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New “Marihuana for Medical Purposes Regulations”: What do Doctors Need to Know?

Health Canada’s new regulations governing the use of marijuana for medical purposes come into force on April 1, 2014.

What this means for physicians:

  • You are not obligated to authorize the use of marijuana by patients.
  • The medical conditions and symptoms under which health care practitioners can support the use of marijuana for medical purposes have not changed.
  • You may be asked questions by your patients about the program changes.
  • Some provincial Colleges of Physicians and Surgeons are developing policy and practice standards specific to authorization of medical marijuana. Consult your College for more information regarding its policies and guidance.
  • The Canadian Medical Protective Association provides guidance on liability issues as they relate to medical marijuana.

The CMA position has not changed:

The CMA still believes there is insufficient scientific evidence available to support the use of marijuana for clinical purposes. It also believes there is insufficient evidence on clinical risks and benefits, including the proper dosage of marijuana to be used and on the potential interactions between this drug and other medications. The CMA will continue to urge that Health Canada support development of rigorous research on the effects, both positive and adverse, that the use of marijuana for medical purposes will have.

The CMA will continue to gather input from members on this issue. An education session will be held at CMA’s annual meeting of General Council, to discuss considerations involved in authorizing marijuana for medical use. This session will examine the issue from physician, patient and regulatory perspectives.

What this means for patients who had a valid Production Licence prior to the March 21, 2014 court ruling:

  • On March 21, 2014, the Federal Court issued a temporary injunction allowing patients who currently hold a valid Authorization to Possess (ATP) and Production Licence (PPL or DPL) to continue to possess and grow marijuana.
  • The injunction will last until a trial on the merits of the case is completed, likely within the next 9-12 months. We will update this site with new information as it becomes available.
  • No new/additional documentation is required from the physician.

What this means for new patients:

  • New regulations will apply in full to patients who did not hold a Production Licence on March 21, 2014.
  • Patients will only be able to purchase marijuana used for medical purposes through licensed producers and will not be able to grow their own supply.
  • To acquire marijuana for medical purposes, a patient will need a medical document signed by an authorized health care practitioner. Health Canada provides a sample medical document. It is the patient’s responsibility to register with a licensed provider.
  • Patients are no longer identified by condition; therefore there is no longer a requirement for an authorization from a specialist.

Frequently Asked Questions:

Question:Will patients need a new authorization on April 1st?
Answer:No. If patients have a valid authorization, they do not need a new one.

Question:What is the medical guidance on marijuana for clinical use?
Answer:As mentioned above, CMA believes that there has been insufficient scientific research or clinical assessment to provide definitive guidance on the use of marijuana for medical purposes. Health Canada’s Information for Health Care Professionals discusses the research and peer-reviewed literature to date, but this document is a research summary only and not practice guidance.

Question:Have the conditions for which one would prescribe marijuana for medical purposes expanded?
Answer:There has been no change to the conditions for which one would prescribe marijuana for medical purposes.

Question:How am I liable if I authorize marijuana for medical use for a patient? How am I liable if I do not authorize marijuana for medical use?
Answer:Consult the Canadian Medical Protective Association for information regarding physicians’ liability regarding medical marijuana.

Question:Where do I refer patients who are looking for a licensed producer of marijuana for medical purposes?
Answer:Health Canada has sole responsibility for licensing producers. A list of producers is available on Health Canada’s Web site, and patients should deal directly with the provider of their choice. If a patient has concerns regarding access, supply or pricing, these should be directed to Health Canada.

Question:What is the regulatory oversight for the use of marijuana for medical purposes?
Answer:Provincial Colleges of Physicians and Surgeons have regulatory oversight. Some are now developing policy and practice standards specific to authorization of medical marijuana. Consult your College for more information regarding their policies and guidance.
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