Cannabis Patient Care - March/April 2021

Cannabis Patient Care - March/April 2021

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12 cannabis patient care | vol. 2 no. 1 cannapatientcare.com holds a partnership with Labourers' International Union of North America (LiUNA) the largest construction union in Can- ada with a number of Ontario-based locals signed. In Janu- ary 2021, the company signed its sixth LiUNA local and first in Manitoba, to the Starseed medical program. "We wanted to build a program that, for the first time, could really bring insurers and employers together to provide in- sured patients with an alternative to other covered drugs, like opiods and benzodiazepines," Blecher said. "We know all the too well the stories about the ripple effect of opiate drugs and addiction. While those pain medications are relatively inex- pensive to pay for up front, the percentage of patients who develop dependency, in turn, run into a host of other issues: a decline in job productivity, more time off the job, slower re- turn-to-work, mental health and addiction issues, and new expenses such as dental care or long-term methadone treat- ment, all of which cost insurers far more in the long run." Starseed works directly with insurers on their patients' be- half to ensure medication is paid for in the background as pa- tients focus on their treatment. The only other group that re- ceives a comparable level of coverage are Canada's veterans. In fact, many licensed producers work with veteran groups to provide advocacy and education to those with medical canna- bis coverage, reimbursed by Veterans Affairs Canada. While national registered patient counts dipped follow- ing legalization, data shows patient counts are once again ris- ing steadily. Today, according to Health Canada, roughly 375,000 patients are registered with federally licensed producers, while 43,000 are registered for personal or designated production. Canada's cannabis industry has grown exponentially in re- cent years. Pre-recreational legalization on October 17, 2018, 125 producers were licensed. Today, more than 570 producers are licensed for various activities, including cultivation, pro- cessing, sale, research, and testing. Paving the Way Forward In Hildebrand's practice, the rates of new patients signing up for medical cannabis—particularly seniors between the ages of 70 and 90—are on the rise. Cannabis is talked about in retire- ment-age communities as a safer treatment option, and pain sufferers are interested in trying it more than ever, she explained. "Considering cannabis is legal for purchase in-store, now when a patient reaches out, I know they are serious," said Hildebrand. "They need professional advice on how to con- sume, how often, and whether there are any contraindica- tions—you can't get that at a recreational shop. It is vital that practitioners are ready and able to support them, but there are still many barriers to access." Though cannabis is legal in Canada, many physicians are still reluctant to prescribe because they are not sure about dos- ing and which formats to prescribe—they simply don't know enough about it, Hildebrand noted. Most patients find her by referral, or through their own research after their requests for medical cannabis are rejected by their own physician. "It happens a lot. I often hear that physicians are only will- ing to try medical cannabis after all else has failed. My mes- sage to other doctors is that we don't have to wait until all other avenues have been explored, especially opiates," she said. "In medicine, we learn a great deal from books, black and white. But when we get in front of patients, most conditions often fall in a grey zone. Though sticking to outlined criterions are important and useful, the really good doctors also follow their intuition and are willing to think outside the box." Data from Health Canada suggests that in some provinces, fewer cannabis prescriptions are being issued. Between Sep- tember 2019 and March 2020, Alberta, Newfoundland, and On- tario saw fewer healthcare practitioners associated with regis- trations, leading to the assumption that many people could be self-medicating by accessing cannabis through other means. The regulator's 2020 Canadian Cannabis Survey (CCS) re- ported that 14% of Canadians aged 16 and older indicated they used cannabis for medical purposes. The report found that just over 20% of medical cannabis patients access treat- ment with a medical document, which means the rest are purchasing their medicines from either the recreational or the illicit market. In addition, Medical Cannabis Canada's 2020 survey found that among medical cannabis patients, 50% reported that it's hard to find a healthcare practitioner to speak with about obtaining a medical document and 83% reported that the stigma about medical cannabis use exists among medical professionals. The optics of cannabis use—smoking, rolling, pipes, and bongs—and antiquated, prohibition-era ideas about the drug contribute to its limited acceptance in the medical doctor focus In many cases, cost is the single-largest barrier for patients, and the reason why they revert back to cheaper, covered, and often more dangerous and addictive medications – D R . P E T E R B L E C H E R CONTINUED ON PAGE 28

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