Thoughts on Medical Marijuana

In the coming days, the Cannabis Act will be passed by the Federal Government to legalize marijuana. Naturally, there has been an increased trend to patients asking about medical marijuana to treat their chronic conditions or ailments. The term “Medical Marijuana” has become a hot topic of late and medical marijuana clinics expect no shortage in clientele.

I have had several patients bring this item up as a first line treatment for their issues, before even discussing any of the more conventional options for treatment. Just last year, one of my patients was diagnosed with cancer. Within minutes of the diagnosis, he voiced his intention to use marijuana to ease his pain in the ensuing months.

One common patient perception is that medical marijuana is low-risk or risk-free because it’s ‘natural’. ‘Natural’ does not imply safe. For example, tobacco can be considered natural, as can cocaine, and even opioids including heroin. Most would agree that these are dangerous substances. Well known is the fact that we are facing an opioid epidemic in Canada. Some consider marijuana a safer alternative to opioid treatments. While this may be true, being less noxious does not make it innocuous. We need to keep this in mind.

The Alberta College of Family Physicians has recently summarized the medical evidence on potential harms. Their summary reads:

Compared to placebo, medical cannabinoids cause multiple different adverse events in patients, from visual disturbance or hypotension (1 in 3-10) to hallucinations or paranoia (1 in 20). Stopping due to adverse effects occurs in 1 in every 8-20 patients. Regardless of the type of medical cannabinoid used, adverse events are common and likely underestimated. Given the extensive harms, potential benefits must be impressive to warrant a trial of therapy.” – November 2017

At the time of writing of this piece, local radio ads are being aired in Calgary, warning individuals of the risks of driving while intoxicated. In the same realm of this conversation, Alberta driving legislation is being revised to include marijuana as an intoxicating substance. We still advise pregnant and nursing mothers to avoid marijuana use. These legislative recommendations do not reflect a substance that is completely risk-free.

The concept of using CBD oil is surfacing as a way to treat ailments effectively, without any inherent risk. Amidst all of the pro-marijuana momentum, the Alberta College of Family Physicians also recently released a bulletin indicating that “for most conditions, (example anxiety), cannabinoid evidence is sparse (at best), low quality and non-convincing.” – December 2017

For my patients with chronic conditions, I have yet to see CBD, THC, or a combination thereof, serve as a real game changer for the majority of patients. While improvement may be obtained from marijuana, patients should temper their expectations.

Altogether, marijuana is merely ANOTHER choice for treating SOME chronic conditions. It is not a panacea, magic-bullet or cure-all. It is one of many options.


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