Cannabis Patient Care - March/April 2021

Cannabis Patient Care - March/April 2021

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8 cannabis patient care | vol. 2 no. 1 doctor focus I F YOU ASKED Georges Theriault what pain feels like, he'd tell you about a day he sat alone in his garage. Unable to walk, barely able to stand, he recalls the moment he real- ized he had become a shell of his former self. "When you're sick, you can't believe what your life has be- come," said Theriault, a 63-year-old Canadian Forces and Royal Canadian Mounted Police (RCMP) veteran, who was diagnosed with diabetes in 2012. Before his diagnosis, Theriault rarely sat still for long. He qualified for pre-Olympic boxing, ran sled dogs in Alaska, worked as a ski patroller in Europe and, before retirement, led an executive security firm protecting top Canadian politicos. After retiring and relocating from Ontario to New Brunswick, his health quickly and steadily declined; before long, the ef- fects of the illness required the replacement of one hip and both knees. After three surgeries and four years of physiotherapy and conventional opioid-based narcotics, as well as naproxen, Theriault still hadn't recovered. "At the very end, I was in the hospital for eight days and the doctor looked at me and said, 'I can't do anything else for you,'" he shared. Theriault's story is all-too-common in Dr. Julie Hildebrand's practice. In her 30 years of biomedical research and patient ex- perience, she has met many patients like him, caught in a pain management symptom-prescription loop. "As physicians, we do not like to star t treatment for pain with narcotics, though it is, unfor tunately, where many pa- tients end up," Hildebrand said. "We usually star t small— with anti-inflammatories and massage—and augment pro- gressively if symptoms do not abate. But once a patient star ts with opiates, treatment can spiral as the body devel- ops a tolerance—after that, there is ver y little left in terms of conventional treatment. Cannabis has given some of my patients new hope, however." Hildebrand is a New Brunswick-based physician published in papers and publications on cannabis medicine as a new therapy, effects of opioid addiction, methadone treatment, analysis, and mental health. She works closely with Starseed Medicinal, the medical division of Canadian licensed cannabis producer WeedMD Inc., to provide cannabis counseling and treatment options for patients in the country's Atlantic- area provinces. A general practitioner, Hildebrand began prescribing can- nabis to patients in 2014. She became interested in learning more—a lot more—about cannabis medicine after seeing sig- nificant improvement in patients suffering from chronic pain. Over the following seven years, Hildebrand became the At- lantic region's foremost exper t physician prescribing medical cannabis. Theriault, a 40-year military and RCMP veteran, had nev- er tried cannabis in any form before. Through a series of re- ferrals, he connected with Dr. Hildebrand, who prescribed the drug in an oil format, high in both tetrahydrocannabinol (THC) and cannabidiol (CBD). Within a year, he had transitioned off all narcotics for cannabis, and today, he says he is pain-free. "The (hospital's) doctor couldn't believe it. I can ride my mo- torcycle, I can walk. I went from using a walker to having a new life," said Theriault. Like Theriault, many of Hildebrand's patients find canna- bis as a third or fourth-line treatment option for conditions, ranging from post-traumatic stress disorder (PTSD) to fibro- myalgia. And like Theriault, who is now a medical patient of a local New Brunswick-based licensed producer, most have gone down traditional pharmacological treatment paths with little success and turned to cannabis when all else failed. "Patients would come to me and say 'cannabis works.' I wasn't comfortable with the idea of patients buying it on the street, so I started to study the phenomenon from a clinical perspective, travelled and met experts, and read all I could that was available to offer treatment and counseling. I was quickly overwhelmed with both the demand and the impact of this medicine. It opened up a new era of treatment for me," said Hildebrand. "As a physician, it is gratifying to see results after so many failed attempts." Finding Your North Star: A Cannabis Alternative in Pain Management in Canada B Y V I C T O R I A D E K K E R

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