Talking To Your Doctor: Medical Cannabis
Dr. Robert Sealey and Dr. David Hepburn, general practitioners in British Columbia, see more Zoomers in their practice asking about medical cannabis than any other demographic. Most have never tried cannabis, even recreationally – or at least not in many years – but they have all been prescribed many other medications to help with various conditions.
“Their backs are up against the wall and they’re looking to get help with an alternative,” explains Sealey. We caught up with the doctors and asked them to share their knowledge and clinical experience with medical cannabis. Here’s what you should know for your discussion with your doctor.
1. You don’t have to get high to get help.
There are over 100 different compounds called cannabinoids in the cannabis plant. Many are non-psychoactive and don’t cause you to get “high.” It depends on the percentage of Delta-9-tetrahydrocannabinol or THC (the psychoactive component) and the percentage of Cannabidiol or CBD (the non-psychoactive component). Hepburn says, “The number one thing people are concerned about is that they don’t want to get high, they want to get help. And they can have it. For some cannabinoids, you can take massive doses and not have a single psychoactive effect. The art of taking cannabis is knowing what combination of cannabinoids is best for what condition.”
2. Start low and go slow.
When it comes to how much cannabis to take, Sealey and Hepburn advise starting low and going slow—just a little bit and the least amount necessary. They suggest beginning with one or two inhalations from a vaporizer. Patients can adjust the dosing and determine what works for them. A little bit goes a long way, so it’s not costly.
3. You don’t have to smoke it.
There are other delivery options for cannabis. Edible cannabis oils developed by licensed producers are now legal and will come to the market shortly. This delivery method is ideal for people who would have a challenge with vaporization, including children and those in palliative care.
4. Medical cannabis is legal.
Any physician in Canada can prescribe it.
5. Learn about your endocannabinoid system.
We all have cannabis in our bloodstreams. Our bodies produce a natural cannabis, and we have cannabinoid receptors scattered throughout the body—in the brain, the nervous system, tissues and organs. Medical cannabis works by harnessing this system.
6. The cannabis plant is safe and non-toxic.
Cannabis is safe because the endocannabinoid system has very few—if any—cannabinoid receptors in the brainstem (which regulates respiration and heart rate). On the other hand, the body’s opiate system has many opioid receptors in the brainstem. These receptors get bombarded when we use strong painkillers (opiates), and people can overdose. As Hepburn reassures, “Nobody has ever died from cannabis, so the safety profile of it is dramatic. The big three—safety, tolerability and efficacy—all address quite well here.”
7. Do your own research.
Sealey and Hepburn recommend Googling your condition and cannabis to find out what’s being done. Take one article to your doctor to open up the discussion. “Hopefully doctors are open-minded and humble enough to realize that we don’t know everything and that we continue to learn from patients, to listen to the patient,” says Hepburn. Medical evidence is growing quickly, with over 12,000 journal articles and robust clinical trials showing cannabis to be beneficial.
8. Medical cannabis is not a recreational drug.
It’s designed to be used as a medicine. The doctors separate medical cannabis from the recreational drug culture, steering clear of words like pot, weed and toke. Hepburn explains, “We don’t want you to translate that you’re going to take cannabis and suddenly you’re entering into the Cheech and Chong clinic of medicine.”
9. Licensed producers provide advice.
If your physician hasn’t prescribed medical cannabis before, they may not know which balance of cannabinoids and dose to prescribe. Licensed producers have pharmacists on call to give you and your doctor advice about strains and doses.
10. It may help your symptoms.
Pain, neurological conditions and psychiatric conditions are the top three prescribed uses of medical cannabis. These include fibromyalgia, arthritic and neuropathic pain; multiple sclerosis, epilepsy and headaches; and anxiety, post-traumatic stress disorder and insomnia. Sealey emphasizes, “Medical cannabis isn’t the number one treatment for necessarily anything. But it could fit in as a second- or third-line treatment when something else fails or there are intolerable side effects from the standard medications.”
CanniMed Ltd. is one of Canada’s licensed producers, and a CARP Recommended partner. To learn more about medical cannabis visit www.cannimed.ca/pages/CARP.