GET READY TO DISPENSE POT, CANADA'S PHARMACISTS TOLD

Medicinal Marijuana Should Be Handled Like Any Other Drug, B.C. Expert Says.

Pharmacists across Canada should be preparing to dispense medicinal
marijuana, learning what information to give users about proper doses, side
effects and potential interactions, a pharmacist at the B.C. Cancer Agency
is advising professional colleagues.

Robin O'Brien, who also teaches pharmacy students at the University of
B.C., said she's not necessarily an advocate of medicinal marijuana, just a
pragmatist who believes that since the federal government is now
sanctioning marijuana use for certain ill people, it should hand over the
dispensing duties to professionals who can give patients "expert counselling."

On July 30, new Health Canada regulations will come into effect to protect
certain patients with chronic or terminal illnesses against
marijuana-related prosecution. Such patients may apply for permission to
grow, possess and use marijuana to relieve symptoms including pain, nausea
and poor appetite.

Once patients have proven they are eligible for marijuana, they have to
grow it themselves or find a designate to do it for them.

"But this unfairly puts the onus on patients to find the drug, a situation
that is lamentable considering some of these patients might be too frail to
grow their own or simply may not live long enough to harvest their own
crop," says the current Pharmacy Practice professional trade journal, which
published O'Brien's lengthy treatise on the pharmacokinetics, dynamics,
clinical effects, toxicity and other information on marijuana.

O'Brien said it is unrealistic to expect terminally ill people to suddenly
become gardeners and grow their own marijuana. "That's silly and
unworkable. How we can expect people with less than 12 months to live to
grow their own, or to know how to obtain good seeds and buds?" she said.

Hilary Black, spokeswoman for the Vancouver Compassion Club, a non-profit
organization that sells organically grown marijuana to registered users,
said she agrees the current plan for users to grow their own pot is
ill-advised.

"We don't expect people to make their own penicillin so why would we expect
them to do grow their own cannabis?"

She said she doesn't oppose pharmacists being allowed to dispense marijuana
as long as the government doesn't give them the exclusive rights to it.

"No one should have the monopoly on distribution and we want to protect the
right of people to access the whole plant and pharmacies won't be selling
that."

Health Canada spokeswoman Roslyn Tremblay said in an interview from Ottawa
Wednesday that the government has not yet figured out how it will
distribute the drug once it is cultivated in a government-appointed growing
operation situated in a former underground mine in Flin Flon, Man.

But she said pharmacists are not yet being considered as an option because
"we're only talking about something that is at the research stage."

"All the [touted] benefits of marijuana are purely anecdotal at this point
and we intend to spend five years researching it. So it's not a therapeutic
product yet," she said.

Nearly 300 Canadians have been granted permission to use marijuana for
medicinal reasons and next January, when that number is undoubtedly much
higher, the government and its subcontractor, Saskatoon-based Prairie Plant
Systems, will start shipping rolled marijuana cigarettes made in Flin Flon
to such people.

Tremblay said the distribution and shipping details have not yet been
worked out nor has the cost of the drug for those who purchase it from the
government.

"This is very much a new program with growing pains, there are no plans
yet, nothing carved in stone," she said.

Initially, the plant plans on cultivating 185 kg of marijuana in the first
year and 420 kg in the second year. The government is funding nearly $8
million in research projects and clinical trials. O'Brien said she and
Vancouver palliative care Dr. Romayne Gallagher have a proposal in mind for
one such trial.

Linda Lytle, registrar of the B.C. College of Physicians and Surgeons, said
she thinks it will be some time before people will be able to walk into a
London Drugs or Zeller's pharmacy to buy their medicinal marijuana.

"But if the federal regulations proceed in the direction they are moving, I
can envision marijuana being added to the list of controlled drugs and
substances, much the same as pain killers like demerol, codeine and
morphine," she said.

The new Health Canada regulations are coming into effect because of a legal
ruling in Ontario that declared Canada's marijuana laws unconstitutional.
The court gave the government until July 31 to establish a new regulatory
process allowing Canadians to use the drug for medical purposes when
conventional treatment has failed.

The regulations apply to people with less than a year to live; those
suffering from AIDS, cancer, multiple sclerosis, spinal cord injuries,
severe arthritis or epilepsy and any others who have been advised by two
medical specialists to use the herbal weed.

Applications must be signed by doctors who indicate the benefits of using
marijuana outweigh the risks, something many doctors have complained about
because there is an abundance of anecdotal evidence, but less scientific
proof of marijuana's therapeutic value.

O'Brien said many oncologists get asked by patients about the drug, so a
decade ago, she began researching what has been reported.

"The cancer information line refers calls here from people who have tried
it and found it to be useful for their nausea. They're tired of taking
pills and find that one or two puffs of marijuana is all that's needed for
relief of their chemotherapy-related nausea," she said.

She used to advise patients at the cancer agency who asked her about where
to get marijuana to ask their kids or grandchildren. But four years ago,
the Vancouver Compassion Club was formed in east Vancouver and since then,
she has referred patients there for more information.

The non-profit club, at Commercial and 14th Ave., sells organically grown
marijuana to registered users for anywhere from $4 to $10 a gram. About
1,500 people are current members, after having their doctors sign forms
attesting to their diagnosis and interest in the drug.

O'Brien said she hopes pharmaceutical companies can come up with a
medicinal form of marijuana that doesn't have to be smoked to prevent users
from the tar and risk of lung cancer.

While lung cancer is not as much of a concern for palliative patients,
there are people with chronic diseases, such as multiple sclerosis, who may
want to use the drug over a long period.

"I'd be very happy if someone developed a sublingual form a pill which
melts under the tongue," she said.