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Medical Marijuana, Marijuana legalization, Pharmaceutical Cannabinoids
Notwithstanding current popular opinion, the advent of medical marijuana as a therapeutic tool remains a work in progress. The Canadian courts enacted the Marihuana for Medical Purposes Regulations (MMPR) on April 1, 2014, but the government of Canada has not yet endorsed the use of marijuana, and dried marijuana is not an approved drug or medicine in Canada.3 Despite the popular conception that dried marijuana is not addictive, there is clinical evidence of a cannabis use disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders V and the World Health Organization. Cannabinoids appear to possess a variety of beneficial medicinal effects, particularly as adjuvant analgesics, but also demonstrate an adverse side effect profile, including potential psychopathologies and toxicities.1 The merit of dried cannabis as a pharmacologic agent has been further compromised by questions of route of administration, dosing and efficacy.5 These observations highlight a double bind, because there is a discrepancy between the law that is perceived to sanction the use of dried cannabis as a medicine, and the responsibility of physicians to adhere to evidence based practice. Today, the regulated legal access to marijuana expected by July 2018 represents an opportunity to re-evaluate the ongoing relevance and necessity for the medical access system.