OTTAWA MDS WON'T HANDLE MARIJUANA

Despite Ontario Having Largest Number Of Federally Approved Users,
Doctors Are Cautious

Ontario leads Canada in the number of people who can legally smoke
medical marijuana, but the 240 certified users in the province are a
long way from having easy access to the drug despite the federal
government's new distribution plan.

The Canadian Medical Association and the Canadian Medical Protective
Association both remain adamantly opposed to the use of medical
marijuana and are telling doctors not to get involved in any aspect of
it.

"There is a possibility that if a physician acts as a distributor,
they might be sued if something goes wrong. We recommend they
shouldn't distribute marijuana unless they truly believe the benefits
outweigh the disadvantages," said Dr. Douglas Bell, managing director
of the protective association's physician services group.

In Ottawa, several doctors interviewed said they would refuse to
distribute marijuana if asked by the federal government. Most say the
medical benefits of marijuana are unproven, despite anecdotal evidence
from users who say it works wonders for them. They say doctors are not
in the business of distributing drugs, and the trouble involved in
keeping something whose medical benefits are dubious at best is not
worth it.

"Do I want to be a drug dealer? No. I have absolutely no interest in
distributing pot. I'll have people breaking into my clinic," said
family physician Dr. Joshua Abiscott.

"I am not going to do it," added Dr. Barry Dworkin, also a family
physician and assistant professor of family medicine at the University
of Ottawa.

"The general thing is doctors look at this and say 'I am not in the
marijuana business.' They are not comfortable in acting as government
distributors when they don't know what the actual effects are."

Dr. Dworkin says cesamet, a pill similar to marijuana, is as effective
for pain, nausea and vomiting and he doesn't understand why people
don't use it.

But Dr. Michael Yachnin, another family physician, says if he is
convinced marijuana will help a terminally ill patient, he will
distribute the drug.

"If I had a patient that I thought needed it and it had to come
through my office, I would distribute it," Dr. Yachnin said. "If it
would help people, why not?"

Those who use medical marijuana, or have family members who need it,
say the problem with the federal distribution plan is that most
doctors don't believe in the medicinal benefits of marijuana -- and in
Ottawa, it is hard to find a willing doctor to recommend its use.

Rick Reimer, a former Ottawa lawyer who got permission three years ago
to legally smoke marijuana because of multiple sclerosis, says the
specialist treating him refused to sign his form, forcing him to buy
the drug on the black market.

He got permission before the federal government introduced the
regulations now in effect, but he has only recently found a Pembroke
doctor who has signed his form and agreed to take delivery of the drug
from Health Canada.

Mr. Reimer says one answer to the problem is compassion centres --
clubs that sell marijuana to sick people. There are such centres in
B.C., Montreal and Toronto, but not in Ottawa. The problem, however,
is that people who run them are constantly harassed by the police, who
consider them lawbreakers.

"They are trying to provide marijuana for medical users, but the
trouble is they sometimes get busted," Mr. Reimer said.

Forced into action by an Ontario court deadline, federal Health
Minister Anne McLellan announced Wednesday a plan to supply marijuana
to chronically ill Canadians. The drug will be distributed by courier
to patients' doctors in pre-packaged 30-gram bags and limited to an
amount a physician says is required for a patient. The going price
will be $5 a gram. As well, the government will sell marijuana at $20
a packet of 30 seeds so sick people can grow on their own.

Jirina Vlk, a Health Canada spokeswoman, said the narcotic will not be
distributed to every doctor -- only those who have signed on and
support medical use of marijuana. She said of the 582 people who have
been certified to use marijuana legally, 240 are in Ontario, 95 in
B.C., 54 in Alberta and 49 in Quebec. The rest are spread out across
the remaining six provinces. Ms. Vlk said in Canada, 322 doctors have
signed on to the medicinal use of marijuana and of this, 136 are in
Ontario, 57 in B.C., 36 in Quebec and 29 in Alberta.

To be classified as a medical user of marijuana, a person applies to a
doctor, who must certify the drug is beneficial to the patient. The
doctor signs a form, including a controversial section that says he or
she agrees "the benefits to the applicant from the recommended use of
marijuana would outweigh any risks associated with that use."

It is this section that has aroused concern among doctors and the
Canadian Medical Protective Association, which provides insurance and
legal help for doctors facing malpractice suits.

To make such a commitment without any scientific evidence medical
marijuana works and has no long-term effects opens physicians to
lawsuits down the road.

Another section of the form requires physicians to affirm they have
considered the risks associated with higher doses, including risks to
the patient's "cardiovascular, pulmonary and immune systems and
psychomotor performance" as well as potential drug dependency -- and
have concluded that the benefits of using the drug outweigh the risks
associated with that dosage.

"Physicians are being asked to attest something as true when they
don't know that," the protective association's Dr. Bell said.

"We are advising doctors not to partake in this particular program
because we feel very strongly that this is a substance that we do not
have the proper evidence-based scientific studies to show its
effectiveness," added Dr. Dana Hanson, president of the Canadian
Medical Association.