More MS news articles for July 2001

Canada legalises the medical use of cannabis

BMJ 2001;323:68 ( 14 July )
David Spurgeon Quebec

From the end of this month, Canada will become the first country to allow the growth and use of marijuana for personal use by people with terminal illness and serious medical conditions.

Dr Judy Gomber, director general of the federal health department’s office of controlled substances, announced the new federal regulations, emphasising that the government was not encouraging the use of cannabis and would not provide it. It is, however, making it available under certain conditions for people who have found that conventional treatments do not work and whose doctors have decided that its medical benefits outweigh its risks.

But the past president of the Canadian Medical Association, Hugh Scully, said that the association does not support the move and believes it is premature for the health department to expand broadly the medical use of marijuana "before there is adequate scientific support." He thinks that most doctors will be reluctant to participate in the process devised by the Canadian government.

Under the new regulations, a doctor must sign the application form, but it is the patient who applies for permission to use the drug. Dr Gomber said: "It’s not an approved medical drug."

Three categories of patient can apply: those with a terminal illness and a life expectancy of less than 12 months; those with serious conditions such as multiple sclerosis, cancer, HIV or AIDS, severe arthritis, and epilepsy; and those who have obtained declarations from two medical specialists that marijuana would help them.

Approved applicants and marijuana growers will receive a photo identification card, specifying possession and production limits, to show police. An unspecified number of federal inspectors will also be employed. An estimated 400 000 Canadians already use marijuana for medical reasons.

The applicants may grow the plant themselves and designate a grower from whom they will obtain seeds, but growing marijuana is otherwise illegal in Canada, so just how this will be done is uncertain. Quantities will be limited to a 30 day supply at the designated dose, which will be set by the doctor.

Dr Gomber said that doctors and patients will have to collaborate to discuss dosage, but it is unclear how that will be set, given the vagaries of cannabis plants’ potency and the uncertainties surrounding its effectiveness. The federal health department, however, plans to issue a guide for doctors, presumably to help in this process.

The department also plans to carry out government sponsored clinical trials, which will receive free marijuana from its own provider, and has committed $C7.5m (£3.5m; $5m) over five years for research on the substance.

Two studies in last week’s issue of the BMJ cast doubt on the efficacy of cannabinoids (7 July, p 13, 16), and an editorial called for more research on their use (pp 2-3).

But Mary Lynch, director of research at the pain management unit of the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, said that the studies’ conclusions should be regarded with caution. Not enough human research had been done to draw any significant conclusions, she said, and she was "very enthusiastic about the future of cannabinoids."

She praised Canada’s approach to medicinal marijuana and said that it would help to make Canada a world leader in cannabinoids research.