In our travels to your offices we have heard a number of misconceptions about what is involved in prescribing medical cannabis. Here is our attempt to clear these up.

Special courses and or certifications are required before a physician can authorize cannabis.

False. There are no such requirements. For education there are some excellent resources available (and we list some here), and in general you should be able to learn what you need to know within an hour or two, especially if your patient engages our nursing service for the detailed education. Keep in mind the safety profile for cannabis is excellent, especially in comparison to some more commonly-prescribed pharmaceuticals.

Only Alberta (CPSA) requires that doctors register before prescribing. An email to the college stating your name, license number, and intent to begin authorizing cannabis is all that is required. Click here if you’d like to do this now.

Cannabis patients will require regular urine screening.

False. There is no such requirement.

There is not enough research on the efficacy and safety of cannabis.

True. There can always be more and higher quality research than what has been done to-date. This is also true for other commonly-prescribed medications. 95% of prescriptions for Gabapentin, for example, are for indications for which the research has found modest to no effect on clinical outcomes (PubMed). Please see our News, Research & Education page for access to the latest research.

The patient will be required to see the physician during titration.

False. Most patients are able to self-titrate to a therapeutic dose with some simple guidelines, and of course our nurses are there to help as well. The typical practice is to authorize 2 to 3 grams of dried cannabis or equivalent daily, and most patients achieve a positive outcome at much less than that. According to Health Canada data, the average prescribed amount is now 2.1g daily, but average daily amount shipped to patients is 0.7g. And even those numbers are skewed as a result of the pre-legalization “recreational patient“. The College of Physicians and Surgeons of Alberta (CPSA) does mandate quarterly eyes-on follow-ups with cannabis patients, however it is up to patients to book these and for physicians to inform patients of the requirement.

Other people will be drawn to your practice as a result of it becoming known that you are authorizing cannabis for some patients.

Possibly. This was much more prevalent in the days before adult non-medical (i.e. recreational) use was legalized. Nowadays, recreational users are far less likely to leverage the medical framework given the additional inconveniences it imposes, and this will continue to abate rapidly as the supply issues in the retail market are resolved. If your panel is full and you are not accepting new patients—of any kind—then turning away patients isn’t an issue anyways.

It is preferable to refer the patient to another doctor who does authorize cannabis, such as those working in dedicated ‘cannabis clinics’.

Yes and no. It might be easier for you, but it is more difficult for your patient and may result in them not receiving the same standard of care as you would expect and hope for. Furthermore, your patient may see a physician whose specialization has nothing to do with their condition (e.g. a cardiac surgeon for chemo-induced nausea, a psychiatrist for arthritis, or an anesthesiologist for MS spasticity). If you have a complex case and would like to refer to a specialist, please see our Referrals page.

Do you have other practice-related concerns preventing you from authorizing medical cannabis? Feel free to drop us a line and we’ll be happy to help. physicians@wayfarenursing.com