seizure disorders, muscular spasticity and chronic pain. PRESCRIBING IN CANADA The medicinal use of cannabis was le-galized in Canada back in 2001 under the Access to Cannabis for Medicinal Purposes Regulations (ACMPR). Can-nabis became legal for recreational use on October 17th 2018. Now both me-dicinal and recreational cannabis guidelines and regulation fall under the Cannabis Act (2018). From 2001 to 2018 patients could get a prescription for medical cannabis if they met certain criteria, namely had a condition can-nabis was approved for, was over the age of 18, and had tried all standard first-line therapies with no benefit. The largest obstacle in the early years of medicinal cannabis legalization was finding an MD or nurse who was com-fortable making the prescription. Cannabis was still very taboo and didn’t adhere to the same dosing guide-lines and algorithms that most pharmaceutical medications had. Can-nabis was in many ways closer to herbal medicine than to pharmaceutical med-icine. The ACMPR dosage guideline to this day states that: “There are no precise doses or established uniform dosing schedules for products such as fresh marijuana, smoked/vapourized marijuana, or cannabis oil.” There was a lot of sketchy dosage recommenda-tions going on during this time. Thankfully as cannabis prescribing clinics started to open and healthcare practitioners worked with cannabis more regularly, better dosage guide-lines were established. One such guide-line, which I personally hand to pa-tients, is the Canadian Pharmacists Association document on how to help patients find a safe and effective dose. “Starting low and going slow” pretty much sums up the best and most agreed upon way to approach the use of medical cannabis. For those of us in the complemen-tary and alternative medicine (CAM) disciplines, we unfortunately cannot as of yet prescribe medicinal cannabis. Prescribing medicinal cannabis is only allowed through an MD or nurse prac-titioner in Canada. It’s bewildering to me as to why HCPs with the most foundation in herbal medicine were unable to prescribe a substance more akin to botanical medicine than to a pharmaceutical. It’s not even an argu-ment of safety since cannabis has a better safety profile than acetami-nophen. For now our role as CAM practitioners, who have undergone additional training in medicinal canna-bis, can be as an educational resource for patients who are currently medicat-ing with cannabis, who are cannabis curious and whom would likely benefit from cannabis therapy. Whether through professional diagnosis or self-diagnosis; recreational or medici-nal markets, patients are trying canna-bis and many of them have no idea how to use it safely and effectively. That’s where we can make a difference. cndoctor.ca Untitled-2 1 May 2020 Chiropractic and Naturopathic Doctor 21 2020-04-24 2:50 PM
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