As the federal government works towards the legalization of recreation marijuana, members of Canada’s medical community are still working out details on prescribing cannabis.
Medical cannabinoids include marijuana, as well as pharmaceutical products derived from the plant.
Dr. Michael Allan is the director of evidence-based medicine at the University of Alberta. He has been working with other medical professionals to develop new guidelines for doctors when it comes to prescribing marijuana-based medicines.
The Simplified Guideline for Prescribing Medical Cannabinoids in Primary Care, published last week in the medical journal Canadian Family Physician, says there is limited evidence to support the reported benefits of medical marijuana for many conditions.
“To make the right choices, or the best choices, by making some recommendations in general and then some specific details for the conditions where we have better research,” Allan told the Alberta Morning News.
“What the chances of getting a benefit from medical cannabinoids are, and what are the chances of having adverse events or side effects.”
Allan participated in creating the guidelines by performing clinical trials with random population samples, to create an evidence review on which recommendations can be based.
He hopes the guidelines will help doctors explain to patients why or why not they make a good candidate for medical cannabis, and also provide insight to those looking for treatment.
“It’ll also really help to show patients this is your chance of getting a benefit on this product, and this is your chance of having a side effect — and different types of side effects,” Allan explained. “That, I think, will go a long way to having a reasonable conversation for patients.”
However, Allan maintains there are many factors when deciding whether a treatment is right. He explained there may be plenty of examples of patients who, according to the guidelines, seem like excellent candidates — but combined with their medical history and their physician’s medical opinion, may not actually hit the mark.
“It certainly shouldn’t be seen as forcing people to behave or prescribe a certain way for the individual patient in front of you,” he said.
“As a clinician, when you’re sitting with your patient, you have to balance the patient, your expertise and experience, and the information and evidence in the guidelines.”
Allan also maintains research into the effectiveness of cannabinoids for specific conditions must continue. There simply are not enough studies in many cases to confidently say whether medical marijuana is right for a patient.
“One of the key issues that it’s used for is pain,” he said. “But the research in certain areas, like back pain, we only have one small study. In other types of arthritis pain, we don’t have near as much.”
Medical cannabinoids are often seen as an alternative treatment for opioids, and are currently mainly prescribed for pain management. However, Allan added there is definitive research that cannabinoids are not effective in cases of acute pain — such as a broken bone.
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