Therapeutic Cannabis use

[Fishbone Jones]

If anyone feels like I'm inundating them with worn out statements they're more than capable of throwing me on ignore.

As for phone and Skype calls to get prescriptions, what? That's news to me. I can't get medical staff to tell me shit over the phone. I'm blown away someone can get a MMJ prescription over the phone? I agree with Chief Stoker that's pretty suspect.

Doctors are hardly infallible. Operating on the wrong limb, leaving instruments inside peoples bodies. It's hardly heresy to question doctors in light of some of the shady stuff we read about. Like $50-$250 will get you a meeting with a doctor to write you a script. 

I'm not sure about epidemic proportions but didn't VAC just talk about a huge increase in MMJ prescriptions? Costing VAC so much that they initiated the whole 3 gram a day rule?

I don't know. If there was 100 neurosurgeons and 2 of them were responsible for prescribing 90% of Oxycontin prescriptions should they be investigated then? I'd say yes. 

As for the doctor shopping question I think you know very well the circumstances of why someone might doctor shop to prescribe them exactly what they want. It's not something that's limited to MMJ, people doctor shop for narcotics too.

Everything in your post has already been addressed, by myself or others. During those discussions, links and posters with experience in the subject, gave you the answers to your questions. Your rumours, unnamed sources and innuendo were addressed. Why then do you persist in saying the same stuff over and over?
I see no links to articles or anything else that goes to research on the subject. I'm afraid I'm not repeating all the answers again, you'll need to go back and read for yourself.

You're right about the doctor shopping. It does happen. However, it's more widespread with narcotics, so why the concentration on cannabis patients?

 

[Stoker]

I read a few of the pages, there is some of it going on, no doubt. I only saw one 3 minute reference. That, I believe, was somebody talking to someone else about a 3 minute conversation. Could be wrong though. I know lots of doctors that see patients for no more than ten minutes, including prescriptions for lots of things so it probably isn't unusual for doctor to spend around the same with a cannabis patient. I'm not a doctor so I won't guess.

Doctors have been Skyping or videoconferencing with patients for a while now. This is neither suspect or unusual. And it's not just cannabis doctors. Like I said, I didn't see in the link where interviews were only 3 minutes long. Perhaps you could point it out?

I guess I misread the "3 min" skype call

Here's some more from the message board

"The doctor at XXXXXX was a pretty cool guy. He explained that everything is confidential. He asked me if I was already using because he likes to know how much, how often, and what I find works for me. He doesn't care either way, so its best to be honest. ""

"The Skype appt will be about 7 minutes. They will ask you about your cannabis use, how much u use, how u use it, how often etc. If you have a legit condition youll get it no problem."


I think the point is that there is plenty of news stories out there with people abusing the system. Apparently in BC you can walk in a store, declare you are self medicating and walk out with a gram after paying a $50 fee. Some are very honest with real problems, but to approve a drug with a short skype call I don't like it and it is open to abuse.

 

[Fishbone Jones]

That's fair. I'm sure there's abuse in this system as any other, but not as much. YMMV.

Once it's legal in the spring, I'm sure many of these concerns will go away.

 

[Loachman]

Caveat: I have no direct interest in medical marijuana. I tried a puff or two of the stuff at a party once, several decades ago. I don't know why, as I'd never been curious about it before, or since. I was too drunk at the time to know if it had any effect or if I inhaled.

I am far from an expert in either recreational or medical use of marijuana - but:

As for phone and Skype calls to get prescriptions, what? That's news to me. I can't get medical staff to tell me shit over the phone. I'm blown away someone can get a MMJ prescription over the phone?

It was news to me, too. Sometimes, progress is a good thing. One can order one's groceries, alcohol, and non-cannabis drugs online or by telephone, too, and have them delivered. For those that have difficulty leaving home, or lack of transport, or lack of time to drive long distances to the nearest doctor, this sounds ideal.

Doctors are hardly infallible. Operating on the wrong limb, leaving instruments inside peoples bodies. It's hardly heresy to question doctors in light of some of the shady stuff we read about.

Definitely. More people die from "medical misadventure" than from misuse of firearms. One should always question one's doctor when he or she says something or wants to do something that does not make sense. Semi-jokingly, I wrote "Do Not Amputate" on each arm and leg with a magic marker when I had my tonsils removed three decades ago, and asked and reminded the nice doctor what he was going to remove before I was anaesthetized. One should thoroughly research every drug and every procedure prescribed/suggested/pushed before accepting it.

I'm not sure about epidemic proportions but didn't VAC just talk about a huge increase in MMJ prescriptions? Costing VAC so much that they initiated the whole 3 gram a day rule?

I'd guess that the huge increase in prescriptions is because more people are finding that it helps them. I see nothing suspicious there.

I wonder how the costs of all of the "official" drugs, that seem to both be inadequate and have lengthy lists of side effects, compare.

I wonder how the costs of inability to work, or even function, compare.

I wonder how the costs of funerals and family devastation compare.

I won't even take Tylenol, Aspirin, or cough medicine, let alone anything more powerful (with two exceptions: the seventh and worst day following my tonsillectomy, and a weekend when an old root canal decided to almost explode about fifteen years ago) - they don't work for me anyway, and I do not like ingesting chemicals. I'd not get in the way of anybody who found relief from pain, physical or mental, in a natural remedy such as marijuana. I know people who suffer from depression and chronic pain. I cannot comprehend what either are like, but I accept that they are very real and can be disabling, and will support anything that gives them even the slightest relief. Their pain, their bodies, their choice, as adults, to make their own decisions and to use whatever works.

I don't know. If there was 100 neurosurgeons and 2 of them were responsible for prescribing 90% of Oxycontin prescriptions should they be investigated then? I'd say yes.

Has anybody tracked such a trend? As long as they are doing so legally and ethically, who should care?

As for the doctor shopping question I think you know very well the circumstances of why someone might doctor shop to prescribe them exactly what they want. It's not something that's limited to MMJ, people doctor shop for narcotics too.

Fifty percent of doctors are below average. People - intelligent people - shop for doctors with whom they feel comfortable, who they perceive to be competent, who listen with open minds, and who they perceive to be caring and genuinely interested in their well-being. If someone knows that something works, why would he/she not bypass a doctor who will not accept that, and find one who will?

Yes, there are, indubitably, people who will abuse any system. There are far more, however, whose needs are genuine and should not be automatically treated as if they are no-good scheming weasels.

Enough people report that marijuana helps them, and is the only thing that helps them. That is good enough for me.

I understand that this is controversial for some. Many things that we now accept as normal were controversial at one time - racial equality, gender equality, homosexuality, OSIs/PTSD etcetera.

I remember when "Sexual deviancy" was a military offence.

Medical use of marijuana, too, will be accepted as normal in a few more years.

 

[Stoker]

That's fair. I'm sure there's abuse in this system as any other, but not as much. YMMV.

Once it's legal in the spring, I'm sure many of these concerns will go away.

I don't think it will go away at all when it becomes legalized and I think its legalization will become a train wreck for some people. I hope the number of restrictions are sufficient to keep it away the people who shouldn't have it. I don't see a change for veterans except that its price will probably increase and VA will probably cut back more or eliminate it was its now a recreational drug like alcohol.

 

[Jarnhamar]

Great posts Rg and Loachman.

Progress is a good thing I agree. I found it infuriating I couldn't get simple results released over the phone and had to piss around with making an appointment at a convenient time then go to a hospital and wait. With a lot of these issues it can be something positive but also abused.  Doctor shopping is a great example. Find a smart one who doesn't have a bad track record for sure.

The conversation here turned me around from being against MMJ to generally supportive of it.

Championing a devils advocate argument is still important I believe.  I'm sure we can all agree the CAF shits the bed on a lot of things. Sexual harassment and assault. Workplace harassment. Vehicle procurement. Recruiting. Boot fiasco. Professionally I don't want to see this turn into yet another running joke so I'm okay with being critical of it, yet still supporting members and ex-members effected by it.

I wouldn't deny it seems to help some people and especially provide a working alternative to some of the crazy drugs out there. It seems 100 times better then Oxycontin and all that(which you can doctor shop for too).

It will be interesting to see how the CAF handles this going forward and if serving members in uniform will start getting prescriptions. Maybe I get social anxiety and need MMJ to attend all those stressful mandatory mess functions, or a new recruit needs a MMJ prescription to deal with the disabling stress of someone they don't like winning the next election.

I don't think it will go away at all when it becomes legalized and I thunk its legalization will become a train wreck for some people. I hope the number of restrictions are sufficient to keep it away the people who shouldn't have it. I don't see a change for veterans except that its price will probably increase and VA will probably cut back more or eliminate it was its now a recreational drug like alcohol.

I think you're right.

 

[Stoker]

Caveat: I have no direct interest in medical marijuana. I tried a puff or two of the stuff at a party once, several decades ago. I don't know why, as I'd never been curious about it before, or since. I was too drunk at the time to know if it had any effect or if I inhaled.

I am far from an expert in either recreational or medical use of marijuana - but:

It was news to me, too. Sometimes, progress is a good thing. One can order one's groceries, alcohol, and non-cannabis drugs online or by telephone, too, and have them delivered. For those that have difficulty leaving home, or lack of transport, or lack of time to drive long distances to the nearest doctor, this sounds ideal.

Definitely. More people die from "medical misadventure" than from misuse of firearms. One should always question one's doctor when he or she says something or wants to do something that does not make sense. Semi-jokingly, I wrote "Do Not Amputate" on each arm and leg with a magic marker when I had my tonsils removed three decades ago, and asked and reminded the nice doctor what he was going to remove before I was anaesthetized. One should thoroughly research every drug and every procedure prescribed/suggested/pushed before accepting it.

I'd guess that the huge increase in prescriptions is because more people are finding that it helps them. I see nothing suspicious there.

I wonder how the costs of all of the "official" drugs, that seem to both be inadequate and have lengthy lists of side effects, compare.

I wonder how the costs of inability to work, or even function, compare.

I wonder how the costs of funerals and family devastation compare.

I won't even take Tylenol, Aspirin, or cough medicine, let alone anything more powerful (with two exceptions: the seventh and worst day following my tonsillectomy, and a weekend when an old root canal decided to almost explode about fifteen years ago) - they don't work for me anyway, and I do not like ingesting chemicals. I'd not get in the way of anybody who found relief from pain, physical or mental, in a natural remedy such as marijuana. I know people who suffer from depression and chronic pain. I cannot comprehend what either are like, but I accept that they are very real and can be disabling, and will support anything that gives them even the slightest relief. Their pain, their bodies, their choice, as adults, to make their own decisions and to use whatever works.

Has anybody tracked such a trend? As long as they are doing so legally and ethically, who should care?

Fifty percent of doctors are below average. People - intelligent people - shop for doctors with whom they feel comfortable, who they perceive to be competent, who listen with open minds, and who they perceive to be caring and genuinely interested in their well-being. If someone knows that something works, why would he/she not bypass a doctor who will not accept that, and find one who will?

Yes, there are, indubitably, people who will abuse any system. There are far more, however, whose needs are genuine and should not be automatically treated as if they are no-good scheming weasels.

Enough people report that marijuana helps them, and is the only thing that helps them. That is good enough for me.

I understand that this is controversial for some. Many things that we now accept as normal were controversial at one time - racial equality, gender equality, homosexuality, OSIs/PTSD etcetera.

I remember when "Sexual deviancy" was a military offence.

Medical use of marijuana, too, will be accepted as normal in a few more years.

I'm not an expert too, never tried the stuff or likely to. I just have no interest. I was added to "Green Veterans Canada" on facebook without permission, so when I seen this thread I went back there and read up on all the threads and became members on many other MM groups to educate myself on the issues. I can understand why some on this board defend their medical use of it so strongly however no one is saying to eliminate it, but to eliminate abuse and place reasonable limits on it. That unfortunately is not looked on very favorably by some.

What I found in a lot of cases people are being helped by this drug either by legit means or by the placebo effect. Some veterans interestingly admitted use either during their careers or before they joined much like a lot of people. In fact some bragged about it. Like you I think pain relief is great but if we placed no limits people would medicate themselves out of existence so reasonable limits of how much MM is issued eg 3 grams is important and not by just me but the government.

Plenty of talk about their family doctors denying their prescription and having to do the skype interview to get one and how easy it is. Many of the doctors who won't give prescriptions is not that they are closed minded, there is not enough data out there on the long term effects and despite attempt to portray this as a non harmful drug, there are dangers. I see no problem with a doctor wanting the best for their patient. I wish seeing the government is potentially putting placing this in every Canadians pocket over 18 yrs old, would spend the money for once and for all determine any benefits to treating any aliment or possible harm.

Any negative story even from credible sources is met with distrust and denial and lots of talk about big pharma and the man taking away their medicine.

I have no doubt of some people gaming the system and using a minor aliment to get high and having the government pay for it. That should be reduced and I think the first step is a comprehensive evaluation by a doctor at the practice face to face before MM is issued, and that goes for any drug with harmful side effects. While video interviews are convenient, its open to abuse.

Perhaps this will subside when this drug becomes mainstream but I hope reasonable limits will be placed on it to prevent abuse both for recreational use and medical use.

 

[jollyjacktar]

Someone I sailed with told me over Christmas that they'd started self medicating themselves about a year ago for pain relief.  They said that it made a huge difference in their quality of life and medical fitness.  They are soon releasing from the CF and will be looking at a more legit source of medication procurement. 

I can't say that I'm interested in trying it myself as I don't have the same needs as they do and it's been about 35 years since I had a joint.  More power to them if it's working and improves their quality of like. Go for it.

 

[Fishbone Jones]

I don't think it will go away at all when it becomes legalized and I think its legalization will become a train wreck for some people. I hope the number of restrictions are sufficient to keep it away the people who shouldn't have it. I don't see a change for veterans except that its price will probably increase and VA will probably cut back more or eliminate it was its now a recreational drug like alcohol.

We seem to be at an impasse. We'll just have to wait and see.

As far as price, that has actually fallen. My provider only charges what VAC requested. $8.50/gm. Lowered from +/- $12.00/gm. The price has gone down, not up. Alcohol is not strictly recreational, there are plenty of other uses for it, just like medical cannabis.

Social media is not where I go for news. Social media is full of charlatans, imposters and ne'er do wells. One has but to look at the US Presidential election coverage, to know it is not a place to looks for facts or credibility. Remember what was said about Wiki? That you can't believe it because anyone can put what they want there? Wiki has been replaced by the whole internet. Unless you're able to drill down and get right into the weeds. As far as drawing conclusions from online forums, caveat lector. It's not a source I depend on for true information.

 

[Stoker]

We seem to be at an impasse. We'll just have to wait and see.

As far as price, that has actually fallen. My provider only charges what VAC requested. $8.50/gm. Lowered from +/- $12.00/gm. The price has gone down, not up. Alcohol is not strictly recreational, there are plenty of other uses for it, just like medical cannabis.

Absolutely and you know what it costs for a 40oz of liquor. Once the government and companies realizes they will make lots of money off it the prices will increase dramatically but not enough to drive everyone back to the dealers or make it too cheap. As you said you'll have to wait and see.

 

[Fishbone Jones]

There's little doubt in my mind that, in Ontario, recreational cannabis will be handled through the LCBO, with all it's requisite taxes, handling fees, stocking fees, etc. I expect that by the time they're done the extras will outstrip the price of the actual product. Then there will be the inevitable and requisite 'Smart Serve for Cannabis' course, that you can only get from the government. If Ontario gets greedy, they'll price themselves out of the market and the street dealers will hardly miss a beat.

If moonshine was available in quantity, the LCBO would be closed in a month. 

 

[Stoker]

There's little doubt in my mind that, in Ontario, recreational cannabis will be handled through the LCBO, with all it's requisite taxes, handling fees, stocking fees, etc. I expect that by the time they're done the extras will outstrip the price of the actual product. If Ontario gets greedy, they'll price themselves out of the market and the street dealers will hardly miss a beat.

If moonshine was available in quantity, the LCBO would be closed in a month.

Question for you, why not just grow it, wouldn't that be cheaper? Is that allowed?

 

[Jarnhamar]

Isn't it kind of crazy the government will charge you taxes and control the sale of a plant that grows in nature.  Maybe we should be taxed on the amount of sun we receive too.

 

[Fishbone Jones]

Question for you, why not just grow it, wouldn't that be cheaper? Is that allowed?

That's allowable and possible. As of April 2016, you have to apply, to Health Canada for permission to grow at home which needs to be accompanied by a doctor note. Once you have that, there's other considerations. Space.You need a good sized space to grow in. You could grow outside, but it'll likely disappear just before you harvest it. Strains and percentages. Most commercial cannabis is grown from cuttings. One of the larger providers that I inspected, had five 15' tall 'mother plants' that they took cuttings from and raised those to maturity. Those plants have trunks, not stems. That allows for always female plants of the same strength and quality. If you start with seeds, you have to separate the male from the female seeds. Male plants will screw up your grow. The plants require a constant airflow to move the plants leaves around, like outside. You can use just about any light, but some have advantages over others. You'll have to decide the size of your grow for which lights to use. LED grow lights, though fairly new, look very promising. The max wattage of your lights will help determine the yield. You'll have to decide your grow medium. Hydroponic is best, but your going to spend a lot of time mixing and applying the nutrients. People with a medical cannabis prescription can grow their own. They are allowed to hold up to 150 gm in possession at a time, when not growing. Health Canada has a formula you can use to determine how much you can grow. So, by their calculations, if you have a script for 5 gm a day, you can grow 25 plants, indoors, and have 1125 grams in storage. You can grow plants outside or plants inside (different yields). That's quick and dirty. There's much more to consider if you think you have a green thumb, but I doubt you'd save money in the near term. There are roughly 40,000 medical cannabis users in Canada.

 

[Fishbone Jones]

Isn't it kind of crazy the government will charge you taxes and control the sale of a plant that grows in nature.  Maybe we should be taxed on the amount of sun we receive too.

Opium poppies grow wild in nature, but you can't have one in your garden. 

 

[George Wallace]

.......  Maybe we should be taxed on the amount of sun we receive too.

Ummmm.....With Cap and Trade and the new Carbon (Tax).....They have figured how to tax the air we breath.  [

 

[Teager]

Ummmm.....With Cap and Trade and the new Carbon (Tax).....They have figured how to tax the air we breath.  [

And then taxed that tax with HST in ON

 

[Nudibranch]

[quote author=recceguy
You're right about the doctor shopping. It does happen. However, it's more widespread with narcotics, so why the concentration on cannabis patients?
[/quote]

1. Cannabis thread
2. Widespread with narcs because narcs have been prescribed forever. Prescribed cannabis is new.

Doctor shopping happens with almost everything. From narcs to "I want antibiotics for my viral cold."

What makes the medical cannabis industry somewhat unique in the doctor-shopping aspect is its singular focus. The patient isn't going to a general pharmacy, s/he's going to a cannabis dispensary. S/he isn't being referred to a clinician who'll do a review of the condition and recommend any number of possible treatments, s/he is referred for a cannabis script, by an operation selling cannabis.

There are similar narc dispensaries (operating as "pain clinics", but their actual focus is prescribing opioids). They get busted with some regularity down south, as much as anything physician-related can be said to be regularly busted.

A non-pill example is also those Dr Bernstein clinics. I have a friend who worked for them as their doc. Client goes in, has a 5-min talk with doc, comes out with recommendation for the Bernstein program. Every client. Same recommendation.

Cannabis dispensaries and their recommended/associated docs function like that. It doesn’t mean the cannabis won't help the patient (or that the Bernstein diet wouldn't help the client), but in order to be honest let's recognize them for what they are. These associated doctors aren't trying to decide on the most proper course of treatment for the individual in front of them, whatever that might be  - they're there to prescribe cannabis.

 

[Fishbone Jones]

I've seen no figures so far to uphold your assessment. That doesn't mean it's not happening.

However, without stats from reliable sources, this is no more than your opinion. If you have something to help prove your point, studies, police reports, Health Canada reports, College of Physicians, etc. I'd be most interested.

Cheers.

 

[Nudibranch]

I've seen no figures so far to uphold your assessment. That doesn't mean it's not happening.

However, without stats from reliable sources, this is no more than your opinion. If you have something to help prove your point, studies, police reports, Health Canada reports, College of Physicians, etc. I'd be most interested.

Cheers.

Check out the recommendations published by the College of Family Physicians of Canada (Authorizing Dried Cannabis (Medical Marijuana) for Chronic Pain or Anxiety: Preliminary Guidance), and compare with what even the VAC review says.
For ex, that the prescribing doc should be primarily responsible for managing the condition the cannabis is rx for, including follow-ups. But hard to do from another province.
Or the "start low, go slow" vice how this was handled with our vetarans  - what "evidence" did the docs have exactly for such high dosage scripts? There's nothing in evidence-based med literature to support 10g/day, esp as starting doses for chronic conditions (8-10g being a not uncommon starting dosage according to the auditor's report on VAC usage of MM; Health Canada has cautioned a dosage above 5g max).

So what evidence are the physicians who rx 10g/day to start using?  They're not following Health Canada. They're not following College guidelines. I suppose they're doing what their patients want, but that's not what being a physician is about.

I support further clinical studies into MM. Definitely. There are some indications for which there already is some demonstrated efficacy - great. The conservative recommendations are due to a dearth of data.
But MM proponents tend to be demanding of hard evidence for risk of harm, or when what the med community generally considers too-high dosages is discussed, or when it's pointed out that there is no evidence of efficacy for x (or even risk of harm). Anxiety, for ex.

OTOH, there's almost faith-based (certainly anecdote and personal experience based) acceptance of the benefits of weed for just about anything and everything.

"Proving your point" goes both ways - and anecdote is merely a bunch of opinions from the medical evidence standpoint.