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B.C. doctors want clarity on prescribing medical marijuana

Clinical trials, tests urged so pot can be treated 'like any other pharmaceutical'
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Commercial production of medical marijuana is ramping up but physicians want better scientific evidence on when to prescribe it.

B.C. doctors want the federal government to clear the haze around when they can appropriately prescribe medical marijuana.

Dr. William Cunningham, past president of Doctors of B.C. (formerly the B.C. Medical Association), said Health Canada should fund in-depth studies to generate scientific evidence on the proper medical use of cannabis.

He said Ottawa has so far shown little interest in conducting clinical trials and tests to  clarify the key issues of concern to physicians – which patients should and should not use marijuana, what the correct dosage is, and what dangerous interactions might arise in combination with other medications.

"It would be much better if government studied it properly and it was treated like any other pharmaceutical agent," Cunningham said.

He spoke in response to the release this fall of preliminary guidelines by the College of Family Physicians of Canada.

The guidelines advise doctors to only authorize medical marijuana for patients with chronic nerve pain who haven't found relief through other treatments.

The college concluded medical pot isn't appropriate for people under 25, those with a history of psychosis or substance abuse, or for treatment of insomnia or anxiety.

The Arthritis Society has also called for research to determine if cannabis is effective in controlling arthritis pain and, if so, what's the best delivery method.

The society says large numbers of authorized medical marijuana users are arthritis sufferers.

B.C. doctors are under growing pressure from the public to prescribe pot but many have refused to do so due to concerns about liability and the lack of acceptable scientific evidence.

Other pot-friendly doctors actively court the medical marijuana business, some running web clinics that offer rapid approvals via video conference.

"That is a huge concern," Cunningham said. "I don't think anybody should be doing that by Skype or FaceTime without examining the patient."

Federal policy has put doctors in a very difficult position of being expected to prescribe a drug that is not authorized for therapeutic use, he added.

Nearly 40,000 Canadians are believed to use marijuana for medical purposes.

Commercial producers are building medical marijuana factories that Ottawa intends to make the sole legal sources.

But a court challenge of the new federal policy is expected to be heard next year and previously licensed users hope to retain their ability to grow their own marijuana.

Cunningham said Doctors of B.C. is also supporting the development of screening tools to detect drivers impaired by marijuana.