Medical marijuana ‘free-for-all’ must end, B.C. doctor says

The head of B.C.’s medical association says the federal government is failing Canada’s doctors by not providing meaningful guidelines on how to talk to their patients about medical marijuana prescriptions in the absence of reliable clinical studies.

Bill Cavers says doctors across Canada are being bombarded with information on medical marijuana by the same companies producing the drug, a clear conflict of interest. Health Canada, which does not endorse medical marijuana’s use, should stop the practice, said Dr. Cavers, who wants an independent process to better educate medical professionals about the benefits and dangers of the drug.

Dr. Cavers, president of Doctors of BC, which represents the province’s 12,000 physicians, said the way the new system of medical marijuana regulation continues to roll out “is a free-for-all.”

“Here we have providers who have a vested interest in promoting the product being the ones to potentially train professionals in how to provide that product,” Dr. Cavers said. “That’s analogous to a pharmaceutical company training me in the use of their product.

“While it may provide me information, it’s not unbiased.”

Last year, the federal government overhauled its system of small licensed growers supplying themselves and other patients in favour of commercial-scale producers that can sell directly to people prescribed the drug.

The Canadian Medical Association has consistently opposed the new regime because its doctors are now forced to assess their patient’s treatment needs and prescribe set dosages, while under the old system they merely needed to verify that a patient had claimed they were benefiting from medicinal pot.

While doctors can prescribe pot like it is a pharmaceutical drug, there is a dearth of clinical evidence on the efficacy of the plant’s touted benefits and many simply don’t know enough about it to recommend it to patients. This is complicated by Health Canada refusing to approve marijuana as a drug or medicine, but being compelled to regulate it by the courts, which have ruled that Canadians must have reasonable access to medical cannabis.

Brian Kierans, a 30-year-old TV industry worker in Toronto, said his general practitioner was too uncomfortable with the new system to give him a prescription for his irritable bowel syndrome and instead signed a legal medical document clearing him to get a supply of cannabis at an illegal dispensary. He eventually secured a prescription from a doctor at a specialized medical marijuana clinic and now has bought from three licensed producers.

“The system that’s set up is set up to be as complicated as possible and, unfortunately, we’re all just caught in it,” Mr. Kierans said. “And we’re all just trying to do our best.”

Dr. Cavers said his association wants Health Canada to offer doctors simpler, much broader data and guidelines on medicinal cannabis. A Health Canada representative was unavailable to comment late Thursday, but pointed to the guide the department published for doctors last year.

The department stated it is actively looking into allegations of industry-wide kickback fees to doctors, clinics and patient groups for access to clients that were levelled earlier this week by Tilray, one of the largest licensed producers. But Dr. Cavers said Health Canada should also look into the ways doctors are learning about medicinal marijuana.

About a decade ago, the Canadian pharmaceutical industry faced stricter guidelines on how drug company representatives could contact medical professionals, Dr. Cavers said. That forced those drug companies to support conferences and events that invite professionals to discuss topics “that are pertinent to the drugs that they provide,” he added. Much of the information provided by growers could be very valuable, but it isn’t from an unbiased source, he said.

Greg Engel, CEO of Tilray, said in an interview with The Globe and Mail last week that his company’s representatives will exhibit at about 10 health care conferences this year. At those conferences, physicians looking for more information about the system can follow up with Tilray representatives, he said. Tilray also offers two online programs for medical professionals to educate themselves on the nuances of the medical marijuana system.

Tilray broke away from the industry’s main lobby group to form its own and establish a code of ethics prohibiting paying any kickbacks. That policy also states that its members ensure “transparency in the presentation of research and study results.”