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10 cannabis patient care | vol. 2 no. 1 cannapatientcare.com Dr. Peter Blecher, Starseed Medicinal's Chief Medical Officer who helped set up the Starseed Medical platform and bene- fits reimbursement structure back in 2014. Medical producers can guarantee access to medical-grade cannabis products such as high-CBD flowers, gel caps, oils, and sprays formulated for precise, metered dosing; and pa- tients can receive one-to-one specialized care from select producers who offer such suppor t. Additionally, medical can- nabis is considered a medical expense and can be claimed on an individual tax return, provided it has been authorized by a healthcare professional and is purchased directly from a licensed producer. "While many producers turned their attention to the rec- reational market, we doubled-down on our ef for ts to care for patients," Blecher said. "We began working with a grow- ing number of practitioners and enhanced our patient program with simple onboarding, education, and a pharma- cy approach to ordering and fulf illment. We wanted to make sure no patients were left behind." Medical Cannabis Research Emerging research continues to validate patients reported success with cannabis, and it is being shown to be an effective treatment for many who suffer from pain. Dr. Blecher has spent more than 15 years working in the field of chronic pain manage- ment, treating complex pain through a combination of inter- ventional, pharmacotherapeutic, as well as guided mindfulness and self-management approaches. In the 2000s, he was witness to the rampant over-prescribing of opioids for chronic pain, and consequent issues of addiction, distress, and societal costs this left in its wake. His personal observations and subsequent investigations into the science of cannabinoids led him to be- come an ardent advocate for the use of cannabis as an opioid displacement strategy. He developed his proprietary TOP-CART program (Tapering of Opioid Prescribing with Cannabis As Re- placement Therapy), and ultimately assembled and trained the team of medical experts that came to be North Star Wellness, and recently started working with Hildebrand to expand care into Atlantic Canada. A 2021 study published in the Canadian Journal of Anesthe- sia (1) that followed 1000 patients using cannabis for chronic pain found that, among those who remained on medical can- nabis for six months, pain intensity and pain-related interfer- ence scores were reduced. In addition to her practice, Hildebrand is the medical direc- tor of the Methadone Maintenance Therapy Program at Saint Joseph's Hospital in Saint John, New Brunswick. She often ob- serves comorbidity of anxiety disorders and opioid addiction in methadone patients. "Anxiety and pain are mechanistic," she said. "I wondered, what if we tr y to treat both the pain and anxiety with can- nabis? I noticed the people who were using cannabis on the side were doing better. They were sticking to their metha- done treatment better than those who weren't. Now what if those patients who had been originally prescribed opiates for pain chose cannabis instead? Because we're complex be- ings, it's rare someone only suf fers from pain. The beauty of cannabis is that it can address many health problems at one time." In the Canadian Journal of Anesthesia study, the propor- tion of studied individuals who repor ted using opioids de- creased by half. Fur thermore, in a 2020 sur vey from Medical Cannabis Canada (2), 72% of medical cannabis patients re- vealed that cannabis decreased their reliance on tradition- al medication. According to the sur vey, 1 in 4 repor ted de- creased reliance on opioid pain relievers, but 36% of these patients repor ted that barriers to accessing cannabis led them to return to those medications. doctor focus Mature cannabis flower freshly harvested at WeedMD's indoor Strathroy, Ontario greenhouse. Dr. Peter Blecher