Saturday, April 9, 2016

Reefer Madness Part 4 and Another 15 Minutes of Fame.

I just attended the annual meeting/course put on by the Canadian Consortium for the Investigation of Cannabiniods which I joined a couple of years ago.  I have prescribed/authorized medical marijuana for patients since 2001.  I do so in the context of my chronic pain practice and with some hesitation. 

A week or so on what must have been a slow news day our local paper announced in a front page headline story that a medical marijuana clinic was opening in our city.  Having commented on medical marijuana in the past, I had a feeling that I was going to be hearing from the Fourth Estate pretty soon.  

While I do provide authorization for medical marijuana in appropriate patients,  I have a jaundiced view of medical marijuana clinics.  Over the past few years patients have informed me that for $400 a clinic somewhere else in Canada will give them a "Skype interview" after which they will get an authorization for medical marijuana (under the old regulations) and usually are able to buy product from the affiliated grower.  

I am not sure what the Skype interview consists of; holding their wallet up to the camera on their computer maybe.  This is sleazy practice, and I usually offered to complete the paperwork for "free" if I think they are appropriate candidates.  

There have been incidents like this:

I also increasingly believe that chronic pain should be managed in a multidisciplinary fashion not in silos of care such as medical marijuana clinics or for that matter the block shops we have in our city.  Unfortunately opportunities for multidisciplinary management are difficult because while health care in Canada is "free", physiotherapy and psychology are not.  Further for lack of resources, I and the loosely affiliated group of physicians I practise with  have an 18 month wait list for consults which even by Canadian standards is excessive. 

Our thankfully former Tea Party government who were of course anti-drug were most distressed by the concept of anybody using marijuana but were bound by a court decision, so came up with a solution that is probably the one thing in their 10 years in office that actually worked.  Instead of patients trying to grow their own marijuana (which most of them were not very good at) buying it on the street or from the lone government approved supplier, growers would be able apply for licences to supply patients who would get "prescriptions" from doctors.  I had previously discussed this in another blog.  The advantage of this system is that patients can now buy cannabis from facilities that are inspected by the government and that the THC and CBD content of the product is known which allows doctors and patients to select products of known potency.  This has resulted in about 30 companies, some large and some small being able to provide medical marijuana and according to the man from Health Canada there are 2000 applications to become licenced producers.  

Anyway, it wasn't long before I was contacted for an interview.  This came from a reporter from one of the free newspapers people read on the bus or in coffee shops.  A little down market from my usual encounters with the press but there is no bad publicity.   I basically told him what I had said above.  I said for reasons above that the medical marijuana clinic would have very little impact on the treatment of chronic pain.  I also said that what should have been the headline was the distressing lack of resources for treating chronic pain.  Further I said that while I hoped the physician starting the clinic had the noblest of motives, many people in the past had exploited the vulnerable chronic pain population.

The interview lasted about 10 minutes of which a few sentences made the article.  You can probably find it on Google but I am not going to help you.  It did state that I said there was no need for new physicians to prescribe medical marijuana because there were already enough in our city which I don't think I said. 

The entrepreneur/physician got to comment the the next edition of said free newspaper in which he claimed in messianic fashion that our city had been selected of all the cities in Canada because there was a need for doctors to prescribe medical marijuana.  I don't really think we are better or worse than anywhere else in Canada and he may have other motives for adding to his chain of clinics such as availability of office space or maybe he has a girlfriend in our city.  

I must say I only read these articles fully on line just now while writing this blog.

My next interview request came from CTV and they wanted to interview me on TV.  I took a media relations course a long time ago and the one thing that stood out was using the interview to advance your agenda.  Unfortunately when they contacted me I was on my way to Toronto to attend the above meeting but we agreed that maybe I could be interviewed by Skype in Toronto which I agreed to and I spoke with the reporter on phone and basically told her what I had told the free newspaper reporter only having had time to reflect in more polished form.

I was subsequently contacted by CBC French who wanted an interview which I did on the phone in English from Chilie's in the Calgary airport where I was having a beer and a burger before flying to Toronto.  I was on a roll by then and gave what was probably the best interview of my life.  Too bad I don't listen to CBC French.

Just before my plane took off, I got an email from CTV stating that they were going to cancel the interview because of lack of time.  I suspect the real reason was they realized that I wasn't going to talk about medical marijuana (which is sexy) but was going to talk about chronic pain (which is not sexy except when people smoke dope).

As I have said during this time I was getting ready to go the CCIC meeting in Toronto and just happened to look at the program and discovered that my entrepreneur friend was one of the speakers. Interesting, I thought I will at least get to put a face to name.  I was a little worried because as above I maybe hadn't been that positive about his little business and he had probably read my comments.  I went to two talks by him and he is pretty smooth and I am not sure what to make of him.  I probably should have taken him out for a beer (or smoked a doobie with him) to welcome him to our medical community.

The only blowback I got during the meeting was at lunch on the second day when someone sat down at my table looking at my nametag and said, "Oh you're the guy who thinks your city doesn't need a medical marijuana clinic."  I said something about how it was a 10 minute interview and they had taken out a few sentences and the moment passed.

Otherwise it was a great meeting with some really good talks and I learned a few pearls.  Unfortunately the meeting was essentially preaching to the choir although there were some people who were really pro cannabis.   It would certainly be nice if the people who oppose medical marijuana attended meetings like this and maybe we could have a dialogue.  

The other interesting thing was that the meeting was heavily sponsored by medical marijuana companies and there was a pharmaceutical trade show.  No free samples though.

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