The Globe and Mail reports on a Canadian doctor urging his fellow doctors to prescribe cannabis for pain to curb the rise in opioid overdoses. Dr. Kerr refers to five recent randomized control studies and two systematic reviews that showed medical marijuana helps relieve neuropathic pain.
He claims that evidence in favor of the therapeutic use of cannabis is stronger than other drugs used to treat the same conditions. He says that the studies also show that cannabis has a more favorable side-effect profile
Opioids such as oxycodone, hydromorphone and morphine, are being prescribed increasingly and are related to nearly half of the deaths caused by overdose in Canada. This country is second on the list of per capita consumers of opioids in the world.
Dr. Kerr, co-director of the B.C. Centre for Excellence in HIV/AIDS’s Urban Health Research Initiative says doctors are still highly opposed to prescribing medication not approved by Health Canada. He says opioids are killing people while there are no cases of mortality related to cannabis use. North America is in a public health emergency caused by opioid overdose deaths.
Doctors could cut down on these deaths if they prescribed medical marijuana as an alternative treatment for chronic pain. Research shows a drop of 25 per cent in states in the US in states that enacted marijuana laws.
He said medical marijuana has also proved to relieve spasm and “wasting” in HIV/AIDS patients and treats nausea and vomiting, caused by cancer chemotherapy, very effectively.
Doctors await Health Canada’s instructions
Medical marijuana is legal in Canada but the federal Conservative government does not condone use, stressing the danger it poses to young people and to public heath. They repeatedly go to court to restrict patients’ use and cannabis production saying it is not an approved drug.
The government notes that courts have ruled that patients should have access to medical marijuana, which is grown and distributed by a large network of federally licensed commercial producers.
Although doctors have the right to prescribe medical marijuana they are just not confident in their knowledge of the medication to feel safe doing so. They are waiting for Health Canada to give them guidelines on dosage, concentration and best practice for administering it.
Dr. Charles Webb, head of the association representing B.C.’s doctors, says he doesn’t think doctors stigmatize cannabis, as they have no problem with prescribing a synthetic marijuana drug, Nabilone. It is used for treating nausea in chemotherapy patients and has complied with regulatory requirements.
Cindy Forbes, president of the Canadian Medical Association wrote,
“The limited clinical evidence combined with very limited guidance for the therapeutic use of marijuana pose a challenge for physicians in providing the best care to patients”.
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The alternative: cannabis for pain
Ultimately it seems like patients should insist doctors prescribe cannabis for pain if they want to go that route. Alternatively they could use equally effective and legal hemp CBD oil, which they can easily obtain from their health store and which Dr. Kerr says is also effective as a remedy for pain.