BIG JUMP IN MEDICAL MARIJUANA APPLICANTS CITING ARTHRITIS PAIN

The federal government has seen a staggering increase in the number of
requests for medical marijuana authorizations from applicants claiming
they have severe arthritis to legally obtain the drug.

Applications to Health Canada based on severe arthritis claims jumped
2,400 per cent between 2008 and 2010, far outstripping the number of
claims for cancer, HIV/AIDS and other serious diseases, an Ottawa
Citizen analysis has found.

The spike in arthritis claims was part of an overall rise in
applications over the past three years, as more private clinics
specializing in marijuana began referring patients to pot-friendly
doctors willing to sign their forms.

But unless there has been an enormous, undocumented surge in arthritis
rates in Canada over the past three years, the data suggests that
patients or their doctors may be gaming the government's rules to
obtain medical marijuana more easily.

Arthritis was listed as the reason for 40 per cent of all applications
under the Marihuana Medical Access Regulations (MMAR) received so far
in 2011. That was double the rate seen in 2008, according to
electronic records released to the Citizen under the Access to
Information Act.

Severe arthritis is one of the Category 1 illnesses that require
patients to obtain the signature of just a single doctor under Health
Canada rules. Cancer, multiple sclerosis, HIV/AIDS infections and
spinal cord injuries and disease and are also listed in Category 1,
but often have more obvious visible symptoms than arthritis.

Patients with other Category 2 illnesses such as hepatitis, glaucoma
or ulcerative colitis must go through the additional step of getting a
specialist to sign their applications, a process that can take many
months and does not always succeed.

Some marijuana advocates believe that patients are asking doctors to
sign off on the faster Category 1 condition of severe arthritis to
speed their applications.

"I think a lot of people are applying under arthritis even if they may
have a different condition," says Scott Gilbert, who runs the Hamilton
Medical Marijuana Centre. "They are going with whatever is the easier
one to get approved on."

Although a patient might otherwise qualify for authorization based on
a Category 2 illness such as fibromyalgia or Crohn's disease, a savvy
doctor familiar with the MMAR program might ask if the patient also
has arthritis, too.

Health Canada is conducting a review of MMAR and plans to overhaul the
way the program works, in part by transferring more authority to
doctors. The department says it is required to approve applications
that have been signed by a doctor and meet the conditions of the MMAR.
It has noticed the sharp increase in marijuana applications but
doesn't know why, exactly, the numbers are rising so sharply.

"Increasing awareness of the program among patient groups and treating
physicians is likely a key contributing factor," said Health Canada
spokesman Gary Holub in an email.

The department is also aware of the increase in arthritis claims,
Holub said.

"The risk of abuse exists within the current system. That's why
changes are being proposed that will balance the legitimate needs of
patients, while reducing the risk of abuse."

Patients often complain that the refusal of doctors to approve their
applications is the greatest obstacle to entering the program. But the
surging number of applications suggest they are finding other ways to
get approved.

Many privately run clinics are sprouting up across the country, with
in-house physicians to sign the 33-page Health Canada application form
or provide referrals to doctors who are willing.

The Do No Harm Clinic in Kelowna, B.C., for example, has helped
process applications for more than 500 patients over the past two
years. It serves patients who have been unable to find a doctor to
sign their forms and will provide a physician to consult with patients
anywhere in the country over the Internet.

A doctor who works at the clinic agreed to speak to the Citizen about
his practice on the condition he not be named, as he does not want to
be deluged with requests from potential patients. The Citizen
confirmed his identity.

"Medical marijuana is not a prescription," he said. "I don't have to
touch the patient to see they have cancer."

But he said he will not list severe arthritis or other illness on the
application unless the patient can produce documentation of the
disease provided by a specialist.

"We would make sure you've seen a specialist," he said. "If you have
severe arthritis, are you telling me you wouldn't have seen a
rheumatologist?"