Medical marijuana: Who is it good for?

Majority of medical marijuana customers at Gravenhurst dispensary age 50 to 70

MEDICAL MARIJUANA

By Samantha Beattie

MUSKOKA — If suddenly seized with paralysis, unable to speak and wracked with pain wasn’t enough, Gary Froude constantly felt strung out, hyper, high.

A cocktail of narcotics – oxycodone, hydromorphine, fentanyl and sleeping pills, to name a few — was prescribed to him after he succumbed to a mysterious virus in 2013. For two years he stayed in hospital, slowly regaining the ability to move his wrists and ankles, then to lift his knees. 

By the time Froude returned to his Port Carling home in June 2015, he knew he wanted out of the fog. 

“After two years on narcotics, I knew I didn’t want to be addicted to anything and wired all the time,” said Froude, still on a respirator and in a wheelchair, but able to talk again. “I wanted to know where ground zero was in my body and what was going on pain-wise.

My doctor certainly knew of medical marijuana, but prescribing it was a new concept." - Gary Froude

With his doctor’s assistance Froude began cutting back the fentanyl and then the hydromorphine. The pain, however, was substantial. His doctor’s solution was to prescribe Froude another type of opioid.

  

Reluctant, Froude asked to try an alternative pain treatment a hospital nurse had suggested he look into – medical marijuana. 

“My doctor said he didn’t know anything about it, but that he’d do some research,” he said. In the fall of 2015, Froude secured a marijuana prescription and began adding it to baked goods and meals.

Over time and with some tweaks to dosage, special brownies replaced the pills and patches. 

“I am now without any narcotic, sleeping pill or mood elevator,” Froude said. “The only other thing I’m taking right now, besides marijuana, is a neuropathic nerve treatment for the pain in my shoulders. 

“I’m still in a fair amount of pain, but I don’t feel dopey.”

Froude said he knows of only one other person in the region who also has a marijuana prescription.

She has multiple sclerosis. Three other people he’s acquainted with are trying to get a prescription, but it’s proving to be extremely difficult, he said.

“My doctor certainly knew of medical marijuana, but prescribing it was a new concept,” Froude said.

Right now in Canada it’s up for debate whether marijuana is an effective way to treat chronic pain or mental health issues. While physicians can prescribe marijuana for any medical reason, Health Canada has yet to review its safety or effectiveness, said the College of Family Physicians of Canada in a report.

“This situation puts family physicians in a difficult position: we are asked to authorize our patients’ access to a product with little evidence to support its use, and in the absence of regulatory oversight and approval,” the report said.

It does recommend physicians use marijuana as a treatment for patients suffering from neuropathic pain caused by conditions like multiple sclerosis or cancer, but only after all other pharmaceutical painkillers are tried.

Other instances when marijuana might be appropriate include boosting appetite and gaining weight in patients with HIV/AIDS, relieving pain from severe forms of arthritis, or preventing epileptic seizures, said Health Canada.

In Muskoka, the consensus from family physicians who responded to the question seems to be that prescribing marijuana is unnecessary, if not dangerous.

The Examiner contacted more than 85 doctors in Huntsville, Bracebridge, Gravenhurst and Port Carling who practice family medicine or prescribe pain medications post surgery. Only 17 responded.

One of those admitted to prescribing marijuana regularly, about half a dozen times in the past year.

“My rationale for prescribing is based on patient testimony that they feel better,” said the Huntsville doctor, who filled out the Examiner’s survey anonymously. “Who am I to say they don’t?”

The doctor prescribes marijuana when patients request it, or if the doctor finds out they’re using it illegally to control symptoms.

“I offer it to keep them legal,” the doctor said.

Three other doctors said if they do prescribe marijuana, it’s not very often.

At the Cottage Country Family Health Team in Gravenhurst, two patients have been prescribed it in the past year under “extreme circumstances where the only thing left to try is to relieve pain at end-of-life care,” a doctor said.

The remaining 13 respondents said they never prescribe marijuana.

General surgeon Dr. Rohit Gupta said he leaves the decision to family doctors.

Dr. Liang Liao at Bracebridge’s South Muskoka Medical Centre said, “Marijuana is currently being used by the majority of the population as a recreational drug, albeit legalized with a marijuana licence.”

  

None of the other doctors at that practice prescribe marijuana either.

Dr. Liao and a few other respondents listed the possible consequences of smoking, vapourizing or generally consuming marijuana.

“(Using marijuana) under the age of 21 increases the risk of developing schizophrenia and reduces IQ,” said Dr. Liao.

To the best of the College of Family Physicians’ knowledge, youth who smoke marijuana are at greater risk than adults to suffer from long-term cognitive impairment. The college strongly recommends doctors don’t prescribe marijuana to patients under the age of 25.

When it comes to schizophrenia, some studies have shown long-term marijuana use may increase the risk of triggering or making worse psychiatric and mood disorders, said Health Canada. These disorders include schizophrenia, psychosis, anxiety, depression and bipolar disorder.

Marijuana has also been deemed inappropriate for patients with addiction issues, or cardiovascular or respiratory diseases. It is also not an effective treatment for anxiety, depression, insomnia or low back pain.

Studies have shown people who smoke marijuana have a greater risk of lung, head and neck cancer.

As an emergency room family doctor put it, “Very little evidence so far of (effectiveness); very little safety data; more good studies are needed.”

For people like Froude, marijuana feels like a much better alternative to pharmaceutical painkillers.

So much so that instead of getting the government-subsidized, less-expensive prescriptions from the drugstore, Froude would rather pay hundreds of dollars a month, out of pocket, to take marijuana oil instead.

“Opiates are paid for by our health-care system, but I can take marijuana that works much better and keeps me feeling much cleaner,” said Froude. “I don’t get wired from it. I don’t get strung out from it.”

He’s not alone.

At the Green Rhino dispensary satellite location in Gravenhurst, Tony Theos sees people come in daily to inquire about and order medical marijuana. The majority of these customers are between 50 and 70 years old.

“You know times are changing when you get parents and elderly people realizing the health benefits of marijuana,” said Theos, who owns the tattoo shop Triple Sick Skin, where the satellite dispensary operates.

He helps connect people to marijuana products sold through the British Columbia-based company Green Rhino. Customers with marijuana prescriptions fill out applications, become members and can order different types of marijuana, which is mailed to their homes. 

“The program works well for those who truly need it,” said Theos. “Many, many, many people are very grateful for the opportunity to have access to these medicinal products.”

As soon as next year, marijuana could be legalized.

Health Minister Jane Philpott made the announcement at the United Nations General Assembly last week that federal legislation will be ready by spring 2017. 

“We will introduce legislation that ensures we keep marijuana out of the hands of children and profits out of the hands of criminals,” Philpott said.

At least two doctors in Muskoka are on board.

“Marijuana and for that matter all drugs should be regulated and legalized and addiction problems medicalized,” said one doctor.

Another said, “I would prefer marijuana be decriminalized because it puts less emphasis on physicians prescribing. Often right now it seems like a way for people using to obtain it legally, not for new medical treatment.”