Doctors consider new rules
SASKATOON — Faced with a future in which doctors have the power to both prescribe and sell medicinal marijuana, the College of Physicians and Surgeons of Saskatchewan is contemplating what restrictions, if any, it should place on the province’s physicians.
Bryan Salte, the college’s lawyer and associate registrar, told the regulatory body’s governing council Friday that it needs a plan in light of Health Canada’s proposal to step away from deciding who has access to medicinal marijuana.
The Canadian Medical Association and the Federation of Medical Regulatory Authorities of Canada have spoken against the move, saying it’s unfair to ask doctors to decide who should get a substance that’s not wellresearched or understood.
“My assessment is that it really doesn’t make any difference what we said, those regulations will come into effect, and we deal with that reality,” Salte told the council Friday.
“We can cry against the wind all we like, but the impact will be that in the nottoo-distant future, the matter of prescribing marijuana will be solely between a physician and a patient.”
One problem with the changes — which were announced by the federal health minister in December and could take effect in 2014 — is how patients would get the drug, Salte said.
Patients can get it directly from a government-approved supplier, but doctors and pharmacists could also sell it to them, which puts doctors in a potential conflict of interest by both prescribing and selling the product. An unscrupulous physician could find a money-making opportunity there, he noted.
The college could ban Saskatchewan doctors from prescribing marijuana, but Salte said he doesn’t recommend it, because that would likely result in a successful charter rights legal challenge.
Salte said the college council must decide if it should create a set of expectations for doctors who are willing to prescribe marijuana. For instance, the college could require doctors to inform patients about the lack of scientific evidence about marijuana’s effectiveness before they leave with a prescription.
He also questioned whether doctors should have to take a training course before the college permits them to prescribe marijuana. The guidelines Health Canada has set for prescribing marijuana based on a patient’s diagnosis would disappear if the recommendations are adopted, Salte said.
Tracking marijuana prescriptions is another move the council should consider, said Salte. Currently, doctors’ prescribing habits for medicines like opiates and anti-anxiety drugs are recorded by the Prescription Review Program in an effort to prevent abuse and illegal trafficking of these addictive substances.
Salte advised the council to make a decision quickly and proactively, before the “horses will have left the barn.”
Council member and Regina orthopedic surgeon Dr. Alan Beggs said he has patients with back pain who both seek and use marijuana to manage their pain. Making a prescription onerous to get is “probably the best safeguard” against abuse, Beggs said.
The matter will be back before council at its next meeting in June.