DOUBTFUL DOCTORS

Since the current incarnation of Canada's medical marijuana program
was established, doctors have been forced by Health Canada to act as
sentinel for a product whose complexities, methods of delivery and
side effects they have little firsthand information-a situation that
leaves many physicians hesitant to sign their names to the documents
required for patients to access government pot.

"Our number one complaint is that patients can't find a doctor who
will endorse their MMAD application," says Eric Nash of Duncan's
Island Harvest.

However, physicians' reluctance often has more to do with the
bureaucratic reach of Health Canada than it does with their own
personal misgivings about prescribing a drug that remains in legal limbo.

The Canadian Medical Association is slowly coming around to
recognizing the valuable role medical cannabis can play in helping
users achieve a higher quality of life, but as recently as 2003
then-CMA president Dana Hanson said, "Physicians should not be the
gatekeeper for a substance for which we do not have adequate
scientific proof of safety or efficacy."

Observers say the CMA's regularly-parroted line rings hollow when
general practitioners regularly prescribe drugs with little more
knowledge than what they were told by representatives of the
pharmaceutical companies that manufacture them.

The Canadian Medical Protective Association, the organization that
insures 95 percent of Canada's physicians, continues to issue its
doctors a release form liability form that protects them from legal
action relating to a clients use of medical marijuana. No such
special form is required when prescribing addictive and dangerous
drugs like Valium and codeine.

South of the border-where the "war on drugs" drags on-the
124,000-member American College of Physicians released a January 2008
position paper that supports comprehensive research into the
therapeutic uses of medical marijuana.

It concludes, "Evidence not only supports the use of medical
marijuana in certain conditions but also suggests numerous
indications for cannabinoids. Additional research is needed to
further clarify the therapeutic value of cannabinoids and determine
optimal routes of administration."

In Canada, new government research on the therapeutic value of
medical marijuana will be a long time coming given the Harper
government's cancellation of the country's $4-million Medical
Marihuana Research Program in 2006.

The continuing prohibitionist view of the product by Health Canada
and its political masters necessitates a need to micromanage
distribution of the drug. It is this overt control that makes doctors
wary of becoming entangled in the bureaucracy that accompanies the MMAR.

Over the past few years, Health Canada has taken to phoning doctors
directly to question attempts to prescribe more than five daily grams
to a patient.

Physicians and patients alike see this as a gross invasion of their
privacy. It seems Health Canada may also be awakening to that fact.

In a March, 2007 correspondence obtained by Canadians for Safe Access
through an ATI request, MMAD division program manager Barry Jones
tells MMAD manager Ronald Denault, "I also feel that we may be going
more into the realm of influencing, rather than informing the renewals."

So Health Canada is now in the business of "influencing" physicians
about dosage levels (between one and three daily grams is MMAD's
recommendation) for a drug it claims to know too little about. In his
November 2007 letter to Victoria's Jason Wilcox, Denault writes, "The
use of dried marihuana for medical purposes has not yet been proven
scientifically."

Fortunately for chronically and terminally sick Canadians, the
country's physicians are not so ill-informed as to overlook the
benefits their patients derive from medical cannabis and often will
endorse compassion club applications.

"Doctors would rather sign a form for a quasi-legal, grey market
source like a compassion club, than get involved with Health Canada,"
says Vancouver Island Compassion Society's Philippe Lucas.