Marijuana medicine and Canadian physicians: Challenges to meaningful drug policy reform

Abstract

There are modest indications of movement in the glacial reform of Canada’s marijuana prohibition. A sign of formal progress is the legal exemption for seriously ill medical users under Health Canada’s evolving Marihuana Medical Access Regulations (MMAR). Several hundred patients have now been approved through an application process that requires support from a medical practitioner or specialist. Physicians are constrained from complying with the MMAR by the highly conservative stance of the Canadian Medical Association (CMA), while the Canadian Medical Protective Association – the body that acts as legal advocates for doctors – maintains a view toward marijuana that, applied to any other drug, would make prescribing even the most routine therapies difficult. On the other hand, it is not clear that physicians really take much interest in their patients’ marijuana use. This article examines the conflict between patients who choose to self‐medicate with marijuana and the community that governs physicians in Canada. It draws on findings from two studies that, respectively, explore doctors’ views on marijuana and the experiences of patients who self‐medicate with cannabis. The inherent conservatism of the medical community – reinforced by lack of interest in how such use might benefit some patients – militates against more learning or widespread acceptance of the use of cannabis as medicine. Nonetheless, the authors argue, doctors ought not to perpetuate the ignoble tradition of ‘Don’t ask – Don’t tell’.