Adam Kassam writes.

- Adam Kassam is a freelance medical writer and senior resident physician in the Department of Physical Medicine and Rehabilita­tion at Western University.

The Canadian Medical Associatio­n (CMA) recently announced that it supports the eliminatio­n of the medical cannabis system once federal legalizati­on is implemente­d in October.

The rationale is “the lack of evidence, the lack of scientific studies showing it actually works, the lack of knowledge around dosing and interactio­ns with other medication­s.”

The CMA’S reservatio­n with cannabis as a safe and effective therapeuti­c option mirrors concerns within the medical community. Cannabis is known to be cognitivel­y impairing, and scientific research on its chronic use is limited.

It is also well establishe­d that cannabis may have deleteriou­s effects in the neurologic developmen­t of the central nervous system, which does not fully mature until 25 years of age. This uncertaint­y, combined with an aggressive timeline for legalized consumptio­n, has handcuffed health-care providers, who possess varying degrees of comfort with prescribin­g medicinal marijuana.

However, with its position, the CMA has not only demonstrat­ed its lack of willingnes­s to learn about this growing field, it has abandoned physicians who will invariably field more inquiries about cannabis from patients.

This is especially problemati­c given the growing scope of cannabis as a therapeuti­c option in conditions including epilepsy and spasticity.

Moreover, in the context of a national opioid crisis, cannabis is growing as an alternativ­e for chronic pain patients, and is recommende­d as a third-line medication according to the national pain guidelines.

Even more concerning is the emerging pattern among medical associatio­ns to be slow to evolve with the changing times.

For example, many were initially resistant to embrace social media and online dialogue, which allowed for the unfortunat­e proliferat­ion of medical misinforma­tion. Nowhere is this more exemplifie­d than with the antivaccin­e movement, which was given space to grow due to the void in evidence-based contributi­ons from the scientific community.

This lack of checks and balances is poised to repeat itself as a result of the reticence from Canada’s largest physician body.

The CMA has not only demonstrat­ed its lack of willingnes­s to learn about this growing field, it has abandoned physicians.

By removing itself from the conversati­on, physicians under the guidance of the CMA run the risk of letting the cannabis narrative be controlled by actors looking to maximize profit ahead of patient benefit.

The CMA recently came under fire for its sale of one of its crown-jewel assets, MD Management, to the tune of $2.5 billion.

CMA members, who do not collect any of the proceeds, criticized the organizati­on for not consulting them before closing the deal.

This eye-watering windfall is expected to further the institutio­n’s strategic vision, which includes improving physician wellness.

This is an important issue, and the CMA should use a portion of the MD Management revenue to create a free, continuing medical education program for physicians to learn about evidence-based research for new interventi­ons, including cannabis.

The Cannabis Act will represent the Trudeau government’s signature legislativ­e victory during its first term, despite expressed concerns from the medical community.

Ultimately, physicians need to be prepared for the new reality of legalizati­on, and the CMA would be wise to support its colleagues to tackle this issue head-on.

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