Open Letter to Mark Emery, Canada's Prince of Pot

Open Letter to Mark Emery, Canada's Prince of Pot

Your efforts have helped raise public awareness of cannabis in Canada and abroad. There now is a meta-analysis in JAMA showing efficacy of cannabis to improve the symptoms of diseases for which medical doctors have no safe or effective treatment. There is no doubt that access to medical cannabis has social and health benefits. Cannabis is much safer than many conventional medications if it is used with vigilance under medical supervision as Mark Ware’s COMPASS study shows.

        

I agree with you that access to medical cannabis should not have barriers. However, a dispensary cannot take the place of a consultation with a medical doctor. People often say to me that my clinic will not be relevant when cannabis becomes legal. I do not concur.  Self- medication with cannabis can be just as harmful as self-medication with any other drug.

 

In medical conditions, where cannabis is indicated, patients have co-existing organ pathology, cardiovascular risks, unique pharmacologic considerations, undiagnosed diseases, and overlap with psychiatric illness. The person selling cannabis at dispensaries cannot address how to use cannabis in the most effective way for these patients.  As much as the marijuana should be easily accessible to patients, it should also be respected and treated as medicine. How can it be medical without input from a medical doctor?   

 

A patient who would like access to cannabis for his condition is vulnerable and can be exploited. Many dispensaries operate clubs that give medical users seeking access an opportunity for consultation with a doctor or nurse practitioner for a fee. My mother recently visited a dispensary and was informed she would have to pay $90 club fees and they will set up a consultation with a doctor. MMPR regulations do not permit doctors to charge additional fees for the purposes of accessing medical cannabis. There are no extra fees.

                  

During the Operation Claudia press conference an activist angrily asked police chief Saunders “where is the harm?” Do dispensaries let people smoke their medical cannabis, do they advise people of the risks of driving after taking their medication, do they educate about the risks of cannabis if taken during pregnancy or breast feeding. Do they dispense to people under 25 whose brains are still developing? And do they warn about the dark side of cannabis, the use disorder? There is no standard for how dispensaries label medical cannabis, a speculative THC or CBD content in the “medical cannabis” being sold.  And there is no quality control on products sold out of dispensaries, no protection again for the medically frail patient from pesticide, or biological contamination.

 

Mark, be patient. Cannabis will be legal for recreational use soon. Dispensaries are dispensable.

 

Dr. Andrew B Cooper MD MHSC FRCPC

Assistant Professor, University of Toronto, Faculty of Medicine, Department of Anesthesia

Medical Director, Caledon Medical Cannabinoid Clinic

16011 Airport Rd.,

Caledon East, Ontario L7C 1E7

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