THE CANADIAN PRESS
VANCOUVER 鈥� Not all medicinal marijuana is created equal. That鈥檚 what some experts are saying as they warn about the health risks and curtailed effectiveness associated with smoking medicine.
As medical pot becomes increasingly mainstream and Canada moves toward legalizing the substance, health experts are emphasizing the need for doctors and patients to consider the sometimes serious side effects linked to the various ways of consuming the drug.
Paul Farnan, an addictions specialist at the University of British Columbia, likened a recommendation to smoke medicinal marijuana to a doctor handing out a prescription to light up an opium pipe.
鈥淲e know there鈥檚 something in opium that helps pain, and we鈥檙e able to pharmaceutically develop morphine and other analgesics, but we wouldn鈥檛 say to people, 鈥榊ou have pain? Why don鈥檛 you smoke opium?鈥� 鈥� he said.
鈥淲e鈥檙e kind of saying to people, 鈥榃e think there鈥檚 some stuff that cannabinoids will be helpful for. Why don鈥檛 you just smoke cannabis?鈥� First of all, cannabis is actually a really dangerous thing for your lungs.鈥�
Mikhail Kogan, medical director of the Center for Integrative Medicine at George Washington University in Washington, D.C., said he sees no reason for people to smoke marijuana medically anymore.
It鈥檚 difficult to absorb enough of the drug through the lungs, and gastric acids interfere when someone eats it, he said, adding that it鈥檚 more effective to take the drug by other means, such as under the tongue.
鈥淩ectally is actually a lot more preferred because of the volume of absorption. You can put a lot more and it gets absorbed a lot better, but not everybody is open to this way of administration,鈥� Kogan said.
鈥淲e have so many other products now, so many modes of delivery, that smoking in my opinion is very archaic and has very little clinical applicability,鈥� he added.
鈥淗aving said that, I think that probably the majority of people still smoke because it鈥檚 the most available method.鈥�
Health Canada officially recommends against smoking marijuana.
鈥淢any of the chemicals found in tobacco smoke are also found in cannabis smoke,鈥� reads its website.
The Canadian Medical Association has no formal position on the consumption of medicinal pot, but it officially opposes the inhalation of any burned plant material.
Association spokesman Jeff Blackmer added that many physicians are reluctant to prescribe medical marijuana because of the absence of peer-reviewed research into whether the drug is medically effective, its possible side effects, appropriate dosage and more.
A 鈥渟trong majority鈥� of doctors would prefer not to be involved as so-called gatekeepers, Blackmer added.
鈥淢ost of them hate it,鈥� he said.
鈥淭his is something that was imposed on us by the government and the majority of physicians do not want to have anything to do with it.鈥�
Debra Lynkowski, head of the Canadian Lung Association, urged patients and doctors to take lung health into consideration when discussing medicinal marijuana.
鈥淲hen you burn something, that combustion releases toxins and carcinogens, and they鈥檙e released regardless of what the source is,鈥� she said.
鈥淥ur primary concern with regard to that is just to be considering any kind of lung health implications.鈥�
Colette Rivet, head of the association that represents licensed cannabis producers in Canada, said that while the industry is against smoking medical marijuana, ultimately it can鈥檛 restrict what patients do.
鈥淲e know that there鈥檚 an issue with smoking. However, we can鈥檛 control it at the patient level,鈥� Rivet said.
鈥淲e鈥檙e trying to develop new product forms so they would be more inclined to go away from that.鈥�
Each licensed producer has its own unique document that physicians fill out when prescribing medical marijuana, which includes a minimum amount of information required by Health Canada, Rivet said.
Beyond that, some companies ask whether a patient would prefer dried marijuana or oil, while others don鈥檛, she added.
A Health Canada spokesman confirmed that patients are in charge of requesting the form of medical marijuana they prefer, whether dry leaf or oil, and they are not restricted in how they wish to consume it.
The sale of edibles is banned, but a June 2015 decision from the Supreme Court of Canada ruled medicinal marijuana patients have the right to prepare their medication however they want, including cooking it.
鈥� Geordon Omand, The Canadian Press
