Medical marijuana prescription challenged by dead man's family

A New Brunswick family has some tough questions over the prescribing and use of medical marijuana. They believe it may have played a part in the death of a husband and father.

Steve Saunders of Fredericton was prescribed medical marijuana to help him cope with an old shoulder injury and they claim that under its influence he became manic.

He lost control of his life, drove away family and friends, emptied his savings and eventually killed himself.

In March 2014, Saunders was given a one-year prescription for 10 grams a day of medical marijuana, enough for about 16 joints. He started taking the marijuana the following month.

According to his family, it was premium pot with high THC content of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)

Manic is what he eventually became.- Jake Saunders

Within four months, Saunders's family says he had become manic. He slept little, hardly ate and was spending a lot of money.

"Manic is what he eventually became," said his son Jake Saunders.

"He went out and he bought a Harley-Davidson. He bought at Porsche. He bought a hotel in Nackawic.

"The spending was just non-stop. Eventually, mother had to freeze the accounts because by that time, everybody knew there was something wrong."

Recreational pot user

Saunders, 54, was as entrepreneur and businessman who ran a bed and breakfast with his wife of 33 years, Kathy, in a Victorian-era home on University Avenue. He was just beginning a new career as a real estate agent.

Saunders's family says he had been a recreational user of marijuana for years, but was always concerned about getting caught on the wrong side of the law.

"The same way I'd drink a beer on weekends, he treated pot the same way," said Jake Saunders.

Saunders had some residual pain from a shoulder operation he'd had and was being treated for some anxiety he suffered following the deaths of his parents a few years ago.

His family doctor discouraged medicinal marijuana use because of Saunders's background, which included a previous brush with alcohol addiction and anxiety. 

She didn't think it was a good idea and warned Saunders against it.

When Saunders got the prescription from another doctor, Dr. Paul Smith, he sent for a supply of medical marijuana and started using it in April 2014.

"We were all a little shocked when he got the prescription so quick because we thought it was going to be a bit of a process," said Jake Saunders.

I could tell that he was smoking too much, especially with the strong stuff. You don't need that much.- Luke Saunders

Luke Saunders said his father lost control of his pot smoking soon after receiving the first two ounces in the mail.

"Smoking joint after joint, three in a row first thing in the morning before anyone is out of bed," said Luke Saunders.

"I could tell that he was smoking too much, especially with the strong stuff. You don't need that much."

Family attempts intervention

Last fall, Saunders's family tried to intervene, setting up appointments with their family doctor and the province's addictions services program.

The family also filed a formal complaint with the New Brunswick College of Physicians And Surgeons against Smith.

They were upset because they allege the prescribing doctor didn't consult with Saunders's family physician.

Smith told CBC News that Saunders was referred to him by another doctor Saunders had consulted, and not by his family physician.

The family is also upset Smith wrote a year-long prescription without any follow up.

"There's very clear guidelines on how to prescribe medical marijuana and this guy, the doctor did not follow them," said Jake Saunders.

"There was no consultation with our family doctor."

He said his father had been told for so long from his family doctor that he was not a candidate for medical marijuana, so there should have been more follow up after he received the prescription.

"When you prescribe something like this, you can't just give somebody 10 grams a day and go away and just think that everything is going to be fine," he said.

Smith says patients are briefed and coached on the use of medicinal marijuana, but, as with any drug, it's up to the patient to use it correctly.

Smith describes the 10 grams a day as "a ceiling dose," or the maximum amount that can be taken a day and not a prescription to use that amount every day.

Last fall, Saunders was stopped by the RCMP in Cape Breton, N.S., with a quantity of non-medicinal marijuana in his car.

Saunders's behaviour was so alarming he was admitted to the psychiatric unit in Sydney on an involuntary admission and transferred to the Dr. Everett Chalmers Hospital in Fredericton and eventually discharged.

By November 2014, with the help of his wife and family doctor, Saunders had stopped smoking marijuana.

But in January, Saunders received a summons from RCMP in Cape Breton and was informed he'd be charged with possession of marijuana for the purpose of trafficking.

Saunders's condition and behaviour appeared to be improving, but his wife says he was sad.

On March 5, Saunders was found dead in the family home. He had taken his own life.

College responds to complaint

Three weeks after Saunders's death, the College of Physicians and Surgeons responded to the family's complaint about Smith.

Both Smith and the college's complaints committee suggest an undiagnosed condition of bipolar disorder may have been an aggravating factor in Saunders's case. Other drugs that Saunders was prescribed for anxiety may also have played a part.

Smith also says Saunders appeared to be mixing the medicinal marijuana with his own supply.

"The guy was a rare circumstance," states Smith, who also said, "our program was lacking, we have acknowledged that."

The College of Physicians and Surgeons has recommended a number of changes as a result of the complaint:

• The prescribing physician now require that patients for medical marijuana have a witness to accompany the patient to ensure unexpected reactions are reported back to the doctor.
• More vigorous follow up of patients be carried out.
• In the future, most patients be given prescriptions of shorter duration so they have to come back to the doctor for renewals and assessments.
• The above recommendations be made known to all doctors through the college's next newsletter.