Physicians in Canada should not be responsible for prescribing marijuana unless the federal government commits to ensuring that it is a prescription drug, states an editorial in CMAJ (Canadian Medical Association Journal).
Health Canada is proposing new regulations that will put the onus on doctors to provide authorization for their patients to take marijuana.
“The language is soothing and suggests that marijuana is a medicine, albeit one that needs special oversight like morphine and for which users may be seen as patients in certain circumstances,” writes Dr. John Fletcher, Editor-in-Chief, CMAJ. “It is but a small step from here to suggest that doctors should prescribe marijuana for medical indications.”
Although marijuana is pharmacologically active, it has not been approved as a pharmaceutical drug, which entails a rigorous evaluative and regulatory process, consistent formulation and safe delivery.
“Doctors are being asked to prescribe a dried leaf containing several compounds of unspecified potency, some of them active and none of them pure; smoking is an unreliable way to deliver a consistent dose, is probably harmful and no other medicine is administered this way; there is no evidence that those offering to supply marijuana understand how to deliver a consistent drug dose in a smoked product; and most important, marijuana has not undergone regulatory testing and approval as a medicine,” states Dr. Fletcher.
Dr. Fletcher notes that physicians should be involved; however, their role should be to determine that a patient meets government criteria to take medical marijuana, rather than deciding who should use it.
The federal government should work with pharmaceutical companies to develop marijuana as a prescription pharmaceutical through proper research and development.
“At the moment, marijuana is a herbal product and not a medicine. Doctors should not allow themselves to be lulled into prescribing it.”