Countless studies have shown the medical benefits of marijuana when prescribed under a medical professional for patients with conditions like chronic pain, multiple sclerosis, anxiety, insomnia, cancer symptom relief, among many others.
However, the medical cannabis system in Canada can be complex and intimidating to navigate for a novice patient who has only used the drug once or twice in his or her lifetime. It is for these patients that cannabis clinics can prove to be beneficial.
But with so many clinics popping up around the nation, what can a patient expect before starting their medical cannabis journey? The Puff Puff Post sat down with Daniel Fattah, who is the founder and managing director of the Cannabis Treatment Clinic (CTClinic), a medical cannabis clinic located in Thornhill, Ontario to give a walkthrough of the process.
1 – Referral through family physicians
Patients first usually reach out to their family physicians if they are interested in cannabis treatment. If the patient is a good candidate for the therapy, their physician would fill out a referral form indicating the patient’s medical history and faxes it to the clinic, similar to other referrals like a cardiologist or psychiatrist.
“We [at CTClinic] see patients via referral basis by family physicians and other clinicians that feel that cannabis might be beneficial for their patients as an alternative medicine,” says Fattah.
Candidacy is based on whether the patient is over the age of 25 as most physicians will not prescribe to patients under 25 due to research indicating the negative effects of cannabis on growing brains. The only exception would be in rare cases where a specialist concurs that cannabis would be beneficial, like in the case of children with epilepsy.
“[The 25-year-old cap] is only for medical, I’m sure the recreational market will go lower,” says Fattah.
“As with any other medication [physicians] are always careful with our pediatric and younger population, and cannabis is not excluded in this.
There is some concern that in the teenage years, cannabis with high THC causes slowing of the progression and development of the prefrontal cortex in the brain. The belief is that by age 25, the brain is fully developed.”
Another condition for candidacy is whether there has been a history of psychosis. Usually, doctors will not prescribe to a patient if they have issues with schizophrenia or hallucinations as studies say cannabis can exacerbate these symptoms.
Yet another reason why doctors will not prescribe cannabis is due to pregnancy or breastfeeding. Studies are showing that patients who use cannabis when pregnant can lead to slow growth of the fetus and can lead to mental disabilities as well.
There may be cases where good candidates are refused a referral by their general practitioners (GPs) who do not believe in cannabis treatment. For these patients, clinics like the CTClinic will still accept them as long as they can get supporting documentation from their GP supporting the condition they have.
“Patients can self-refer, and when they do, we contact their family physician, and personally talk to them to send us the documents. Usually, they are on board and our physicians then can assess,” says Fattah.
Supporting documentation can be anything from consult notes, to imaging (ie. MRI, x-rays, CT scans etc), or even prescriptions. As long as the clinic has something concrete to go by, many of them will book patients to be assessed by their own cannabis physicians within a few weeks. Fattah says his clinic will book patients in for an appointment within 5 days of receiving the referral.
2- Medical marijuana appointment at the clinic
When a patient enters a clinic, intake forms are filled out to paint a better picture of their condition. Consent forms are also signed since it relates legalities like doctor-patient confidentiality.
A urine sample may also be collected, depending on the clinic, to ensure the patient is not on conflicting substances which may impede a cannabis treatment.
During the appointment, the patient is assessed for vitals such as heart rate and blood pressure, and a physical is performed by a physician assistant. The patient’s entire medical history is collected to help assess the need for cannabis by the prescribing physician.
Most clinics now provide remote consultations, which means the doctor appears via a Skype-like program through the Ontario Telemedicine Network (OTN), a secure and private video portal. At the CTClinic, they have doctors who do both remote assessments and those who physically work in the clinic for the benefit of all patients.
Once the doctor assesses, he or she determines whether cannabis is a viable treatment for the patient. Usually, a prescription in the form of a Medical Document is filled out and faxed to a Licensed Producer (LP), who are like the pharmacies of the cannabis world. Usually, the doctor gives a three-month prescription so that an ample time can be given for a proper trial period to determine the risks and benefits of marijuana as a drug.
The visit usually includes a counseling or education session, where patients are taught about dosing and proper storage of their cannabis. The educator usually helps the patient register with an LP and fills out all the necessary forms for them in order for the patient to be able to access their medication.
3 – After the in-clinic appointment
Once the patient leaves the clinic, they will usually receive a shipment from the LP via Canada Post or Purolator within a week’s time. Patients are encouraged to follow the dosing provided to them by the clinic during the education session for optimal treatment.
If the patient has any concerns regarding their dosage, most clinics will have educators who will attend to their questions via telephone. At the CTClinic, Fattah’s team provides 24/7 support to their patients.
“We basically hold their hand throughout the whole process and ensure they are using their medication safely,” he says.