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New rules for medical use of marijuana issued

New rules announced by Health Canada permitting producers of marijuana to sell it in different forms present even more challenges for Canadian physicians.

As the result of a recent Supreme Court of Canada decision, the federal department has issued new Section 56 exemptions — which allow the 25 licensed producers of marijuana in Canada to sell cannabis oil and fresh marijuana buds and leaves, in addition to the dried marijuana already available.

Health Canada noted “the role of healthcare practitioners in authorizing marijuana for medical purposes does not change.”

The Health Canada statement also reiterated that marijuana is not an approved drug or medicine in this country “and has not gone through the necessary rigorous scientific trials for efficacy and safety.”

The change to allow marijuana to be sold in other forms does not permit producers to sell edible products or plant material that can be used to grow marijuana. Patients who receive an authorization will have to prepare foods or drinks with fresh marijuana or oils themselves.

“Canadian courts have required reasonable access to a legal source of marijuana for medical purposes when authorized by a physician,” the statement says. “The Government of Canada's position is that this must be done in a controlled fashion to protect public health and safety.”

CMA President Chris Simpson commented: “The Canadian Medical Association continues to feel that the regulatory approach to medical marijuana places physicians in a difficult position and is normalizing use of a substance of unproven scientific benefit.”

However, Simpson added, “we recognize that some individuals for which conventional therapies are not effective may get relief from marijuana used for medicinal purposes, and in some cases the benefit might come from using marijuana as an oil.”

Simpson said the new changes should make physicians even more cautious when approving use of marijuana for medical purposes, because of variations in the bioavailability of marijuana’s active ingredients that can occur when it is consumed orally rather than inhaled. There is little or no evidence to guide physicians in the authorization.

The revisions to Health Canada regulations were made to address uncertainty following the Supreme Court’s June 11 unanimous decision stating that marijuana can be consumed in a variety of ways in addition to smoking or vaporizing the dried product.

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