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College issues consultation on new medical marijuana policy

Clinics and doctors involved in the prescribing of medical marijuana should take heed of a new draft policy on medical marijuana – though not yet in force – from the College of Physicians and Surgeons of Ontario and provide feedback if they feel it requires revision, says Toronto health lawyer Lonny Rosen.

The new policy, approved at the College’s most recent council meeting in September, is now open for a period of consultation that will extend until Dec. 5. The College is looking for feedback on the new policy from physicians, patients and clinics that are involved with the prescription of marijuana.

The College will post the feedback it receives, after which it will consider whether the draft policy requires revisions. Using the input, the College will determine whether: the draft policy provides useful guidance; if there are issues that aren’t addressed in the new policy and whether there are ways it can be improved.

“Ultimately, at the end of that process, the College will approve a new medical marijuana policy, which will then be in force,” says Rosen, partner at Rosen Sunshine LLP.

The draft was designed to replace the College’s existing policy, which was based on the former legislative regime for medical marijuana called the Health Canada’s Medical Marijuana Access Regulations.

On April 1, Health Canada released a new regime called the Marijuana for Medical Purposes Regulation.

“Previously, physicians would have to complete a document authorizing a person to obtain a licence from Health Canada to possess marijuana for medical purposes,” Rosen tells “Now, physicians can prescribe marijuana and then the person with a prescription for marijuana can obtain dried marijuana from a licensed producer.”

To reflect the change in the regulatory regime, the College is revisiting its policy on medical marijuana. And while its existing policy remains in force, the College has a new draft policy for marijuana for medical purposes.

Rosen says the draft policy sets out expectations for physicians who are considering prescribing marijuana.

“Like the old policy, it doesn’t endorse or prohibit the use of medical marijuana,” he says. “It simply says that physicians who prescribe marijuana must do so in accordance with their own clinical and professional judgments.

“The College’s position is clearly articulated that no physician is ever going to be required to prescribe marijuana, but physicians who do so must ensure that they meet all of their legal and professional duties for the prescribing of any drug. Those duties include obtaining informed consent and completing appropriate documentation as well as other obligations.”

The College also provides guidance in the policy regarding physicians’ duties to assess the appropriateness of marijuana for their patients before prescribing some.  Interestingly, the policy also deals with the issue of billing.

“The policy addresses the fact that where the prescription is in relation to a medically necessary treatment, physicians may bill OHIP and may not charge patients directly including for the prescription of marijuana,” says Rosen. “It also sets out guidance in terms of managing risks associated with the medical use of marijuana, including health risks and risks of abuse, misuse or diversion.”

Rosen says the policy recommends that physicians and patients enter a treatment agreement to manage the risks associated with medical marijuana. These types of treatment agreements are frequently used when physicians prescribe narcotics and the like.

It’s unknown when the final draft of the policy will be approved by the College’s council.

“It will depend on whether the feedback the College receives on the draft policy indicates that further revisions are required,” Rosen says.

Rosen offers this advice for clinics and physicians: “physicians should tread carefully, obtain legal advice, and be guided by both the existing and the draft policies of the College before implementing office protocols relating to the prescription of marijuana for medical purposes.”

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