When discussions of issues of sex work, drugs, and so on come up, it’s not uncommon for people to confuse the idea of legalization with decriminalisation.
It sounds like they should be the same thing. After all, if something is legal, then by definition it’s not criminal? But the difference in practice turns out to have major repercussions. Continue reading “Understanding Legalization versus Decriminalization using Marijuana”
Dear Doctors,
I understand. Marijuana, for all that it has been legalized, is still a controversial topic when it comes to its uses in medicine. It wasn’t that long ago that medical professionals feared reprisal for prescribing it, either from government bodies, law enforcement, or insurance companies. Despite all the mounting evidence suggesting its benefit in treating various conditions and its relative safety, it’s hard to overcome the conditioning of several years that viewed it as an illicit substance.
Even if you disagree with the use of marijuana, however, it is important that you educate yourself about it from reliable sources, and not just about the negatives either.
Why?
Because regardless of how you feel about it, I guarantee that you have patients who either use it or are exposed to it regularly. Ignoring for the moment the problems surrounding making your disapproval obvious making it more difficult for your patients to discuss their health, use, symptoms of concern, and so on; not being educated about marijuana on a medical level puts your patients at risk. Continue reading “Dear Doctors: Even if you Disapprove, You Need to Educate Yourself”
Scientists confirm that marijuana, whether medical or recreational, is safer than both alcohol and tobacco. One of the considerations that went into this statement has to do with the lethal dose determinations.
When it comes to determining the danger of various drugs, there is a need to compare the lethal dose to the standard dose. How much do you need to get high, versus how much will kill you. One of the dangers of addiction with a chemical tolerance component, has to do with the fact that a higher tolerance means a higher consumption. In the case of drugs with a low ration of needed to get high to lethal dose, increased consumption can mean higher fatalities due to what people call overdose.
Among one of the concerns regarding medical marijuana are the potential barriers to the use of this medication. In places, medical marijuana is still not legal, but even in places where it is, like Canada, there are still challenges that present themselves. While my experience is limited to Canada, I find that a lot of the barriers that exist remain the same. If you have experiences you would like to share, please feel free to include them in the comments.
Knowledge – Patient’s
One of the first and biggest barriers to medical marijuana is a lack of information as to how to go about getting a prescription. It used to be that you had to fill out a large complicated set of forms to be submitted to Health Canada. The application would then be handled by some bureaucratic process at which point you would be approved or denied.
In March 2014 the rules changed. Now, instead of filling out a Health Canada form, you fill out a form directly with your choice of dispensary. The Health Canada website provides you with a list of licensed dispensaries, and most of them have their forms available online.
The forms include two parts: personal information, and doctor prescription.
The prescription form has to be filled out by a medical doctor, and includes dosage information as well as the doctor’s office information.
The forms are mailed to the dispensary, which confirms that the doctor who filled out the prescription is properly licensed, and you become a registered patient.
Knowledge – Doctor’s
While patients are uninformed, so too are doctors. When I was first looking for a prescription, I asked my GI for it. He said no. I was surprised since he actually seemed supportive of my occasional use.
Over the next few months, whenever marijuana came up with other doctors like those at the ER, they recommended that I get a prescription. I was torn, doctors seemed supportive of the idea, but yet I seemed unable to get a prescription. Finally, I decided to bring it up with my GI again and ask why he was unwilling to give me one.
It turned out that my doctor was under the impression that a condition had to be fatal in order to allow for the use of medical marijuana. Even though he thought that pot would be beneficial for me, he believed he wasn’t allowed to prescribe it for me.
Other doctors are unaware of the current available research. I had one ER doctor believe that marijuana was counter-indicated for Crohn’s even though Crohn’s is one of the few conditions that have had studies confirming the benefit of marijuana.
Patients are not the only people being fed misinformation about medical marijuana. Doctors are just as likely to have mistaken ideas about its use, its addictive properties, and so forth. The new rule changes make doctors the gatekeepers to prescriptions, but no efforts have been made to properly educate them. This leaves it up to patients to educate them or find a sympathetic doctor.
Even those patients who are more knowledgeable in the effects and use of marijuana may find it difficult to find a sympathetic doctor. It is counterintuitive to most patients to push their doctors for explanations. Since there is the fear of being labeled a drug seeker, patients might also worry about seeming over-eager about the acquisition of a prescription.
