Monday, Feb 13, 2017 

 

Health News
High Without Being "High"

Doctor offers advice to doctors on prescribing cannabinoids
Submitted by Tracy Lamourie

 

Tracy Lamourid and her husband flank federal NDP party leader Jack Layton.

 

 

r. Ira Price speaks on the topics related to his experience in the emergency room, with sports medicine, and how that work lewd to, and was impacted by, his leadership in cannabinoid medicine.

 

Dr. Price on how cannabis helps with various ailments:


"The key is to first "Do no Harm" then do everything you can! This should be the creed of all medicine. Cannabis is no exception. We have been extremely fortunate with Cannabis, for
the past 30 years governments have funded plenty of studies trying to prove the harmful effects of Cannabis on the human body, and each time, and for the most part, without exception the majority of these studies failed to show significant harm and in the contrary showed us that Cannabis has a large safety profile. Sure we need larger longitudinal studies but which drug doesn't and to deny this body of literature is to deny our duty to do no harm. As not seeing cannabis as an alternative to traditional medicine, especially opioids, is to cause patient harm"

Dr. Price on cannabis as treatment for opiods:

 
"Cannabis has the potential to be used for an array of diseases and ailments. The vast majority of pain patients are tired of their opioids. They are tired of popping pills that can potentially
kill them. In Canada, one of the leading causes of death in young people are opioids either intentional or otherwise. Have you seen cannabis killing people? I don't think so. If cannabis
is so dangerous the bodies would be piling up - 40 percent of our population has tried it and 14 percent on a regular basis but there are no bodies. While on the other hand opioid overdoses are increasing on a dangerous level. We know there are synergies between opioids and cannabis, so of course it works.

 

We have the literature and I certainly have the patients to
show for it...I got into Cannabinoid Medicine because I was tired of seeing opioid overdoses. Each shift, I see at least 1 or 2 overdoses, intoxications or abusers all because of opioids and
it needed to stop. This is my way of stopping it. I have 2700 patients in my Hamilton clinic, all of whom work on decreasing their narcotic use. Our success is astonishing. "

Dr. Price on role educating doctors:


"For the past 5 years I've been fortunate enough to educate hundreds of physicians on the clinical application of cannabis. Cannabis wasn't one of the lectures we received in Medical
school and to no physicians fault, most don't even know where to begin. It can be intimidating for a physician, who is held to the unrealistic standard of "knowing all" about health, to sit with
a patient who knows more about a drug then they do. So I don't blame physicians who don't prescribe cannabis.

 

That being said, Cannabis is here to stay and so I made it my mission to educate as many physicians as possible on The use of Cannabis in Medicine. I've taken serious flack for it in the early years for sure. When I first started, there weren't more then a handful of physicians Prescribing cannabis, there were no guidelines or protocols, I sat out there basically waving my flag all alone and yeah, it brought a lot of attention. I didn't care, I was helping patients! One day I'd be used by the media as a medical expert (for example Global National) and the next day I'd be their public enemy. There was a significant amount of poor  reporting. This still happens. It's a systemic issue. The same as it is in medicine. At least in medicine, we search for truth, no matter what are bias. So I found myself trying to change the message and now colleges accept cannabis, physicians are prescribing it, a legal industry literally blooming in front of us and I'll keep on educating until that message is clear; cannabis is safe and a viable alternative or adjunct for many ailments."

Dr Price on the questions doctors have about prescribing cannabis:
 

My patients just want to smoke the stuff and be lazy. Any drug can be abused. The message should be clear, it's not for everyone and no drug, whatever it is should be abused.

How do you dose cannabis?


It's a long answer. The short answer is follow "the price protocol" which is the protocol I created 4 years ago for initiating the naive user.

The most fascinating sociological part of cannabis is that it's the only medicine I can think of that truly requires a collaborative process between patient and physician."

Dr Price discusses his perspectives on cannabis in sport / use among athletes:

"We know it's safe, we know it isn't a performance enhancing drug, we know it's Neuro protective (it protects the brain), so why not? Why are opioids that kill people ok? It's backwards thinking. It's not progressive and it's not science, if we continue to ban cannabis. 
 

Addiction amongst athletes is an issue, I know because I work with teams! We can avoid these things. It's my recommendation that Cannabis should to be seriously considered and taken off
the ban substances list."

Dr Price on the media and it's reporting on cannabis as medicine:

"I have one major regret throughout this whole experience, and that's that I haven't been able to change the conversation in the media. We are still using terms like marijuana, despite knowing it's origins, we are still portraying cannabis users holding big blunts and smoking joints, when the news comes on I see it being reported as the Wild West or "pot nation" but the truth is cannabis is far from this and it's my regret that I haven't been able to explore these avenues with a reliable media source. For the most part I've always avoided the media because after what Global National did, I didn't trust any of them, it was totally inaccurate and sensationalized reporting, that severely damaged both the medicine and my reputation. So I avoided them. They seem to always come back when there are defeats but never during the successes and the success of cannabis far out-ways the defeats and set backs. I focused on my patients, and I still do but the conversation needs to change and now it's time."

Dr. Price on the current state of medical cannabis supply in Canada:

There is a supply and demand issue that is facing Canadians. There are approximately 40 LPs in Canada and together they aren't able to supply the needs of Canadians currently. Every LP
faces similar issues, after all Cannabis is a plant and one has to farm it and there are always issues. The strict regulations that Health Canada imposes on the Legal Grow Operations under the ACMPR, combined with the neglect and lack of surveillance by authorities of "dispensary model", a model which should be seen as an utter disgrace to the cannabis community (both medical and lifestyle alike), drives a money hungry black market.
 

That being said, regulation on quality is absolutely necessary but we need to create a system that provides safe access to everyone whether medical or otherwise.

 

There should be tax breaks for those who require Medical Cannabis and a proper taxation on those who are lifestyle users but all should be required to have proper quality assured cannabis.


As a physician, the MMPR was by far a larger step forward for the progression of Cannabinoid Medicine than the ACMPR. The ACMPR was two steps backwards in my opinion. Placing
physicians in a position (by the government) to write prescriptions for people who are growing their own cannabis is unsafe and unfair to doctors. Legalize it for these people before placing physicians at the helm of a system that has virtually no ability to be monitored for the majority of physicians.

 

For myself, I've implemented systems to help monitor people
that are self growing but I've had to be creative to do it as legislation itself pretty much prohibits physicians from monitoring the quality of self growing.


Should physicians prescribe medications without doses? If I told you to go take your diabetes pills and you asked me how much and I responded, I don't know take a few and see what
happens, I would be not only in neglect of my duty to do no harm but I would feel extremely horrible if there was a side effect. Knowing that this medication can help but having my hands
tied is tough. The reason for moving back for the ACMPR from my understanding was basically to increase affordable access to medication. So make it affordable, impose legislation forcing insurance companies to cover Cannabis. That is a far more responsible choice then creating another black market of self growers looking for the highest possible
prescription doses.

Dr Price on the widely reported storefront dispensaries that are illegal under the current system and whether they might have a role in the coming legal and regulated marketplace:

The current dispensary model disgusts me. For the most part (and there are of course the odd exception to this) owners of these dispensaries have absolutely no interest in helping their
clients, no compassion as they like to claim and definitely could care less about the quality of their cannabis. Some of them, specifically in Hamilton, have even committed fraud, placing
my name without put my permission on cards, presenting them to their clients and saying "Dr. Price is now your doctor is anyone asks". I've had to call the police and send cease and desist
letters. One story even worse then this stands out in my mind, I was hiring a cannabis Educator for my Burlington clinic who divulged that she had previously worked at a dispensary
who forced her to obtain a thirty gram per day medical document from a disgusting physician out of Toronto, for self growing.

 

This physician, charges $100.00/gram to these people and
will sign scripts for anything. It's disgusting and appalling. This is what the ACMPR has created. When I first started prescribing Cannabis in 2010, I had to bill patients directly, as OHIP at the time, in writing told me that it was a federal program and therefore not covered by the provincial insurance company. At that time I billed patients $250.00 dollars per year and still saw them every three months. I spent the next three years writing letters to OHIP asking if they would change their mind and finally in 2013 when the MMPR came into effect, they finally wrote stating "given the changing political atmosphere it is now going to be a covered service".

 

From that moment forward I have never charged a mandatory fee in my clinic. When I see physicians working with dispensaries like this it literally makes me sick and makes me so disappointed. It detracts from the hard work, that those who really care have fought for so hard over the years.

I think there is a place for store fronts to sell cannabis in the future marketplace. I would likely partake from a medical perspective. It will be great when patients no longer have to
wait weeks to obtain their medicine and can purchase it on the spot. I also think this requires regulation. The most important aspect of regulation in my mind is quality assurance. Granted,
there aren't bodies piling up from cannabis deaths, over the thousands of years cannabis has existed but there also weren't killer pesticides and chemicals for thousands of years. With the
increasing fungal and bacterial loads found in recreational cannabis, along with the mixture of harmful new synthetic cannabinoids like K2, spice and bath salts showing up in ERs around the country, we need quality assurance regulation. Once this is figured out, I don't see a problem with store fronts selling cannabis. There is more harm, I'd say with putting Cannabis in places that sell alcohol and Cigarettes, both of which are far more detrimental to health then cannabis.

When the Doctor was asked for a a story that sticks out about a patient who benefited from cannabis where other medicines had not helped, he responded:


I'm going to give you hundreds of stories! The experience is not unique anymore. I have approximately 2700 patients in my Hamilton clinic. We have a 75% success rate at decreasing patients opioid use at least 50%. We have a huge success rate, at getting patients off there opioids altogether. Patients who's opioid doses are 8-10 times higher then the recommended daily amounts come in at wits end! They are frustrated, their physicians are frustrated, their family is in shambles and no one knows where to turn. So they put their faith in us. This is the story of Synergy on a daily basis and it doesn't matter if you are 3 years old (our youngest CBD prescribed patient) or 93 (our eldest cannabis patient) We work with our patients. We don't judge them. We accept them. We collaborate and council and then create a treatment plan. I couldn't be more proud of a group of health care workers and patients then those that you see at Synergy.

Sure, cannabis doesn't work for everyone. I've had to fire patients for being abusive to our physicians and staff. I've had to call the police and I've dealt with threats and college complaints from unsatisfied patients not getting what they want but at the end of the day, these people are far fewer and in between then our outstanding patients.


In general, I explain the benefit of Cannabis on a population like this; out of five people it works excellent for two, ok for 1 and doesn't do much for two.


Dr Price on community reaction to the cannabis clinics and the reaction of other doctors:

When I first began prescribing Cannabis in 2010, there was negative feedback from well everyone, aside from the patient. I had the media accusing me of "charging money to access health care", as we have all seen, I've had the college investigate my clinics for four years and 97% of my patients were self referred. Today, seven years later, I have a 99% physician referral clinic with over three hundred referring physicians; I have 2700 patients in my Hamilton clinic and just about to open a Cannabis Wellness Centre in Burlington full with Vape Yoga and exercise therapy; I've published a clinical guide to prescribing Cannabis with a specific dosing protocol called "the price protocol" (named by another physician) which is used by physicians around the country; my practice has been peer reviewed and accepted by the College; I've lectured at most large medical schools around the province; I've educated thousands of physicians around the country; the conversation in the media, although still has a way to go, has come quite far; and most importantly Cannabis is viewed, in my opinion, by the majority of Canadians as a therapeutic option! This is amazing. Has the journey been easy?


Hell no! I've taken bumps and bruises. I've been the scapegoat for everyone at some point. But I've also never felt better. I've seen Cannabis change the lives of thousands of people and
I've been at the forefront of a new, developing medication. An industry built on the request of patients who have had enough.

Sure, there are roads that still need to be crossed. Landlords are hesitant to lease space, and community members are hesitant to have cannabis related services in their neighbourhoods but this is just a matter of education and these barriers are being "up rooted" one lecture at a time.

 

See more from Tracy Lamourie on her blog here.

 


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