A Clinical Approach to Prescribing Cannabis
The Clinic Network (TCN) is committed to supporting physicians who wish to acquire “working knowledge” of the science behind cannabinoids and how to effectively apply this knowledge within a clinical setting. Given that this branch of medicine does not have an established clinical history (evidence based research), the 5 years of experience our physicians and support staff have acquired is vitally important.
Patients who are tired of or unresponsive to prescription drugs are turning to natural types of medicine; and cannabis requests to physicians are increasing exponentially. The following document is intended to clarify and answer some of the questions that physicians may have.
TCN support staff and physicians have in place standard policies and procedures to deal with patient screening, intake, assessment and documentation. This includes identifying patients with risk factors to cannabis use. It is important to convey that the use of cannabis is simply a part of an overall strategy to assist the patient in achieving an improved quality of life.
To initiate the process, TCN has created an “Intake form” which patients can fill out online or in clinic and our central care team will aid them through our process. The form includes information concerning the patients past medical history, previous cannabis use (including frequency, timing and method of consumption) as well as a list of previous and current medications. The purpose of acquiring this information is to ensure the patients safety and prevent abuse. Certain risk factors are considered including history of addiction, depression, emotional disorders and high dose recreational use.
Once the patient completes the screening process, an appointment will be made with one of our trained educators and with a TCN healthcare professional. The initial consultation will involve a review of the information from the screening process, identify the main purpose (ailment) for the patients visit and provide cannabis education. When appropriate to recommend medicinal cannabis, a daily dosage regimen will be stipulated, a strain type may be suggested, the “medical document” signed and an interval care schedule is established. Following the physician consultation an educator discussion will ensue regarding Licensed Producer options and registration.
Finally TCN support staff are available throughout the term of the medical document to answer patient questions regarding product delivery, quality concerns, alternative strain types, pricing options, new strain development and longitudinal care.
There are two subspecies of cannabis: Indica and Sativa. Indicas are as a rule more sedative and Sativas more stimulatory. Since they are not individual species, they are cross breed to create hundreds of hybrid strains, each strain holding a different pharmacology.
There is no “established” dosing schedule for medicinal cannabis, however according to Health Canada, the average patient use is between 1-3 grams daily. The average percentage of tetrahydrocannabinol (THC) and cannabidiol (CBD) is 17% and 5% respectively. However, it should be noted that there is an increased demand for high CBD with low THC flower and oil products. CBD can promote calmness, a positive sense of well being, an upbeat mood and relaxation. Patients describe the experience as that of being clear-headed and focused, with no change in cognitive function.
Dosage regimes vary depending on the patients aliment, and preferred method of intake (i.e vaporizing, oral ingestion or smoking).
TCN educators will advise patients on usage parameters as well as the risks of cannabis treatment. In particular patients will be cautioned with regard to driving or the of use heavy equipment while using cannabis. Also possible side effects are discussed such as anxiety or mood changes.
From our support staff, patients will receive a thorough understanding of the relevance of Licensed Producers, cannabis types (Indica and Sativa), THC and CBD ratios, pricing, product delivery, packaging, labeling and maintenance of documentation to ensure legality.
TCN and most Licensed Producers (LP) offer compassionate pricing based on disability and/or the patients financial circumstances. Patients are advised that medicinal cannabis & related product purchases are tax deductible.
Please fax/provide a copy of any relevant reports/letter from consulting specialists.
Please Note: If you are an Ontario physician and belong to a family health team (FHN, FHT, FHG) you will not be negated for referring to one of our Specialists or Nurse Practitioners.