For over 18 years, I have been authorizing, managing and supervising patients in my practice with medical cannabis.  The reason I started this journey was because of a single persuasive individual who convinced me to take a chance and agree to support her choice to try cannabis under the newly regulated legal access program founded in 2001. At that time, this meant a mountain of paperwork that involved volumes of submitted evidence why this patient may be a suitable candidate for the use of cannabis for medical purposes. Since she suffered chronic back pain that was not responding to standard therapy, we had to write a submission which included relevant X-Rays and confirmation of a specialist’s opinion as well. Trying to convince another physician to provide a letter of recommendation for medical cannabis was one of a series of hurdles among the red tape that existed in the early years of legalization.

After 8 months of review of the documents along with a required passport photo, Health Canada in Ottawa finally approved my patient’s application and she became one of the very 1stmedical cannabis individuals in the Province of British Columbia. Once that designation was achieved, we managed to order her initial cannabis product from the only approved Licenced Producer at the time which back then was located in a secret underground location of an abandoned coal mine.  There was also no choice with regards to cannabis varieties…a patient was only allowed to access a single strain containing 9% THC and was expected to smoke it for possible benefit.

The good news is that my patient responded dramatically to the use of this alternative option and to my surprise was even able to return to work after a lengthy period of disability.  The even better news is that this convinced me to explore the possible benefits of medical cannabis in other individuals and opened my eyes to the mounting clinical evidence that was happening now that legalization allowed research into this area.

Over the past two decades, I have had the unique opportunity of managing over one thousand patients for a host of conditions using medical cannabis with variable success. Each patient has taught me something unique about this therapy and has made me more curious about how it might be helping alleviate specific symptoms.  With each passing year, there is more and more evidence-both anecdotally and clinically.

Because of my passion and interest along with the relative lack of medical education when it comes to cannabinoids, I have chosen to speak to as many doctors as I can in an effort to share my experience.  Along with health care professionals, I have presented over 500 medical cannabis talks to pharmacists, medical schools and a whole variety of organizations who are interested in learning more about this unique therapeutic option.

Not to say that it has been an easy journey…there were times along the way when I almost caved to the increasing pressures from my fellow colleagues and the College of Physicians and Surgeons who doubted the benefits of medical cannabis because of the lack of robust clinical research.  On more than a few occasions it was suggested that I should lose my medical license for what I was prescribing to patients as an option to mainstream medicine.

Thankfully, with the support of my patients and the positive experience I have gained over the years, I have persevered.  Now, some of the same physicians who questioned my clinical skills are referring patients to me for assistance in medical cannabis management. Although there still remains a relative paucity of research-based evidence, more doctors are becoming curious to the possibility that cannabis may be a viable option when there is an ineffective response or intolerable side effects to standard pharmaceuticals.

A big reason for this shift in thinking among health care professionals is because of patients themselves.  Patients are increasingly becoming their own health advocates armed with a wealth of information obtained from the world wide web.  However, the concern with some of the internet based advice is the potential spread of ‘mythinformation’ as well.  To that end, I envision a day when there is a consensus agreement among respected and reputable medical authorities to help navigate patients safely through the confusing network of information that is presently available.  As health care professionals, we should be providing that guidance to our patients if they choose the option of medical cannabis to help manage their condition.

However, at present, there is still only about 7 % of Canadian physicians who are knowledgeable or comfortable with authorizing a patient for medical cannabis.  Until there is formal education for doctors not only on the possible harms of cannabis but in the practical application for potential benefits, many patients will be left to their own devices to try and figure out how to treat themselves with the accompanying safety risks.

Nonetheless, Canada is one of the world leaders when it comes to the progressive use of cannabis and we have the opportunity to set an example for others to follow.

We now have over 200 choices when it comes to obtaining certified, quality controlled medical cannabis from Licenced Producers…and the variety of strengths along with the option to take it orally opens up a number of possibilities to use it for specific conditions in each individual.  Furthermore, the process of authorization has been reduced from several months to literally hours meaning accessibility is no longer a barrier for medical patients as long as there is physician acceptance.

So, although the journey at times felt like a salmon swimming upstream, the exhilaration when a patient responds to medical cannabis when nothing else seemed to work, keeps me battling the current

I can feel the tide turning…