Canadian Medical Association shouldn’t give cannabis cold shoulder

The Canadian Medical Association (CMA) recently announced that it supports the elimination of the current medical cannabis system  once federal legalization is implemented in October. The rationale is “the lack of evidence, the lack of scientific studies showing it actually works, the lack of knowledge around dosing and interactions with other medications.”

The CMA’s reservation with cannabis as a safe and effective therapeutic option mirrors concerns within the medical community. Cannabis is known to be cognitively impairing, and scientific research on its chronic use is limited. It is also well established that cannabis may have deleterious effects in the neurologic development of the central nervous system, which does not fully mature until 25 years of age. This uncertainty, combined with an aggressive timeline for legalized consumption, has handcuffed health care providers, who possess varying degrees of comfort with prescribing medicinal marijuana.

However, with its position, the CMA has not only demonstrated its lack of willingness to learn about this growing field, it has abandoned physicians who will invariably field more inquiries about cannabis from patients. This is especially problematic given the growing scope of cannabis as a therapeutic option in conditions including epilepsy and spasticity. Moreover, in the context of a national opioid crisis, cannabis is growing as an alternative for chronic pain patients, and is currently recommended as a third-line medication according to the national pain guidelines.

Even more concerning is the emerging pattern among medical associations to be slow to evolve with the changing times. For example, many were initially resistant to embrace social media and online dialogue, which allowed for the unfortunate proliferation of medical misinformation. Nowhere is this more exemplified than with the anti-vaccine movement , which was given space to grow due to the void in evidence-based contributions from the scientific community.

This lack of checks-and-balances is poised to repeat itself as a result of the reticence from Canada’s largest physician body. By removing itself from the conversation, physicians under the guidance of the CMA run the risk of letting the cannabis narrative be controlled by actors looking to maximize profit ahead of patient benefit.

The CMA recently came under fire for its sale of one of its crown-jewel assets, MD Management, to the tune of $2.5 Billion. CMA members, who do not collect any of the proceeds, criticized the organization for not consulting them before closing the deal. This eye-watering windfall is expected to further the institution’s strategic vision, which includes improving physician wellness. This is an important issue, and the CMA should use a portion of the MD Management revenue to create a free, continuing medical education program for physicians to learn about evidence-based research for new interventions including cannabis.

The Cannabis Act will represent the Trudeau government’s signature legislative victory during its first term, despite expressed concerns from the medical community. Ultimately, physicians need to be prepared for the new reality of legalization, and the CMA would be wise to support its colleagues to tackle this issue head-on.