On Oct. 17, 2018, Bill C-45, otherwise known as the Cannabis Act, became effective, leading to the legalization of cannabis across Canada.
The Canadian Medical Association (CMA), the voice of Canada’s doctors, has always stressed the importance of taking a broad public health approach when it comes to cannabis legalization. Reducing potential harm to Canadians should be the top priority for all governments and health care providers. In the last couple of years, it became clear that there was no question of whether legalization was going to happen —so what mattered was how we approached this change in our society.
A public health approach to cannabis must focus on:
• preventing drug dependence and addiction;
• increasing availability of assessment, counselling and treatment services for those who wish to stop using; and
• increasing the safety of those who are using through harm reduction programs and awareness.
The CMA has also endorsed the Lower-Risk Cannabis Use Guidelines, which provide guidance on how to minimize the risk of consuming cannabis if people choose to do so. We continue to remind Canadians that just because it’s legal, doesn’t mean it’s safe.
There are other questions to consider. The CMA remains concerned about the lack of clinical research, guidance and regulatory oversight for cannabis as a potential medical intervention. Over the years, physicians have been put in the position of gatekeepers for a substance that has not undergone regulatory review processes required for all other prescription medicines. These processes are designed to protect patients and to provide critical information to prescribing physicians, such as clinical indications, dosages and potential interactions with other medications. This information is currently not available for cannabis, which is why many Canadian physicians feel uncomfortable in authorizing it for usage or recommending it for specific clinical purposes. Physicians are trained scientists who rely on scientific evidence to inform their decision-making.
In this new reality of cannabis legalization, it is vital to monitor how the health landscape will change and determine what further action is needed to protect the safety of Canadians. We continue to urge the federal government to invest in funding for independent research to assess the impact of cannabis on health, to increase access to assessment, counselling and treatment services for those with cannabis use disorders, and to continue public awareness campaigns to educate the public, and in particular youth and young adults, on the health risks of cannabis. Until we have all the information we need, we’ll continue to work with patients directly to provide them with the best care possible.
Dr. F. Gigi Osler is President of the Canadian Medical Association, the first female surgeon to take over the post. A passionate advocate for physician health, she co-chaired the 2015 Canadian Conference on physician Health and serves as chair of the Physician Health and Wellness Committee for Doctors Manitoba. The committee oversees the Physician and Family Support program and creates events to promote physician wellness. In 2017, she was awarded their Health or Safety Promotion Award in recognition of her efforts to develop and implement programs to support the health and well-being of doctors. The daughter of a physician from India and a nurse from the Philippines, Dr. Osler was born and raised in Winnipeg, Manitoba.
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