The organization that regulates physicians in Manitoba is worried recent federal rule changes governing medical marijuana will place more pressure on doctors to authorize its use.
The province's MDs have generally been resistant to helping patients become registered to legally use a drug most see as having little or no medical value. The number of Manitoba doctors known to be willing to authorize the use of medical marijuana can be counted on the fingers of one hand.
New rules that came into effect last year also allow -- but do not require -- doctors to dispense cannabis, subject to provincial approval. Manitoba allows physicians to dispense drugs in certain limited situations.
The College of Physicians and Surgeons of Manitoba is concerned by the regulatory change, saying the vast majority of physicians want nothing to do with dispensing medical marijuana.
"It's a really big issue for the regulatory authorities," said Dr. William Pope, the college's registrar.
Across Canada, more than 37,000 persons -- including 443 in Manitoba -- are currently registered to possess cannabis for severe pain, muscle spasms, nausea and other conditions.
Officials project the number could explode to as many as 450,000 by 2024 after Ottawa recently streamlined the application and approval processes. Under the new regime, applicants are no longer required to submit their personal health information to Health Canada. The government has also simplified the approval process for people with less debilitating diseases and conditions.
'As far as most of us are concerned, there is really no appropriate prescribing'
New rules coming into effect April 1 will also prevent thousands of Canadians -- including hundreds in Manitoba -- from continuing to grow their own pot for medical use. They will be required to purchase from federally licensed commercial growers. That has infuriated many registered marijuana users who expect to have to pay $10 a gram instead of the $1 to $2 it costs to grow it themselves, the Free Press has reported.
Pope said the college is concerned the rule changes will cause more patients to press doctors to authorize the use of medical marijuana. It has advised physicians against doing so unless all other medical remedies have been tried.
"As far as most of us are concerned, there is really no appropriate prescribing," he said in an interview.
That position has caused some Manitobans to seek help out of province. The Vancouver-based Medicinal Cannabis Resource Centre Inc. (MCRCI) will -- for a $400 fee -- provide a doctor to meet patients via Skype to discuss how medical marijuana can help them and arrange for medical authorization. The centre also assists patients in filling out the necessary federal paperwork.
Terry Roycroft, founder and president of the centre, estimates his organization has assisted as many as two dozen Manitobans in obtaining federal permission to use medical marijuana. It has advised or shepherded thousands of Canadians through the approval process.
Applicants must submit a diagnosis of a qualifying illness from their primary caregiver, be it for cancer, severe arthritis, multiple sclerosis or some other disease or condition.
"They're pre-diagnosed. All we're doing is counselling them on the uses and the strains (of cannabis) that would work well with those illnesses," Roycroft said. "Then we also support them legally with a medical document that allows them to go to the new (cannabis) producers that Health Canada is licensing so they can actually purchase those strains."
MCRCI has gathered a group of 40 medical specialists and general practitioners from across the country that act as a resource. Its medical staff is also involved in clinical research on a cannabis-based topical cream for patients with rheumatoid arthritis of the hands.
Roycroft said the health benefits of cannabis are only beginning to be tapped. In its dealings with clients, MCRCI outlines alternatives to smoking a joint in obtaining the benefits of the cannabinoids in the marijuana plant. Recent research, including work done in Canada under federal permission, has seen the production of edible cannabis products (which take the body longer to absorb but can provide longer relief), mouth sprays, creams and vapours (in which cannabinoids are inhaled but without the harmful smoke), he said.