HEALTH CANADA SET TO RELEASE USERS' MANUAL FOR MEDICAL MARIJUANA

Health Canada is set to release a user's manual this week for a drug
it has long opposed: marijuana.

The unprecedented move has been triggered by the courts, which
compelled Health Canada this month to begin distributing
government-certified marijuana to a group of patients who take the
substance to alleviate symptoms.

The department must also release a manual on how to use its dope - but
a draft version of the document shows patients will get little
practical advice about ingesting marijuana and lots of warnings
against using it at all.

"Administration by smoking is not recommended," says the 59-page
document, which is modelled on drug product monographs, standard for
approved medicines.

"Marijuana can produce physical and psychological dependence and has
the potential for abuse."

The March 30 draft document, obtained under the Access to Information
Act, warns that smoking marijuana can be more dangerous to the lungs
than tobacco, but provides patients no practical alternatives.

"We're not recommending, in fact, that marijuana be used," Suzanne
Desjardins, a Health Canada scientist who helped produce the manual,
said in an interview from Ottawa.

"It's a drug we don't recommend. If people want to use it, then we're
saying, well, don't use it by smoking it. . . . There's no study that
demonstrates (in) what form it should be used."

The manual specifically advises against administering marijuana to
children up to 16 years of age or to those 65 years or older because
"the potential for harm is likely to outweigh benefits." Nursing and
pregnant women are similarly urged to steer clear.

Users who do choose to smoke are warned that "smoking should be gentle
and should cease if the patient begins to feel disoriented or agitated
.. naive smokers should take great care and be supervised."

The document, headlined Information for Health Care Professionals,
warns of potential panic attacks, psychosis and convulsions in some
cases.

"If disturbing psychiatric symptoms occur at the prescribed dosage,
the patient should be closely observed in a quiet environment and
supportive measures, including reassurance, should be used."

Users are also advised that traces of marijuana remain in the urine
for weeks and may turn up in drug tests carried out by employers or
police.

Apart from brief sections citing scientific studies on taking
marijuana orally - baked in a chocolate cookie, for example - or
rectally as a suppository, the manual offers no techniques to avoid
smoking.

Experienced, health-conscious users have long turned to tinctures and
vaporizers as alternatives to smoking dope, which delivers the main
active ingredient, THC, quickly but can harm the lungs.

A doctor based in Berkeley, Calif., who uses marijuana or cannabis to
treat patients, posted his own user's manual on the Internet last
Friday, providing detailed advice on non-smoked forms of ingestion.

"For both efficiency and health reasons, I recommend to all my
patients that they set a goal of taking all (or almost all) of their
cannabis medicines in non-smoked forms, mostly using edibles and
drinkables, 'topping off' as necessary with vaporization," Dr. David
Hadorn wrote on his Web site (www.davidhadorn.com/cannabis/CM-guideline.htm).

Eric Nash, a Health Canada-approved grower of medical marijuana,
provided his only customer with a vaporizer, which heats the substance
to release THC for inhaling without any burning.

"Vaporizers are very popular with medical users," he said from his
Duncan, B.C., home. Nash is one of 32 growers in Canada each licensed
to provide one approved medical user with marijuana.

Tinctures can be produced by soaking marijuana leaves and buds in
alcohol, which extracts the active ingredient. Drops of the tincture
can then be used in cooking or under the tongue.