Pot: Reservations from the Medical Perspective

"It's interesting that [the results were] so polarized."
"The other interesting thing is that regionally, we didn't notice any significant differences. That level of support, that level of opposition was relatively consistent across the country."
"Those that supported legalization tend to view recreational cannabis as a viable treatment option."
Rahim Shah, vice-president, client services, MD Analytics

"There are other treatments we know well, are well-studied and we know how to give them."
"We don't know that about cannabis."
Dr. Eric Cadesky, president, Doctors of British Columbia

Inside the cannabis greenhouse at Pure Sunfarms in Delta on Aug. 1. Arlen Redekop / PNG

The medical and pharmaceutical marketing research firm, MD Analytics conducted a survey just recently of family physicians in Canada, in anticipation of the looming October 17 deadline for federal legalization of recreational cannabis. And what the survey revealed is that there remains a deep division among the Canadian medical establishment on whether the legalization, on the cusp of becoming reality, with be a positive or a negative change for Canadian health outlooks.

It would appear from the conclusions of the survey that 47 percent of general practitioners in the country firmly oppose legalization, 32 percent of family doctors support it and 21 percent have a neutral attitude. The survey of 235 family doctors by MD Analytics is, on the basis of the results, indication that legalization is not a universally approved move by the federal government, on the part of medical professionals.

The Canadian Medical Association's attitude toward legalization, expressing its concern to the government made it clear both to legislators and the medical community that they view the change in the law with great unease and no little amount of trepidation. The CMA urged the government to adopt a "broad, public-health policy" approach. That sentiment, originally expressed in a 2016 submission to the federal task force on legalization did not criticize the legislation directly, but expressed concern over the results and urged government to be prepared to respond to fallout from the legislation.

In January of this year, the Canadian Medical Association repeated its concern and recommendations to Health Canada on the implementation of Bill C-45. The potential health effects linked to marijuana, and which the CMA outlined to both the government and Health Canada range from marijuana health effects in smoked form; addiction; cardiovascular and pulmonary illness; all the way to mental illness, psychosis in particular.

Dr. Cadesky recommends that the "top priority" of the medical community in response to the reality that many already use cannabis for medical reasons, mandates that patient safety be top of mind. Much of doctors' concerns relate to unknowns involved in constant cannabis use. What doctors do know, however is the possible damage that can be the outcome of cannabis on developing brains, at the same time that they haven't much data on best practice prescribing of the drug.

Doctors, urged family physician Dr. Cadesky, must acquire more knowledge relating to the therapeutic benefits of cannabis, along with its potential harms, inclusive of smoking cannabis and the resulting risks. Dr. Shah points out that his company's survey pinpoints fears raised by the CMA of the drug's abuse and the related expectation that doctors will come across increasing numbers of patients with mental health concerns.

Legalization led 88 percent of the family doctors opposed, to anticipate an increase in patient visits stemming from dependence, compared with 48 percent among doctors who support legalization who also expect that fewer patients will ask for prescriptions while patients begin to experiment with substituting prescription drugs with cannabis under the freedom of availability. In the same token 60 percent of physicians in support of legalization anticipate fewer visits from patients asking for prescription medication for anxiety or stress.

Of that number as well, 43 percent feel there will be a diminished number of patient visits to obtain drugs for chronic pain, as well as 41 percent expecting that fewer patients will be seeking out medications related to panic attacks. In other words, patients will feel freer to 'self-medicate' with the legal availability of recreational marijuana.

Medical marijuana is shown with its packaging label in Toronto. More Canadian physicians oppose legalizing recreational pot than support it, according to a nationwide survey. Graeme Roy / THE CANADIAN PRESS