The date Oct. 17, 2018 and the legalization of cannabis will no doubt go down in Canadian history. But with this significant moment comes concerns that still have to be worked out. The CPSA has communicated a great deal over the past few years about cannabis for medical purposes, but you have likely noticed that we have not come out with a formal policy or standard on the consumption of cannabis for recreational purposes. There is a good reason for this and hopefully, I can provide you with some clarity on the subject.
Continue putting good patient care first
I don’t think I need to remind physicians that practising medicine while impaired is not acceptable and puts patients’ lives at risk. Impairment can come from a multitude of prescribed medications, alcohol or recreational drugs such as cannabis. For this reason, we don’t believe there is a need for a specific policy on cannabis consumption by physicians. Any cannabis with THC will cause a degree of impairment that could affect your ability to practise medicine and therefore should be avoided. It would be considered unprofessional to provide care to patients while impaired by any drug.
Many people are struggling with how to determine impairment after consuming cannabis and knowing how long after consumption the effects are still present. There are no really good answers to these questions, so my advice is to avoid consuming cannabis for recreational purposes if there is any chance you could be providing care to a patient. It’s just not worth the risk.
So what’s going to happen to cannabis for medical purposes after Oct. 17? While people won’t need authorization from a physician to possess or consume cannabis once it’s legal, I suspect we won’t see much change in the people who seek help from their physicians.
We may see a drop off of patients requesting cannabis authorization, but in many cases, people are struggling to find some form of treatment for their conditions and it’s important to continue providing the holistic care they need. Authorizing the use of medicinal cannabis without an appropriate assessment or follow-up is not good care, just as it wouldn’t be for any prescription medication.
There is support available if you need it
There will be many challenges ahead of us as legalization of cannabis occurs, but I know our profession will do well if we all focus on the CPSA Code of Conduct’s Expectations of Professionalism, especially the following line:
“As a physician, I will avoid misuse of alcohol or drugs that could impair the ability to provide safe care to patients.”
Last but not least, I want to remind all physicians that there is help if you need it. If you find yourself in a difficult place, suffering with an alcohol or drug use disorder, the AMA Physician and Family Support Program (PFSP) is available to support you, as is the CPSA Physician Health Monitoring Program (PHMP).
As society’s views on cannabis shift, so must the medical profession. But if we approach these types of situations with an open mind and continue to act in the best interest of our patients, we’ll adapt just fine.
Looking forward to your comments,