Medical marijuana could cut down on the use of addictive painkillers according to a new paper in the Canadian Journal of Public Health, but some of Vancouver's best known researchers say reluctant doctors and a confused federal government are failing to act.
"When it comes to prescription marijuana, patients' needs should be considered above political considerations," said study co-author Dr. Julio Montaner of the B.C. Centre for Excellence in HIV/AIDS. "There could be great harm in ignoring the medical uses of marijuana."
Study co-author Dr. Thomas Kerr says Canada is in the midst of an epidemic of opioid abuse and related overdose deaths, and that numerous studies have shown painkillers such as oxycontin are dangerous and prescribed too frequently.
At the same time there is strong evidence showing that prescription cannabis can be as effective in controlling pain in some cases, but with far less risk.
"If we can enhance access to medicinal cannabis for the right conditions it may have the positive effect of reducing prescription opioid misuse and the associated overdose epidemic," says Kerr.
Under Canada's current medical marijuana laws patients must obtain prescription cannabis from federally licensed producers, generally through the mail. There are currently 26 licensed producers listed on Health Canada's website.
Kerr says sending a prescription drug through the mail doesn't make sense.
"We would never do that in the case of treating someone with diabetes," he said.
The caution towards cannabis comes because it is illegal and because the federal government has been making up the science on the fly according to Kerr.
"It's unfortunate that the federal government has really failed to deliver an effective medical-cannabis program and it's
unfortunate that they've also misrepresented the science in this area," he said.
In response to the publication, the Canadian Medical Association released a statement saying there is a role for medical marijuana, but prescribing it remains a challenge under the current system.
Dr. Mark Ware of Montreal's McGill University Health Centre researches cannabis for pain and prescribes it to his patients. He considers it unrealistic to demand clinical trials for a drug that is already used to treat many conditions.
"I think it's just unreasonable to expect that kind of level of data to be produced," Ware said. "It sort of sets the whole thing up as an impossible target to meet."
Ware said if the CMA truly wants more confidence in prescribing cannabis, there are more than enough scientists in Canada eager to share their research, but the CMA should take the lead.