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Regulations to access marijuana
The Access to Cannabis for Medical Purposes Regulations (ACMPR) came into force on August 24, 2016, repealing the Marihuana for Medical Purposes Regulations.163 Physicians should be familiar with the new regulations, and should know and abide by applicable College policies.
The aim of the ACMPR is to treat marijuana as much as possible like other narcotics used for medical purposes. Under the regulations, a patient must consult with a prescribed healthcare practitioner, a physician or a quali ed nurse practitioner, and obtain a signed “medical document.” Patients then submit the medical document directly to a licensed commercial producer to obtain the medical marijuana or register with Health Canada to produce a limited amount of marijuana for their own medical purposes, or designate someone else to produce it for them. Alternatively, arrangements can be made for the producer to transfer the drug to the healthcare practitioner who signed the medical document, and the patient can obtain it from the healthcare practitioner.
All Colleges have been critical of the regime to access marijuana for medical purposes. Many Colleges have issued guidelines or policies, which impose additional obligations over those set out in the regulations. Although there are some common themes expressed in the College policies and guidelines, there are some notable variances.
Some of the common themes include:
Regulations to access marijuana
The Access to Cannabis for Medical Purposes Regulations (ACMPR) came into force on August 24, 2016, repealing the Marihuana for Medical Purposes Regulations.163 Physicians should be familiar with the new regulations, and should know and abide by applicable College policies.
The aim of the ACMPR is to treat marijuana as much as possible like other narcotics used for medical purposes. Under the regulations, a patient must consult with a prescribed healthcare practitioner, a physician or a quali ed nurse practitioner, and obtain a signed “medical document.” Patients then submit the medical document directly to a licensed commercial producer to obtain the medical marijuana or register with Health Canada to produce a limited amount of marijuana for their own medical purposes, or designate someone else to produce it for them. Alternatively, arrangements can be made for the producer to transfer the drug to the healthcare practitioner who signed the medical document, and the patient can obtain it from the healthcare practitioner.
All Colleges have been critical of the regime to access marijuana for medical purposes. Many Colleges have issued guidelines or policies, which impose additional obligations over those set out in the regulations. Although there are some common themes expressed in the College policies and guidelines, there are some notable variances.
Some of the common themes include:
- Physicians are under no obligation to provide patients with a medical document to access the drug.
- Physicians should obtain informed consent before completing the medical document and should record the consent discussion in the medical record.
- Physicians should evaluate the patient’s clinical condition regularly to assess the bene ts and risks of marijuana use. Some of the variations include:
- - In Québec, physicians are prohibited from providing a medical document to access medical marijuana unless the patient is enrolled in a recognized research study and only for speci ed conditions.164
- - In Saskatchewan, physicians must obtain a signed, written treatment agreement from patients that spells out the patients’ obligations, including using the marijuana as prescribed.165
- - In British Columbia and Prince Edward Island, physicians must avoid using telemedicine to complete the medical document.166
- - In Nova Scotia and Ontario, physicians are prohibited from charging fees related to the completion of the medical document.167
Physicians who choose to complete a medical document should always rely on sound medical judgment and comply with their College’s relevant guideline or policy. The CMPA website (www.cmpa-acpm.ca) includes up-to-date information on this evolving topic. Members can also call the CMPA for advice
- - In British Columbia and Prince Edward Island, physicians must avoid using telemedicine to complete the medical document.166
- - In Québec, physicians are prohibited from providing a medical document to access medical marijuana unless the patient is enrolled in a recognized research study and only for speci ed conditions.164
