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Authorizing Cannabis for Medical Purposes

https://policybase.cma.ca/en/permalink/policy11514

Last Reviewed
2020-02-29
Date
2015-02-28
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
  1 document  
Policy Type
Policy document
Last Reviewed
2020-02-29
Date
2015-02-28
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Text
Authorizing Cannabis for Medical Purposes The legalization of cannabis for recreational purposes came into effect with the Cannabis Act in October 2018, and patients continue to have access to cannabis for therapeutic purposes. The Cannabis Regulations have replaced the Access to Cannabis for Medical Purposes Regulations. Patients can obtain cannabis for medical purposes when a physician or nurse practitioner provides a “medical document” , authorizing its use, and determining the daily dried cannabis dose in grams. With the authorization, patients have the choice whether to (a) buy directly from a federally licensed producer; (b) register with Health Canada to produce a limited amount for personal consumption; (c) designate someone to produce it for them; or (d) buy cannabis at provincial or territorial authorized retail outlets or online sales platforms, if above the legal age limit. While acknowledging the unique requirements of patients suffering from a terminal illness or chronic disease for which conventional therapies have not been effective and for whom cannabis may provide relief, physicians remain concerned about the serious lack of clinical research, guidance and regulatory oversight for cannabis as a medical treatment. There is insufficient clinical information on safety and efficacy for most therapeutic claims. There is little information around therapeutic and toxic dosages and knowledge on interactions with medications. Besides the need for appropriate research, health practitioners would benefit from unbiased, accredited educational modules and decision support tools based on the best available evidence. The Canadian Medical Association has consistently expressed concern with the role of gatekeeper that physicians have been asked to take as a result of court decisions. Physicians should not feel obligated to authorize cannabis for medical purposes. Physicians who choose to authorize cannabis for their patients must comply with their provincial or territorial regulatory College's relevant guideline or policy. They should also be familiar with regulations and guidance, particularly:
Health Canada’s Information for Health Care Practitioners – Medical Use of Cannabis (monograph, summary and daily dose fact sheet),
the Canadian Medical Protective Association’s guidance;
the College of Family Physicians of Canada’s preliminary guidance Authorizing Dried Cannabis for Chronic Pain or Anxiety; and
the Simplified guideline for prescribing medical cannabinoids in primary care, published in the Canadian Family Physician. The CMA recommends that physicians should:
Ensure that there is no conflict of interest, such as direct or indirect economic interest in a licensed cannabis producer or be involved in dispensing cannabis;
Treat the authorization as an insured service, similar to a prescription, and not charge patients or the licensed producer for this service;
Until such time as there is compelling evidence of its efficacy and safety for specific indications, consider authorizing cannabis only after conventional therapies are proven ineffective in treating patients’ conditions;
Have the necessary clinical knowledge to authorize cannabis for medical purposes;
Only authorize in the context of an established patient-physician relationship;
Assess the patient’s medical history, conduct a physical examination and assess for the risk of addiction and diversion, using available clinical support tools and tests;
Engage in a consent discussion with patients which includes information about the known benefits and adverse health effects of cannabis in its various forms (e.g., edibles), including the risk of impairment to activities such as driving and work;
Advise the patient regarding harm reduction strategies and the prevention of accidental exposure for children and other people;
Document all consent discussions in patients' medical records;
Reassess the patient on a regular basis for its effectiveness to address the medical condition for which cannabis was authorized, as well as for addiction and diversion, to support maintenance, adjustment or discontinuation of treatment; and
Record the authorization of cannabis for medical purposes similar to when prescribing a controlled medication. The Cannabis Regulations provide some consistency with many established provincial and territorial prescription monitoring programs for controlled substances. Licensed producers of cannabis for medical purposes are required to provide information to provincial and territorial medical licensing bodies upon request, including healthcare practitioner information, daily quantity of dried cannabis supported, period of use, date of document and basic patient information. The Minister of Health can also report physicians to their College should there be reasonable grounds that there has been a contravention of the Narcotic Control Regulations or the Cannabis Regulations. Approved by CMA Board February 2015 Latest update approved by CMA Board in February 2020

Documents

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National multidisciplinary knowledge-sharing network for precision medicine research

https://policybase.cma.ca/en/permalink/policy11619

Last Reviewed
2018-03-03
Date
2015-08-26
Topics
Ethics and medical professionalism
Physician practice/ compensation/ forms
Resolution
GC15-43
The Canadian Medical Association supports the development of a national multidisciplinary knowledge-sharing network for precision medicine research.
Policy Type
Policy resolution
Last Reviewed
2018-03-03
Date
2015-08-26
Topics
Ethics and medical professionalism
Physician practice/ compensation/ forms
Resolution
GC15-43
The Canadian Medical Association supports the development of a national multidisciplinary knowledge-sharing network for precision medicine research.
Text
The Canadian Medical Association supports the development of a national multidisciplinary knowledge-sharing network for precision medicine research.
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Precision medicine into clinical care

https://policybase.cma.ca/en/permalink/policy11663

Last Reviewed
2018-03-03
Date
2015-08-26
Topics
Health systems, system funding and performance
Physician practice/ compensation/ forms
Resolution
GC15-84
The Canadian Medical Association supports the development of a national strategy to integrate precision medicine into clinical care.
Policy Type
Policy resolution
Last Reviewed
2018-03-03
Date
2015-08-26
Topics
Health systems, system funding and performance
Physician practice/ compensation/ forms
Resolution
GC15-84
The Canadian Medical Association supports the development of a national strategy to integrate precision medicine into clinical care.
Text
The Canadian Medical Association supports the development of a national strategy to integrate precision medicine into clinical care.
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Around-the-clock services for frail and elderly Canadians living in the community.

https://policybase.cma.ca/en/permalink/policy11600

Date
2015-08-26
Topics
Health human resources
Physician practice/ compensation/ forms
Resolution
GC15-20
The Canadian Medical Association supports improved training, resource allocation and incentives to help primary care physicians develop robust, around-the-clock services for frail and elderly Canadians living in the community.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health human resources
Physician practice/ compensation/ forms
Resolution
GC15-20
The Canadian Medical Association supports improved training, resource allocation and incentives to help primary care physicians develop robust, around-the-clock services for frail and elderly Canadians living in the community.
Text
The Canadian Medical Association supports improved training, resource allocation and incentives to help primary care physicians develop robust, around-the-clock services for frail and elderly Canadians living in the community.
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Tax incentives and/or other financial supports for caregivers

https://policybase.cma.ca/en/permalink/policy11609

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Resolution
GC15-29
The Canadian Medical Association recommends that tax incentives and/or other financial supports for caregivers be available for all family members, without a requirement for co-habitation.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Resolution
GC15-29
The Canadian Medical Association recommends that tax incentives and/or other financial supports for caregivers be available for all family members, without a requirement for co-habitation.
Text
The Canadian Medical Association recommends that tax incentives and/or other financial supports for caregivers be available for all family members, without a requirement for co-habitation.
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National skin cancer awareness and prevention campaign

https://policybase.cma.ca/en/permalink/policy11613

Date
2015-08-26
Topics
Health care and patient safety
Resolution
GC15-52
The Canadian Medical Association supports the development of a national skin cancer awareness and prevention campaign.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health care and patient safety
Resolution
GC15-52
The Canadian Medical Association supports the development of a national skin cancer awareness and prevention campaign.
Text
The Canadian Medical Association supports the development of a national skin cancer awareness and prevention campaign.
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Systems-thinking approach across all stages of the medical career life cycle

https://policybase.cma.ca/en/permalink/policy11623

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-45
The Canadian Medical Association will advocate for incorporation of a systems-thinking approach across all stages of the medical career life cycle.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-45
The Canadian Medical Association will advocate for incorporation of a systems-thinking approach across all stages of the medical career life cycle.
Text
The Canadian Medical Association will advocate for incorporation of a systems-thinking approach across all stages of the medical career life cycle.
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Gradual transition toward retirement

https://policybase.cma.ca/en/permalink/policy11626

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-46
The Canadian Medical Association supports physicians who choose a gradual transition toward retirement.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-46
The Canadian Medical Association supports physicians who choose a gradual transition toward retirement.
Text
The Canadian Medical Association supports physicians who choose a gradual transition toward retirement.
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Academic writing and editing among practicing physicians and physicians-in-training

https://policybase.cma.ca/en/permalink/policy11627

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Health systems, system funding and performance
Resolution
GC15-47
The Canadian Medical Association will promote the development of resources to foster academic writing and editing among practicing physicians and physicians-in-training.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Health systems, system funding and performance
Resolution
GC15-47
The Canadian Medical Association will promote the development of resources to foster academic writing and editing among practicing physicians and physicians-in-training.
Text
The Canadian Medical Association will promote the development of resources to foster academic writing and editing among practicing physicians and physicians-in-training.
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Best practices to assist patients aged 16 to 24 transitioning from pediatric to adult health services

https://policybase.cma.ca/en/permalink/policy11628

Date
2015-08-26
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC15-57
The Canadian Medical Association supports the development of best practices to assist patients aged 16 to 24 transitioning from pediatric to adult health services.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC15-57
The Canadian Medical Association supports the development of best practices to assist patients aged 16 to 24 transitioning from pediatric to adult health services.
Text
The Canadian Medical Association supports the development of best practices to assist patients aged 16 to 24 transitioning from pediatric to adult health services.
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The Pan-Canadian Joint Consortium for School Health

https://policybase.cma.ca/en/permalink/policy11632

Date
2015-08-26
Topics
Health systems, system funding and performance
Physician practice/ compensation/ forms
Resolution
GC15-60
The Canadian Medical Association supports the Pan-Canadian Joint Consortium for School Health.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health systems, system funding and performance
Physician practice/ compensation/ forms
Resolution
GC15-60
The Canadian Medical Association supports the Pan-Canadian Joint Consortium for School Health.
Text
The Canadian Medical Association supports the Pan-Canadian Joint Consortium for School Health.
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Governments undertaking unilateral action

https://policybase.cma.ca/en/permalink/policy11641

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-97
The Canadian Medical Association stands against governments undertaking unilateral action in lieu of a negotiated agreement with physicians.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-97
The Canadian Medical Association stands against governments undertaking unilateral action in lieu of a negotiated agreement with physicians.
Text
The Canadian Medical Association stands against governments undertaking unilateral action in lieu of a negotiated agreement with physicians.
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Ontario Medical Association’s request for the inclusion of a binding dispute resolution mechanism

https://policybase.cma.ca/en/permalink/policy11642

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-98
The Canadian Medical Association supports the Ontario Medical Association’s request for the inclusion of a binding dispute resolution mechanism in its contract negotiations with the Government of Ontario.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Ethics and medical professionalism
Resolution
GC15-98
The Canadian Medical Association supports the Ontario Medical Association’s request for the inclusion of a binding dispute resolution mechanism in its contract negotiations with the Government of Ontario.
Text
The Canadian Medical Association supports the Ontario Medical Association’s request for the inclusion of a binding dispute resolution mechanism in its contract negotiations with the Government of Ontario.
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The medical profession’s critical role in supporting immunization

https://policybase.cma.ca/en/permalink/policy11643

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Population health/ health equity/ public health
Resolution
GC15-63
The Canadian Medical Association will provide information and tools to physicians to promote the medical profession’s critical role in supporting immunization.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Population health/ health equity/ public health
Resolution
GC15-63
The Canadian Medical Association will provide information and tools to physicians to promote the medical profession’s critical role in supporting immunization.
Text
The Canadian Medical Association will provide information and tools to physicians to promote the medical profession’s critical role in supporting immunization.
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Generalist approach across the medical career life cycle

https://policybase.cma.ca/en/permalink/policy11644

Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Resolution
GC15-64
The Canadian Medical Association will advocate for a generalist approach across the medical career life cycle.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Physician practice/ compensation/ forms
Resolution
GC15-64
The Canadian Medical Association will advocate for a generalist approach across the medical career life cycle.
Text
The Canadian Medical Association will advocate for a generalist approach across the medical career life cycle.
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Arm’s- length, anonymous pre-accreditation survey

https://policybase.cma.ca/en/permalink/policy11647

Date
2015-08-26
Topics
Health human resources
Physician practice/ compensation/ forms
Resolution
GC15-67
The Canadian Medical Association affirms its support for the continued use of the arm’s- length, anonymous pre-accreditation survey as an integral component of the national system of accreditation for postgraduate medical education.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health human resources
Physician practice/ compensation/ forms
Resolution
GC15-67
The Canadian Medical Association affirms its support for the continued use of the arm’s- length, anonymous pre-accreditation survey as an integral component of the national system of accreditation for postgraduate medical education.
Text
The Canadian Medical Association affirms its support for the continued use of the arm’s- length, anonymous pre-accreditation survey as an integral component of the national system of accreditation for postgraduate medical education.
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Price negotiations for prescription drugs

https://policybase.cma.ca/en/permalink/policy11649

Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-69
The Canadian Medical Association urges the pan-Canadian Pharmaceutical Alliance to invite the federal government and private health insurance industry to participate in its price negotiations for prescription drugs.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-69
The Canadian Medical Association urges the pan-Canadian Pharmaceutical Alliance to invite the federal government and private health insurance industry to participate in its price negotiations for prescription drugs.
Text
The Canadian Medical Association urges the pan-Canadian Pharmaceutical Alliance to invite the federal government and private health insurance industry to participate in its price negotiations for prescription drugs.
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National strategy on the use of naloxone

https://policybase.cma.ca/en/permalink/policy11651

Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-71
The Canadian Medical Association supports the development and implementation of a national strategy on the use of naloxone.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-71
The Canadian Medical Association supports the development and implementation of a national strategy on the use of naloxone.
Text
The Canadian Medical Association supports the development and implementation of a national strategy on the use of naloxone.
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Equitable and comprehensive national pharmacare program

https://policybase.cma.ca/en/permalink/policy11652

Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-72
The Canadian Medical Association supports the development of an equitable and comprehensive national pharmacare program.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Resolution
GC15-72
The Canadian Medical Association supports the development of an equitable and comprehensive national pharmacare program.
Text
The Canadian Medical Association supports the development of an equitable and comprehensive national pharmacare program.
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Cradle-to-grave health records for patients living in Canada

https://policybase.cma.ca/en/permalink/policy11653

Date
2015-08-26
Topics
Health care and patient safety
Health information and e-health
Population health/ health equity/ public health
Resolution
GC15-73
The Canadian Medical Association supports the organization, centralization and management of cradle-to-grave health records for patients living in Canada.
Policy Type
Policy resolution
Date
2015-08-26
Topics
Health care and patient safety
Health information and e-health
Population health/ health equity/ public health
Resolution
GC15-73
The Canadian Medical Association supports the organization, centralization and management of cradle-to-grave health records for patients living in Canada.
Text
The Canadian Medical Association supports the organization, centralization and management of cradle-to-grave health records for patients living in Canada.
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