Number of cannabis prescribing physicians flatlines in Alberta as drug grows in popularity, new stats show

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The number of Albertans receiving prescriptions for medical cannabis continues to grow by leaps and bounds, new statistics show, but the number of physicians prescribing it has flatlined.

In 2017, 25,766 Alberta patients received a medical cannabis prescription, statistics released this week by the College of Physicians and Surgeons of Alberta (CPSA) show.

That represents a 50 per cent increase over 2016, when 17,195 Albertans received a prescription for some form of the drug.

During that same time period, though, the number of physicians prescribing medical cannabis dropped to 357 from 358.

Ed Jess, director of prescribing and analytics with the college, said that represents about four per cent of all physicians in Alberta.

Some have grown comfortable prescribing the drug, he said, but others remain “reluctant” to authorize it.

“There’s not much in the literature with respect to medical cannabis that talks about specific indications, or specific patients that might benefit from the product,” he added.

“So we’re not really surprised that those patients would then be referred on to somebody who has more experience or understands the product better.”

Monitoring medical marijuana

Medical cannabis is one of several drugs the college monitors — along with opioids and benzodiazepines — because of the potential for misuse, Jess said.

The CPSA began tracking medical cannabis authorizations in 2014, a Sept. 6 report to the organization’s council said. Just 825 Albertans had a medical cannabis prescription in 2014.

Statistics from the College of Physicians and Surgeons of Alberta on the number of patients receiving medical cannabis, and the number of doctors prescribing it.

To keep tabs on the drug’s use, the college contacts physicians who prescribe large doses of medical cannabis — greater than 10 grams per day — to understand their rationale. Physicians who authorize cannabis for patients under the age of 18 are issued questionnaires to explain why.

Three physicians have been referred to the college’s professional conduct branch for “egregious” concerns related to medical cannabis prescriptions, the report states.

More complicated than prescribing a pill, clinic says

Medical cannabis has been legal in some form since 1999, when dried marijuana was permitted for medical purposes through an exemption in the Controlled Drugs and Substances Act, according to Health Canada.

In 2013, the federal government brought in regulations that laid the groundwork for a commercial medical cannabis industry. Two years later, the Supreme Court ruled that restricting legal access to only dried marijuana was unconstitutional, opening the door to cannabis oils and other products.

Tim Baxter, a vice-president with Marijuana For Trauma, a chain of medical cannabis clinics with a location in Edmonton, was not surprised by the prescribing trends.

The 63 Avenue clinic, which employs physicians, nurses and cannabis experts, exclusively takes referrals from other physicians, then passes clients on to licensed producers that have potentially helpful products, Baxter said.

More and more physicians recognize cannabis can be helpful for people suffering from ailments including chronic pain, depression, anxiety, PTSD, and gastrointestinal issues, he said. But they often don’t know what kinds of cannabis might be beneficial.

“It’s not like a pharmaceutical drug where it’s a formulated thing, it’s the same every time,” said Baxter, a former combat engineer who served in Afghanistan. “It’s a plant … it’s not always the same.”

“Unless you take the time to learn about it as a family doctor before you make that prescription, you shouldn’t be doing it,” he said. “You should be referring to an expert.”

In 2017, physicians who prescribed medical cannabis averaged 72 patients, up from 48 the year before.

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