MARIJUANA DOES HELP CERTAIN PATIENTS

Re: MDs Should Not Encourage Pot Use, letter to the editor, March 2.

Dr. Meldon Kahan is correct to be concerned about cannabis and the
risk of psychotic symptoms. Studies reveal that the main increased
risk remains for teens and individuals with established psychotic
disorders. From the European Archives of Psychiatry (2009): "It is
likely that cannabis exposure is a component cause, that interacts
with other factors to 'cause' schizophrenia or a psychotic disorder,
but is neither necessary nor sufficient to do so alone." From the
International Journal of Drug Policy (2010): "The criteria for causal
association between cannabis and psychosis are supported by the cohort
studies reviewed, but the contentious issue of whether cannabis use
can cause serious psychotic disorders that would otherwise not have
occurred cannot be answered from the existing data."

What does this mean to doctors and medical cannabis patients? No
different than any other medical treatment: close monitoring for
benefits and side effects, compliance of dosing, negative risk
avoidance strategies. In other words: pick and choose your patients,
pick and choose your drug therapy, follow up regularly. It is science,
not unfounded fear, which should dictate the practice of medicine.

Dr. David Saul, Toronto.