Medical marijuana prescription 'gap' challenged
Ed Schollenberg of College of Physicians says lack of pharmacy involvement makes patient intervention harder
The ability of people to fill medical marijuana prescriptions directly with a government-approved grower, rather than a pharmacist, creates difficulty for physicians trying to keep tabs on a patient, says the registrar of the College of Physicians and Surgeons of New Brunswick.
A Fredericton family went public on Monday with questions about medical marijuana prescriptions after Steve Saunders, a 53-year-old businessman, husband and father, committed suicide about one year after receiving a prescription for medical marijuana.
The Saunders family challenges a lack of consultation between prescribing physician Dr. Paul Smith and the Saunders family doctor.
They also question the need for a one-year prescription of up to 10 grams of marijuana a day — enough for about 16 joints, as well as the use of marijuana they maintain had a THC concentration of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)
Schollenberg was not prepared to discuss the specifics of the Saunders case, but in general terms he notes the college has always opposed the dispensing system for medical marijuana, which was approved by the federal government, giving the patients a direct route to the approved drug suppliers.
Dispensing protocol problematic
"Unlike going down to the local pharmacy, which the physician will have a long-standing relationship with, the patient may transmit this prescription in any grower in Canada, who will then mail the supplies to this patient on a monthly basis," said Schollenberg. "The physician may not always know where the patient got that prescription filled."
Schollenberg maintains if a medical marijuana prescription was filled through a local pharmacy a doctor is accustomed to dealing with, there would be a greater chance of the physician intervening.
"There could be an intervention saying, `Before you refill the prescription again for Mr. X, please have him come and see me,'" said Schollenberg. "Physicians can do that now because they know the patient gets their prescriptions fills at Shoppers or Jean Coutu down the street. In this case, they may not know where that prescription is filled."
However, Schollenberg doesn't expect the dispensing protocol to change any time soon.
Physicians just have to be aware of that and mindful there are yellow signs on this road that say slow down and do things differently.- Dr. Ed Schollenberg, registrar College of Physicians and Surgeons of New Brunswick
"The reality is that's the way it is," he said. "That's not going to change because any changes will have to be done by the federal government, they will be glacial at best.
"Physicians just have to be aware of that and mindful there are yellow signs on this road that say, Slow down and do things differently because you don't have the same controls you might have for actually much more dangerous drugs, like some of the narcotics and some of the sedatives physicians prescribe for patients,'" said Schollenberg.
"Right now, if a pharmacist has any reason to question something about a prescription, they contact the physician and they pass the information along," he said. "We have no idea whether the commercial growers will feel the same obligation, whether they'll even be aware of issues.
"They will be dealing very much at arm's length. It won't be somebody walking into their store to physically pick the stuff up. Everything will be done at a long distance and it's really unclear whether they will be that interested in intervening."