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Patients' Voices Must Be Heard In Cannabis Legalization Debate

The current debate and coverage focuses on legalization and regulation combining the interests of everyone from recreational users to growers to government. Without the interests of patients represented in this debate, we run the risk of establishing a future framework that is set up to fail and will require further modification.
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On Wednesday, Sept. 18, 2013, Frank, a marijuana caregiver who does not want to reveal his last name, holds up marijuana buds from plants he has grown for use as medical marijuana for legally approved patients. (Photo by Gordon Chibroski/Portland Press Herald via Getty Images)
Portland Press Herald via Getty Images
On Wednesday, Sept. 18, 2013, Frank, a marijuana caregiver who does not want to reveal his last name, holds up marijuana buds from plants he has grown for use as medical marijuana for legally approved patients. (Photo by Gordon Chibroski/Portland Press Herald via Getty Images)

A quick survey of recent headlines around the legalization discussion, even the federal task force's press conference, reveals a conspicuous absence: medical cannabis and the patients who rely on it.

The current debate and coverage focuses on legalization and regulation combining the interests of everyone from recreational users to growers to government. Without the interests of patients represented in this debate, we run the risk of establishing a future framework that is set up to fail and will require further modification.

The debate about cannabis legalization is complex and encompasses many different aspects from distribution models, to the rights of medical patients, from Canadian's right to freedom of choice, to large-scale commercialization. When the legalization conversation does include medical issues, much of the focus is on medical cannabis users and dispensaries and, more to the point, the quality of medicine available at dispensaries. Fundamental to this discussion are the interests of the 450,000 Canadians who use medical cannabis and how best to monitor medical cannabis to safely and effectively treat them.

To understand medical cannabis, it helps to understand the path to choosing it. Medical cannabis can be a last line of treatment for those who have unsuccessfully tried pharmaceuticals. When pharmaceuticals are successful, the side-effects of treatments -- for more than a dozen diseases classified by Health Canada eligible for medical cannabis -- can be especially intense and unbearable causing patients to either seek other options, or incorporate cannabis into their regimen to ease these symptoms.

For example, a person living with multiple sclerosis (MS) may change treatments three or more times because the side-effects are excruciating, including reoccurring hot flashes, tissue degradation, digestive problems or hair loss. On the other hand, patients may eschew pharmaceutical treatments altogether, opting for a more "natural" option -- as is their choice.

The medical industry works hard to ensure treatments are safe and effective, but sometimes the results are not optimal and another option is prescribed. Throughout the process, physicians look after patients' best interests.

We need to define a model for medical cannabis that puts patients first as well, and allows their physicians to provide the same level of care with cannabis as they do with other medications.

Prohibition has largely denied the medical community the chance to study the effects this plant has on the human body so we have quite a bit of catch up to do. Canada has a system in place called Marihuana for Medical Purposes Regulations (MMPR) that has created a starting point to treat patients.

The logical next step is enhancing patient care and improving the collaboration between clinics, doctors, licensed producers and Health Canada. Access is a great start, but it's not enough. Patients need more trained nurses and health professionals with the ability to guide patients in the right direction, to sup-port them on their journey to wellness with medical cannabis.

Lastly, understanding where your medication comes from and what exactly is in it is critical. While it's understandable that the current legal landscape discourages dispensaries from disclosing their sources, this is one thing that must change in order for us to progress toward medical standardization. If we are to treat medical cannabis as a true medicine, then we must adhere to the same rules and regulations that all medicine is subject to.

Regulating the source of the drug allows physicians and patients alike to study and better understand how their medicine works in concert with other pharmaceuticals, or with various conditions and lifestyles. Medical cannabis has different effects on different people and treatments must involve not only the medicine, but education around the medication, personalized treatment plans and regular follow-up care.

Patients are critical to the success of future legalization and regulation of marijuana in Canada, and specifically medical cannabis. The needs of 450,000 Canadians who depend on medical cannabis are the fundamental criteria that will guide and help shape a positive trajectory for the Federal Task led by Anne McLellan.

These patients' needs and experiences regarding medical cannabis must be represented and fully considered by the task force and government as they make decisions on regulations for a legal cannabis marketplace for both marijuana and medical cannabis.

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