MEDICAL CANNABIS QUICK REFERENCE GUIDE

Size: px
Start display at page:

Download "MEDICAL CANNABIS QUICK REFERENCE GUIDE"

Transcription

1 MEDICAL CANNABIS QUICK REFERENCE GUIDE

2 CANNABIS 101: MEDICINE HOW IT WORKS DEFINITIONS Cannabinoids Class of compounds that act on cannabinoid receptors in the human body (Internal or External) Endocannabinoids Cannabinoids that are naturally produced in the body (Anandamide & 2AG) Phytocannabinoids Cannabinoids produced by the cannabis plant (THC & CBD) Synthetic Cannabinoids Laboratory-synthesized compounds that bind to cannabinoid receptors (e.g. Nabilone) HOW IT WORKS 3

3 ENDOCANNABINOID SYSTEM ENDOCANNABINOID SYSTEM ENDOCANNABINOIDS Cannabinoids are naturally produced in the body. The two most commonly known endocannabinoids are : 1. Anandamide 2. 2-arachidonoylglycerol (2AG) Endocannabinoids stimulate Cannabinoid receptors CB1 and CB2 What can we do? By exogenously administering a cannabinoid one can potentially suppress abnormal pre synaptic firing and potentially control abnormal nerve transmission Why is this important? Gives rise to possible therapeutic effect of targeting CB1 as being able to supress abnormal firing in the instance of epilepsy, neuropathic pain Cannabinoid receptors are part of the receptor system in the brain involved in a variety of psychological processes including appetite, pain-sensation, mood and memory. THC s chemical structure is similar to the brain chemical anandamide. Similarity in structure allows drugs to be recognized by the body and to alter abnormal brain communication. MANAGING HUMAN HEALTH The goal in health is homeostasis to consistently keep things in balance The body makes endogenous cannabinoids naturally (anandamide & 2AG) to stimulate CB1 & CB2 Balance is managed through various receptors and endocannabinoids Exogenous cannabinoids with similar structures will also stimulate CB1 & CB2 BRAIN CHEMICAL DRUG HOMEOSTASIS is a key element in the biology of all living things. Best described as the ability to maintain internal conditions that are necessary for survival. DISEASE is simply a result of some aspect of failure in acheiving homeostasis, making the endocannabinoid system a unique target for medical applications. ANANDAMIDE THC 4 HOW IT IS CONSUMED 5

4 RECEPTORS CANNABIS SAFETY Locations have different actions when CB1 receptors are stimulated The density and type of cannabinoid present will impact how the body will respond EG cannabis with high THC content activates CB1 receptors in the hypothalamus. This increases appetite and depending upon the person, it could be beneficial or create an adverse effect. LD50-1:20,000 to 1: 40,000 In order to introduce death someone would have to smoke 20,000 to 40,000 as much cannabis as found in one marijuana cigarette. A smoker would theoretically have to consume nearly 1500 pounds of marijuana within fifteen minutes to induce a lethal response. DISTRIBUTION OF CB1 RECEPTORS IMPAIRMENT cerebral cortex decision making, cognition & emotional behavior caudate nucleus learning & memory system putamen regulate movements & influence various types of learning globus pallidus regulate voluntary movements amyglada responsible for anxiety & stress, emotion & fear, pain THC disolves in fat, whereas alcohol disolves in water. Because THC is fat suluble, it moves readily from water environments, like blood to fatty environments. You can still measure THC in the brain, even if its no longer measurable in the blood. hypothalamus body temperature, feeding, neuroendocrine function hypocampus memory & learning substantia nigra important role in reward, addiction & movement cerebellum motor control & coordination X no cannabinnoid receptors to cause central apnea dorsal vagal complex emesis IMPORTANT Explains why residual THC levels are in the body for a long time after use. CB1 receptors are located in the brain and spinal cord. CB2 receptors are located in the immune system. However, both receptors can be found all over the body. 6 HOW IT IS CONSUMED 7

5 HOW IT IS CONSUMED MODES OF DELIVERY PRIMARY ROUTES OF ADMINISTRATION LUNGS INHALATION Diffusion into alveolar capillaries and then enters in the bloodstream Maximal onset occurs at min and lasts generally 2-3 hours (short-term relief) Interpatient variability # of inhalations Duration of inhalations Spacing of puffs Hold Time Inhalation Volume Metabolism occurs in the lung, liver, brain GUT INGESTION Metabolized in the liver and turned into 11 hydroxy THC Patient will see more sedation or euphoria Onset can be anywhere from 30 min to 2 hours and can last generally 5-8 hours (long-term relief) Interpatient variability Other food ingested/or lack of Individual variation in metabolism rates Frequency of use Variable absorption in the gut Low plasms THC levels 5 ngrams/litre High plasma levels 100 ngrams/litre 8 HOW IT IS CONSUMED 9

6 INHALATION VERSUS INGESTION ENDOCANNABINOID SYSTEM Inhalation Versus Ingestion THE MEDICAL ASSESSMENT History of Presenting Illness Current Medications Past Medications trials/therapy trials Risk Assessment (addiction potential, contraindications) Physical Examination KEY PRIORITIES Before physicians may prescribe medical marijuana, many factors are carefully considered. Whether it is the most appropriate treatment for their patient The risks associated with the use of cannabis: - A risk of addiction (9%) - Symptoms of chronic bronchitis - Onset or exacerbation of mental illness MEDICAL ASSESSMENT If adequate pharmaceuticals for the primary condition have been trialed CONTRAINDICATIONS Under age 25 (relative) History of serious mental disorder (schizophrenia, psychosis, hallucinations) Active alcohol or drug abuse or substance dependence Serious liver, heart or lung disease Pregnancy Allergy to Cannabis 10 MEDICAL ASSESSMENT 11

7 PATIENT DISCUSSION SIDE EFFECT CONSIDERATION Review how cannabis works and the potential benefits and risks Understand how different formulations can have different effects on the body/mind Evaluate potential drug interactions as cannabis may interact with many medications (blood thinners, anti-epileptics, alcohol, opiates, insulin) Cardiovascular Tachycardia, palpitations, hypertension/hypotension Respiratory (smoked) Coughing Wheezing Sputum production Neurologic Lethargy, (sedation, slowed reaction time, dizziness) Psychological dysfunction (paranoia/hallucinations) INTERACTIONS WITH OTHER DRUGS Co-Antagonistic Effect Highest risks (side effects) are: At the onset of treatment During the titration phase Dosage change/strain change Method of delivery 12 MEDICAL ASSESSMENT 13

8 DOSING PROTOCOL 1 Can begin with synthetic cannabinoids THE SCRIPT AND DOSE 2 3 Start with the lowest effective dose of THC for their condition Titrate up THC to effectiveness Dosing remains highly individualized and relies to a great extent on titration Prior cannabis experience can guide starting dosages (self-medicating patients) Start low, go slow Patient factors to consider: Preference for delivery of medicine Prior cannabis experience (tolerance) Lung capacity Pharmaceuticals THE MEDICAL DOCUMENT Dosage (per day) Length of time THC limit 14 THE SCRIPT AND DOSE 15

9 SEED TO SALE TREATMENT AGREEMENT 1 Treatment Agreement 2 Driving Safety Clones taken from mother plant and assigned barcode Clones are germinated Fully grown plants are dried Product gets packaged and labeled Patients profiles are verified before sending Product sent by Canada Post or Purolator Prescribing Physician (only one) Avoidance of illicit drugs/ non-prescribed controlled substances Avoidance of sharing medication, To avoid using a motor vehicle within four hours of inhalation, and possible 6 hours post inhalation with euphoria If ingesting one must be aware using other s, supplementing from drowsiness may occur and should illicit sources abstain if sedation, altered LOC To be taken as prescribed (same warning as other medications such as narcotics, benzodiazepines, gabapentin etc.) Clones taken from mother plant ensures the genetics are identical in each plant. Allows for standardized label claims and product consistency. Clones grown in separate system until they can get transferred into standardized growing materials Each strain is provided with its own unique blend of nutrients until the flower is ready to be harvested. Trimmed and dried to an optimal moisture level. Our product is then labeled to display the THC and CBD percentages of the product. From there the product is heat and tamper proof sealed in child proof containers. Barcode for each strain is recorded throughout this entire process. The labeled and sealed product is then put in a discrete Canada Post or Purolator bag ensuring discretion and privacy. The patient is also provided with an official tracking number. A signature from the patient is required when accepting the package. 3 Harmful Smoking 4 Long Term Effects Patients should avoid using bongs, Science on cannabinoids is rapidly joints, blunts, pipes and should not combine with tobacco evolving and we may not yet appreciate long term effects of chronic use (motivation, mental health, IQ, memory) DOCUMENTS REQUIRED The following documents are required for a legal prescription in Canada: MD signed medical document Amount to be used daily, THC limit and duration of prescription Licensed Producer Form (downloadable form online) Cannabis remains a controlled substance and narcotic. Patients should be educated and sign an agreement

10 ALEAFIA S PROCESS Pre-Doctor Assessment 1 Referral form received 2 Client contacted Intake package provided Completed packaged triaged Doctor selected Post-Doctor Assessment 3 Script Management Licensed Producer selected 4 Patient monitoring Client Support Management HOW TO ACCESS CARE 18 19

11 For your convenience, we have compiled key points of interest from Health Canada s, Consumer s Information on Cannabis. Expanded information, education and training on use, administration and management of medical cannabis is available through Aleafia s Cannabis Resource Centre. Please contact for more information or to book a consult. WHAT THE PRODUCT MAY BE USED FOR? Your health care practitioner may have authorized the use of cannabis (marihuana, marijuana) for the relief of one or more of the following symptoms associated with a variety of disorders, which have not responded to conventional medical treatments. These symptoms (or conditions) may include: severe refractory nausea and vomiting associated with cancer chemotherapy; loss of appetite and body weight in cancer patients and patients with HIV/AIDS; pain and muscle spasms associated with multiple sclerosis; chronic non-cancer pain (mainly neuropathic); severe refractory cancer-associated pain; insomnia and depressed mood associated with chronic diseases (HIV/AIDS, chronic non-cancer pain); and symptoms encountered in the palliative/end-of-life care setting. This is not an exhaustive list of symptoms or conditions for which cannabis may be authorized for use by your health care practitioner. The potential therapeutic and adverse effects associated with cannabis use may vary depending on the amount of cannabis used and the concentration of cannabinoids in the cannabis product, the frequency of cannabis use, the patient's age and medical condition, previous experience with cannabis or cannabinoids, and the use of other prescription or non-prescription drugs. REFERENCE 20 21

12 POTENTIAL THERAPEUTIC USES LISTED BY HEALTH CANADA INCLUDE: WHAT THE PRODUCT DOES: Palliative Care Nausea and vomiting Wasting syndrome and loss of appetite in AIDS and cancer patients To stimulate appetite and produce weight gain in AIDS patients To stimulate appetite and produce weight gain in cancer patients Anorexia nervosa Multiple sclerosis, amyotrophic lateral sclerosis, spinal cord injury Multiple sclerosis Amyotrophic lateral sclerosis Spinal cord injury (or spinal cord disease) Epilepsy Pain Acute Pain Experimentally-induced acute pain Post-operative pain Chronic pain Experimentally-induced pain Neuropathic pain or chronic non-cancer pain Cancer pain Headache and migraine Arthritides and musculoskeletal disorders Osteoarthritis Rheumatoid arthritis Fibromyalgia Osteoporosis Other diseases and symptoms Movement disorders Dystonia Huntington s disease Parkinson s disease Tourette s syndrome Glaucoma Asthma Hypertension Psychiatric disorders Anxiety and depression Sleep disorders Post-traumatic stress disorder Alcohol and opioid withdrawal symptoms Schizophrenia and psychosis Alzheimer s disease and dementia Inflammation Inflammatory skin diseases Gastrointestinal system disorders Irritable bowel syndrome Inflammatory bowel diseases Diseases of the liver Metabolic syndrome, obesity, diabetes Diseases of the pancreas Anti-neoplastic properties One of the principal active ingredients in cannabis (THC) acts on very specific targets found in the body known as cannabinoid receptors. Other cannabinoids, such as CBD, may also have targets other than the cannabinoid receptors. Cannabinoid receptors are found throughout the body, in most tissues and organs, but they are especially numerous in the brain and nervous system. Cannabinoid receptors are involved in the regulation of many bodily functions including: brain and nervous system activity, heart rate and blood pressure, digestion, inflammation, immune system activity, perception of pain, reproduction, wake/sleep cycle, regulation of stress and emotional state and many other functions. WHEN THE PRODUCT SHOULD NOT BE USED: Cannabis should not be used if you: are under the age of 25 are allergic to any cannabinoid or to smoke have serious liver, kidney, heart or lung disease have a personal or family history of serious mental disorders such as schizophrenia, psychosis, depression, or bipolar disorder are pregnant, are planning to get pregnant, or are breast-feeding are a man who wishes to start a family have a history of alcohol or drug abuse or substance dependence Talk to your health care practitioner if you have any of these conditions. There may be other conditions where this product should not be used, but which are unknown due to limited scientific information. INTERACTIONS WITH THIS PRODUCT Cannabis may interact with several drugs. Make sure to tell your health care practitioner which prescription drugs, non-prescription drugs or herbal products you are currently taking, particularly: Any drugs which slow down the central nervous system, causing drowsiness. These may include sleeping pills, tranquilizers, some pain medications, some allergy or cold medications, or anti-seizure medications. Other drugs may include antiretroviral drugs used in the treatment of HIV/AIDS, certain anti-depressants, stomach acid inhibitors, certain antibiotic and antifungal medications, certain heart medications, and Saint John's Wort. WHAT THE ACTIVE INGREDIENTS MIGHT BE Tetrahydrocannabinol (THC) Cannabidiol (CBD) The type and amount of these ingredients may vary depending on the cannabis strain. WHAT THE OTHER INGREDIENTS MIGHT BE There are over 70 different cannabinoids as well as hundreds of other chemicals in cannabis. Many of the chemicals found in tobacco smoke are also found in cannabis smoke. DOSING INFORMATION AND ROUTES OF ADMINISTRATION There is no scientifically defined dose of cannabis for any specific medical condition. If you have not consumed cannabis before, it would be prudent to have someone with you the first time you use it. Dosing remains highly individualized and relies greatly on titration (i.e. finding the right dose where potential therapeutic effects are maximized while adverse effects are minimized). The current available information suggests most individuals use less than 3 grams daily of dried marijuana, whether that amount is taken orally, inhaled, or a combination of both. 22 Patients with no prior experience with cannabis or cannabinoids are cautioned to begin at a very low dose and to stop therapy if unacceptable or undesirable effects occur. 23

13 There are a small number of clinical studies of short duration with smoked/vapourized cannabis for therapeutic purposes. Smoking/vapourizing cannabis results in a more rapid onset of action (within minutes), higher blood levels of cannabinoids, and a shorter duration of acute effects compared to oral ingestion. While there are no established dosing guidelines for smoking/vapourizing cannabis for therapeutic purposes, it is prudent to proceed slowly and cautiously in a gradual fashion, waiting between puffs or inhalations for a minimum of 30 minutes to gauge for strength of effects or for possible overdosing. A dosing increase should be carried out slowly, only if required, and only until you reach a comfortable dose. In contrast to smoked/vapourized cannabis, there are no clinical studies of cannabis-based edible products for therapeutic purposes (e.g. oils, foods). Absorption of cannabinoids by the oral route is known to be slow and erratic, and the onset of acute effects is delayed with the acute effects generally lasting much longer compared to smoking/vapourizing. Furthermore, dosages for orally administered products are even less well-established than for smoking/ vapourization. These particularities have contributed to overdoses with some orally administered products. If ingesting cannabis orally (e.g. in oils, foods) wait a minimum of 2 hours between administration of single doses of oral products to gauge for strength of effects or for possible overdosing. Stop using cannabis right away and consult your health care practitioner if you begin to experience any side effects (see side effects section for additional information). OVERDOSE Symptoms of overdose may include: sleepiness, confusion, disorientation, clumsiness/ loss of coordination, fainting, dizziness, chest pain, fast, slow or pounding heartbeat, panic attacks, loss of contact with reality, and seizures. Seek immediate medical attention in case of overdose, and especially if experiencing chest pain, panic attacks, loss of contact with reality, or seizures. Cannabis should be used with caution in patients receiving concomitant therapy with other psychoactive drugs because of the potential for greatly enhanced effects on the brain and other parts of the nervous system. An overdose can also occur if a patient is smoking/vapourizing cannabis and at the same time consuming orally administered cannabinoids whether from prescription cannabinoid medications, or from consumption of oils, teas, baked goods or other products. HOW THE PRODUCT IS SUPPLIED Dried marijuana plant material, fresh marijuana plant material and products derived from fresh or dried marijuana. HOW TO STORE THE PRODUCT Dried marijuana plant material and cannabis products should be stored in a cool place, preferably away from light and air. See manufacturer's instructions on the product label for recommended storage conditions. Keep any cannabis and cannabis products out of the reach of children and locked in a safe place to prevent theft, misuse and accidental ingestion by children. This product should not be shared with anyone else. ONSET, PEAK, AND DURATION OF EFFECTS With inhalation (smoking, vaporizing), effects may be felt within a few minutes of dosing and will generally peak within 30 mins., effects generally last between 2 and 4 hours but may be longer (e.g. 24 hours). With oral ingestion (e.g. oils, foods, capsules), acute effects may begin to be felt as quickly as 30 mins and as late as 3 or 4 hours after administration. This variability in timing depends on a number of factors (e.g. amount of food in stomach). It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing. Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer e.g hours). With topical application, it is not known how long it takes for potential therapeutic effects to appear, nor how long they last. There have been reports of hypersensitivity reactions (e.g. rashes, itching) when skin has come into contact with cannabis. SIDE EFFECTS AND WHAT TO DO ABOUT THEM The information on side effects associated with therapeutic use of cannabis is limited. Some of the more well-known side effects are intoxication-like reactions including: dizziness, drowsiness, feeling faint or lightheaded, fatigue, headache; impaired memory and disturbances in attention, concentration and ability to think and make decisions; disorientation, confusion, feeling drunk, feeling abnormal or having abnormal thoughts, feeling "too high", feelings of unreality, feeling an extreme slowing of time; suspiciousness, nervousness, episodes of anxiety resembling a panic attack, paranoia (loss of contact with reality), hallucinations (seeing or hearing things that do not exist); impairments in motor skills and perception, altered bodily perceptions, loss of full control of bodily movements, falls; dry mouth, throat irritation, coughing; worsening of seizures; hypersensitivity reactions (contact dermatitis/hives); higher or lower blood levels of certain medications; nausea, vomiting; and fast heartbeat

14 DOSING AMOUNTS Information obtained from a limited number of small and short-term clinical studies of cannabis for medical purposes indicate the daily doses of smoked or vapourized dried cannabis ranged from as little as 75 mg of dried cannabis 9.4% THC by weight) (i.e. 7 mg THC/day) to a maximum of 3.2 grams of dried cannabis (1 8% THC by weight; i.e. 32 to 256 mg THC). Doses of THC as low as mg of THC (and even lower) are associated with a therapeutic benefit and minimal psychoactivity. Various surveys published in the peer-reviewed scientific and medical literature have suggested that the majority of people using smoked or orally ingested cannabis for medical purposes reported using between grams of cannabis per week, or approximately 1 3 grams of dried cannabis per day. One study reported the average daily dose of dried cannabis (of various potencies) used by patients in the Netherlands Medical Cannabis program was 0.68 grams per day (range: grams per day) Another study suggests that regardless of route of administration (inhalation vs. oral), individuals reporting use of cannabis for medical purposes reported consuming equivalent amounts of cannabis per day and that amount averaged at around 3 grams per day. For smoking and vapourizing, the median reported dose was grams per day respectively. For edibles, the median reported dose was 1.5 grams per day. For teas, the median reported dose was 1.5 grams per day. There is no information available on dosing amounts for topically applied cannabis products (e.g. ointments, creams, lotions, oils, balms, salves), however one study suggests approximately 5% of individuals who use marijuana for medical purposes use such products. There is no information available on dosing amounts for fresh marijuana. In the absence of any clinical studies conducted with cannabis products, such as oils that are ingested orally, the following information has been provided as a reference to give some potential guidance around dosing. FOR PRODUCTS SUCH AS OILS THAT ARE INGESTED ORALLY The available clinical evidence for Marinol, an orally administered capsule that has received market authorization and that contains synthetic THC dissolved in sesame oil, indicates a dosing range from as low as 2.5 mg THC per day to a maximum dose of 210 mg THC per day. Doses lower than 2.5 mg (e.g. 1 mg) THC may further avoid incidence and risks of adverse effects. Average dose of Marinol is 20 mg THC per day. Maximal recommended daily oral dose of Marinol is 40 mg per day. Preliminary information from an open-label clinical trial with Epidiolex (an orally adminis tered oil extract containing mainly cannabidiol (CBD) for treatment of certain types of childhood epilepsy not responsive to conventional treatment), suggests a daily dosing range between 5 and 20 mg/kg CBD. However, further clinical studies are required to substantiate this information. Important Note: EQUIVALENCY FACTOR The quantity of product other than dried marijuana (for example, fresh marijuana or cannabis oil) that is equivalent to one gram of dried marihuana ("the equivalency factor") must be determined. However, the equivalency factor depends on the production method, form of supply and the THC/CBD yield. The licensed producers will provide this information on the label. The information about the equivalency factor will also be available on the licensed producer's website. If the patient chooses to produce cannabis themselves or to have it produced by another person, the patient and the designated person, if any, are required to manage their possession or storage limit based on the quantity of fresh marijuana, cannabis oil or other products that are equivalent to a given quantity of dried marijuana. As such, five grams of fresh marijuana is determined to be equivalent to one gram of dried marijuana and the quantity of products that is equivalent to a given quantity of dried marijuana is calculated by taking into account the weight of fresh or dried marijuana that was used to make the products. DRUG SCREENING TESTS Because of the long half life of elimination of cannabinoids and their metabolites, drug tests screening for cannabinoids can be positive for weeks after last cannabis/ cannabinoid use depending on he sensitivities of the tests used. Step 1: Consult with a Health Care Practitioner Treatment decisions are best made in consultation with your health care practitioner. Under the ACMPR, an authorized health care practitioner includes physicians in all provinces and territories, and nurse practitioners in provinces and territories where supporting cannabis for medical purposes is permitted under their scope of practice

15 Step 2: Obtain a Medical Document from your Health Care Practitioner You will need to obtain a medical document from your practitioner. NOTE: The medical document can be submitted from the health care practitioner's office to the licensed producer by secure fax. If you choose to submit the medical document by secure fax, initial the statement below to acknowledge agreement. The following information must be included on the medical document signed and dated by the health care practitioner: I, the health care practitioner, acknowledge that the faxed medical document is now the original medical document and that I have retained a copy of this document for my records only. your full name; your date of birth; address where you consulted with the practitioner; daily grams of dried marijuana you are authorized to use, the period of use (i.e. number of days, weeks or months), which cannot exceed one year from the date the medical document is signed by the healthcare practitioner; the healthcare practitioner's name and, administrative information (profession, licence number, province of licence, business address, phone number, fax number and address, if applicable); and an attestation by the healthcare practitioner that the information contained in the document is correct and complete. Initial here: Step 3: Register and Order with a Licensed Producer Once you have obtained a medical document from your authorized healthcare practitioner, you can register as a client with the licensed producer of your choice. To register, you will need to submit certain information, including the original medical document. Please contact the licensed producer for further information regarding application requirements. After registering as a client, you will be able to order cannabis for medical purposes from the licensed producer. 28 This document may be completed by the applicant's health care practitioner as defined in the Access to Cannabis for Medical Purposes Regulations (ACMPR). A health care practitioner includes medical practitioners and nurse practitioners. In order to be eligible to provide a medical document, the health care practitioner must have the applicant for the medical document under their professional treatment. Regardless of whether or not this form is used, the medical document must contain all of the required information, (see in particular s. 8 of the ACMPR). Patient's Given Name and Surname: Patient's Date of Birth (DD/MM/YYYY): Daily quantity of dried marihuana to be used by the patient: _ g/day The period of use is day(s) week(s) month(s). NOTE: The period of use cannot exceed one year Health care practitioner's given name and surname: Profession: Health care practitioner's business address: Full business address of the location at which the patient consulted the health care practitioner (if different than above): Phone Number: Fax Number (if applicable): Address (if applicable): Province(s) Authorized to Practice in: Health Care Practitioner's Licence number: By signing this document, the health care practitioner is attesting that the information contained in this document is correct and complete. Health Care Practitioner's Signature: Date Signed (DD/MM/YYYY): Do not send your medical document to Health Canada. Step 4: Shipping of your Cannabis for Medical Purposes Your cannabis will be sent to you directly by the licensed producer. The Controlled Drugs and Substances Act (CDSA) prohibits possession, trafficking, import and export, and production of controlled substances, including marijuana, unless authorized by regulations. Neither the ACMPR nor any other Health Canada regulations authorize licensed producers to provide cannabis for medical purposes through a storefront. POSSESSION OF CANNABIS FOR MEDICAL PURPOSES: The amount of dried marijuana you can possess is the lesser of thirty times the daily amount stipulated by your healthcare practitioner or 150 grams. For example, if your healthcare practitioner recommends 3 grams per day, you would be allowed a maximum of 90 grams at any one time (30 days 3 grams). However, if your healthcare practitioner recommends 6 grams per day, you would be allowed to possess a maximum of 150 grams at any one time, which would therefore be less than a 30-day supply. SHOWING PROOF OF LEGAL POSSESSION OF CANNABIS FOR MEDICAL PURPOSES: If asked by law enforcement, you can demonstrate that you are in legal possession of cannabis for medical purposes obtained from a licensed producer by showing either the label on the package containing your specific client information or the separate document containing the same information, which accompanied your shipment of cannabis. INFORMATION FOR HEALTHCARE PRACTITIONERS If you are a licensed health care practitioner and you want to know more about the use of cannabis for medical purposes (for example, pharmacology, potential therapeutic uses, contraindications, adverse reactions etc.) the following resources will provide you with scientific and medical information to help you inform patients. 29

16 INFORMATION FOR HEALTHCARE PRACTITIONERS (continued) Health care practitioners should consult their provincial or territorial health care licensing authority's guidelines and policies before authorizing the use of cannabis for medical purposes. In addition, the College of Family Physicians of Canada has published preliminary guidance on authorizing dried cannabis for chronic pain and anxiety, which can be found here: If you and your patient conclude that cannabis for medical purposes is an appropriate option for her/him, you will need to complete a medical document (or other document containing the same information). For additional application requirements, you can direct your patient to the section When you discuss daily amount of cannabis with your patient, it is useful to remember that the recommended daily amount dictates the total amount the patient will be authorized to possess or produce. Various surveys published in the peer-reviewed scientific and medical literature have suggested that the majority of people using smoked or orally ingested cannabis for therapeutic purposes reported using the equivalent of up to three (3) grams of dried marijuana per day. While there are no restrictions under the Access to Cannabis for Medical Purposes Regulations on the daily amount that you may authorize, there is a possession limit of the lesser of the equivalent of 150 grams or 30 times the daily amount of dried marijuana. DAILY AMOUNT EXPRESSED IN GRAMS OF DRIED MARIJUANA You must indicate on the medical document the daily amount that you authorize expressed in grams of dried marijuana. If the patient chooses to access either fresh marijuana or cannabis oil, from a licenced producer, the producer will determine the amount of fresh marijuana or cannabis oil that is equivalent to a given amount of dried marijuana by taking into account the dried marijuana equivalency factor established by the licensed producer. If the patient chooses to produce cannabis him/herself or to have it produced by another person, the patient and the designated person, if any, are required to manage their possession or storage limit based on the amount of fresh marijuana, cannabis oil or other products that are equivalent to a given amount of dried marijuana. As such, five (5) grams of fresh marijuana is determined to be equivalent to one (1) gram of dried marijuana and the amount of products that is equivalent to a given amount of dried marijuana is calculated by taking into account the weight of fresh or dried marijuana that was used to make the products. For fresh marijuana and cannabis oil sold or provided by licensed producers, information about the equivalency in dried marijuana will appear on the product label. The information is also available on the licensed producer's website. The courts in Canada have ruled that the federal government must provide reasonable access to a legal source of marijuana for medical purposes. The legal sources of cannabis for medical purposes are licensed producers, personal production and designated production. A complete list of licensed producers can be found on the Health Canada website. Cannabis is not an approved therapeutic product and the provision of this information should not be interpreted as an endorsement of the use of cannabis for therapeutic purposes, or of marijuana generally, by Health Canada. This leaflet is designed by Health Canada for patients authorized to possess cannabis for medical purposes. It is based on the document "Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the Cannabinoids", and is a summary only - it will not provide you with all the facts about cannabis for medical purposes. Contact your health care practitioner if you have any questions. SERIOUS WARNINGS AND PRECAUTIONS Keep any fresh or dried marijuana and cannabis oil out of reach of children. Cannabis (marihuana, marijuana) contains hundreds of substances, some of which can affect the proper functioning of the brain and central nervous system. The use of this product involves risks to health, some of which may not be known or fully understood. Studies supporting the safety and efficacy of cannabis for therapeutic purposes are limited and do not meet the standard required by the Food and Drug Regulations for marketed drugs in Canada. Smoking cannabis is not recommended. Do not smoke or vapourize cannabis in the presence of children. Using cannabis or any cannabis product can impair your concentration, your ability to think and make decisions, and your reaction time and coordination. This can affect your motor skills, including your ability to drive. It can also increase anxiety and cause panic attacks, and in some cases cause paranoia and hallucinations. Cognitive impairment may be greatly increased when cannabis is consumed along with alcohol or other drugs which affect the activity of the nervous system (e.g. opioids, sleeping pills, other psychoactive drugs)

17 32

Consumer Information Cannabis (Marihuana, marijuana)

Consumer Information Cannabis (Marihuana, marijuana) Consumer Information Cannabis (Marihuana, marijuana) The courts in Canada have ruled that the federal government must provide reasonable access to a legal source of marijuana for medical purposes. The

More information

MEDICAL CANNABIS QUICK REFERENCE GUIDE

MEDICAL CANNABIS QUICK REFERENCE GUIDE MEDICAL CANNABIS QUICK REFERENCE GUIDE CANNABIS 101: MEDICINE MEDICAL CANNABIS QUICK REFERENCE GUIDE HOW IT WORKS DEFINITIONS Cannabinoids Class of compounds that act on cannabinoid receptors in the human

More information

LGP CLASSIC Oil Products

LGP CLASSIC Oil Products LGP CLASSIC Oil Products Patient Information Leaflet (PIL) PRODUCT RANGE Medicinal Cannabis Oil Extract LGP CLASSIC 10:10 LGP CLASSIC 10:15 LGP CLASSIC 20:5 What is in this leaflet Please read this leaflet

More information

Objectives. 1. Review controversy 2. Pathophysiology 3. Indications for Use 4. Adverse Effects 5. How Patients Access

Objectives. 1. Review controversy 2. Pathophysiology 3. Indications for Use 4. Adverse Effects 5. How Patients Access Medical Marijuana Deb Evans, RN, MScN, CON(C), CHPCN(C) Clinical Nurse Specialist Pain and Symptom Management Team Juravinski Cancer Centre May 29, 2014 Objectives 1. Review controversy 2. Pathophysiology

More information

Acknowledgements: What it is What it s not. Cannabis Evidence Series. Evidence-informed decision-making

Acknowledgements: What it is What it s not. Cannabis Evidence Series. Evidence-informed decision-making Cannabis Evidence Series What it is What it s not Acknowledgements: The evidence presented is from the Cannabis evidence series authored by the HTA unit at the University of Calgary and from Rapid response

More information

Medicinal Cannabis. Patient Log Book. Record your cannabis use and find the right dose

Medicinal Cannabis. Patient Log Book. Record your cannabis use and find the right dose Medicinal Cannabis Patient Log Book Record your cannabis use and find the right dose 1 Introduction A federal system is in place for medicinal cannabis that is distinct from recreational sales. To get

More information

CBD and Your Health.

CBD and Your Health. CBD and Your Health. Cannabidiol (CBD) is a molecule found in plant species such as agricultural (or industrial) hemp, and Echinacea. CBD is one of at least 489 distinct compounds within hemp: it is clear

More information

INITIAL PATIENT INTAKE FORM

INITIAL PATIENT INTAKE FORM INITIAL PATIENT INTAKE FORM Name: Last Name First Name Date of Birth: MM / DD / YYYY Gender: Male Female Address: Town: State: Zip Code: Preferred method of contact. For internal promotional use only.

More information

Medical Cannabis MATT WEBSTER DO, MS

Medical Cannabis MATT WEBSTER DO, MS Medical Cannabis MATT WEBSTER DO, MS Cannabis Sativa One of the oldest used drugs and medicinal remedies Most commonly abused illicit drug in the US There has been increasing access for medicinal MJ use

More information

Use of Cannabinoids in Medical Practice

Use of Cannabinoids in Medical Practice Use of Cannabinoids in Medical Practice Annual Scientific Assembly Family Medicine Review 2016 Murray Opdahl BSPE, MD, CCFP Objectives Briefly present: An overview of available cannabinoids Concerns voiced

More information

PATIENT INTAKE FORM. Name: Address: Town: State: Zip Code: MMJ Card #: Exp. Date: Drivers License #: Exp. Date: Home Phone: Cell:

PATIENT INTAKE FORM. Name: Address: Town: State: Zip Code: MMJ Card #: Exp. Date: Drivers License #: Exp. Date: Home Phone: Cell: PATIENT INTAKE FORM Name: Last Name First Name Date of Birth: / / Gender: Male Female Address: Town: State: Zip Code: MMJ Card #: Exp. Date: Drivers License #: Exp. Date: Home Phone: Cell: Email: Primary

More information

Medical vs Recreational Use of Cannabis. 11 th December 2017

Medical vs Recreational Use of Cannabis. 11 th December 2017 1 Medical vs Recreational Use of Cannabis 11 th December 2017 2 Defining Cannabis and Chemical Constituents Cannabis is a plant species. Two main Cannabis sub-species are Cannabis Sativa and Cannabis Indica.

More information

Medical Cannabis: A Patient Primer

Medical Cannabis: A Patient Primer Medical Cannabis: A Patient Primer This primer is meant for documented patients who are using medicinal cannabis or considering using it in the future. The information provided about this medication in

More information

Medical Marijuana Consent Form

Medical Marijuana Consent Form Medical Marijuana Consent Form A qualified physician may not delegate the responsibility of obtaining written informed consent to another person. The qualified patient or the patient s parent or legal

More information

CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS

CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS CANNABIS LEGALIZATION: SUPPORT MATERIAL FOR MANITOBA PHYSICIANS 1. GENERAL INFORMATION Cannabis 101 What is cannabis? Cannabis is a product derived from the Cannabis sativa plant. Cannabis contains hundreds

More information

Understanding the New Access to Cannabis for Medical Purposes Regulations

Understanding the New Access to Cannabis for Medical Purposes Regulations Understanding the New Access to Cannabis for Medical Purposes Regulations Health Canada August 2016 Table of Contents 1. Introduction 2. Health Canada's role 3. What it means for health care practitioners

More information

CDHA 2016 Fall Symposium. Speaker Handout Files. For registered attendees only

CDHA 2016 Fall Symposium. Speaker Handout Files. For registered attendees only CDHA 2016 Fall Symposium Speaker Handout Files For registered attendees only Providing Care in a Marijuana Legal World Heather Rogers, BSDH heatherrdh@heatherrdh.com Objectives We will discuss some of

More information

Welcome to MedWell. MedWell Health and Wellness Centers. Don t live with PAIN Live WELL MedWell. o Newspaper o Referred by.

Welcome to MedWell. MedWell Health and Wellness Centers. Don t live with PAIN Live WELL MedWell. o Newspaper o Referred by. 1 Welcome to MedWell Patient Information Date: Name: Date of Birth: / / Address: City: State: Zip Code: Home Phone: ( ) - Cell Phone: ( ) - Email: Gender: o Male o Female State Drivers License: Social

More information

Research: Medical Cannabis

Research: Medical Cannabis Research: Medical Cannabis Background The hemp plant Cannabis sativa (cannabis) is commonly known as marijuana and can be used as a therapy to alleviate symptoms such as pain and fatigue caused by chronic

More information

This questionnaire will ask you about approved medical use of extracts and tinctures of cannabis at national level.

This questionnaire will ask you about approved medical use of extracts and tinctures of cannabis at national level. Introduction This questionnaire will ask you about approved medical use of extracts and tinctures of cannabis at national level. Definition: The term "extracts and tinctures" refers to substances that

More information

These documents were created to support the work of the Coalition of Colorado Campus Alcohol and Drug Educators. We welcome prevention teams at

These documents were created to support the work of the Coalition of Colorado Campus Alcohol and Drug Educators. We welcome prevention teams at These documents were created to support the work of the Coalition of Colorado Campus Alcohol and Drug Educators. We welcome prevention teams at institutions of higher education to utilize these documents

More information

Marijuana and the Workplace : Changing Times

Marijuana and the Workplace : Changing Times Marijuana and the Workplace : Changing Times By: Stéphane Thiffeault 2018 AMCTO Conference Blue Mountain Resort June 12, 2018 Presentation Outline Current Status of Cannabis Some Facts and Statistics Summer

More information

POLICY NUMBER: POL 153

POLICY NUMBER: POL 153 Chapter: CLAIMS Subject: MEDICAL CANNABIS Effective Date: October 25, 2018 Last Update: October 25, 2018 PURPOSE STATEMENT The purpose of this policy is to explain how the Workers Compensation Board determines

More information

Outcome. Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C

Outcome. Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana Connie J. Cerilli, APRN, FNP-C Outcome Participants will be able to list 3 approved medical conditions Participants will

More information

Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C

Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana. Connie J. Cerilli, APRN, FNP-C Educating Ohio Providers On The Basics Related To Recommending Medical Marijuana Connie J. Cerilli, APRN, FNP-C Outcome Participants will be able to list 3 approved medical conditions Participants will

More information

6. Never give SUBSYS to anyone else, even if they have the same symptoms you have. It may harm them or even cause death.

6. Never give SUBSYS to anyone else, even if they have the same symptoms you have. It may harm them or even cause death. Medication Guide SUBSYS (sub sis) CII (fentanyl) sublingual spray 100 mcg, 200 mcg, 400 mcg, 600 mcg, 800 mcg IMPORTANT: Do not use SUBSYS unless you are regularly using another opioid pain medicine around-the-clock

More information

PATIENT QUESTIONNAIRE

PATIENT QUESTIONNAIRE PATIENT QUESTIONNAIRE Personal Information Date Name Date of Birth Age Height Weight Gender: Male / Female Address City State / Zip Home Phone Cell phone Work phone E-mail address Do you currently have

More information

Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE

Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE Life s brighter under the sun MEDICAL CANNABIS AND GROUP BENEFITS PLAN COVERAGE With the legalization of recreational cannabis upon us in Canada, our conversation about cannabis use is changing. It s not

More information

INITIAL PATIENT INTAKE FORM

INITIAL PATIENT INTAKE FORM INITIAL PATIENT INTAKE FORM Name: (Please, print legibly) Registry ID: Date of Birth: MM / DD / YYYY Gender: Male Female Address: Town: State: Zip Code: Preferred method of contact. For internal promotional

More information

Medical Marijuana Update Chris Belletieri, DO

Medical Marijuana Update Chris Belletieri, DO Dr. Belletieri has provided no disclosures. Graduated PCOM in 1996 In private practice since 1999 Board Certified in FP since 1999 Program Director of FP residency at Lower Bucks Hospital in Bristol, PA

More information

Medical Cannabis use in the Older Patient. Amanjot Sidhu, MD, FRCPC Division of Geriatric Medicine McMaster University

Medical Cannabis use in the Older Patient. Amanjot Sidhu, MD, FRCPC Division of Geriatric Medicine McMaster University Medical Cannabis use in the Older Patient Amanjot Sidhu, MD, FRCPC Division of Geriatric Medicine McMaster University Disclosure Relationships with commercial interests: Grants/Research Support: none Speakers

More information

James Donaldson CEO and Executive Director

James Donaldson CEO and Executive Director Welcome! James Donaldson CEO and Executive Director Dr. Natasha Ryz Chief Science Officer, Zenabis Cannabis 101 Introduction to Cannabis Plant Cannabis is a genus of flowering plants within the family

More information

I would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people

I would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people I would like to begin by acknowledging that we are on the ancestral grounds of the Beothuk people Introduction to the Cannabinoid System And Medical Use Dr Alia Norman Radiation Oncologist Cannabinoid

More information

Medical Marihuana for Patients in the Lymphoma Setting. Speakers: Ruth Turner, RN, Con Rob Laister, PhD

Medical Marihuana for Patients in the Lymphoma Setting. Speakers: Ruth Turner, RN, Con Rob Laister, PhD Medical Marihuana for Patients in the Lymphoma Setting Speakers: Ruth Turner, RN, Con Rob Laister, PhD Medical Marihuana for Patients in the Lymhoma Setting Disclosure: No endorsement or promotion of marihuana

More information

A look at Marijuana in 2014

A look at Marijuana in 2014 A look at Marijuana in 2014 Paul Snyder MA., LADC Overview and Objectives Discuss the mental and physical effects of marijuana use Describe the criteria for Cannabis use disorder according to the DSM 5

More information

Cannabis and What we Know. Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017

Cannabis and What we Know. Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017 Cannabis and What we Know Bonnie Schnittker RN PHN Public Health Nurse October 20, 2017 We All Have a Role to Play! Objectives What is Cannabis? What do we know about the health effects? Legalization:

More information

Welcome to MedWell. Patient Information. Name: Address: City: State: Zip Code: !Other. Name: Address: City: State:

Welcome to MedWell. Patient Information. Name: Address: City: State: Zip Code:   !Other. Name: Address: City: State: 1 Welcome to MedWell Patient Information Date: Name: Date of Birth: / / Address: City: State: Zip Code: Home Phone: ( ) - Cell Phone: ( ) - Email: Gender:! Male! Female Last 4 of Social Security Number

More information

Is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has been increasing among young

Is the most common illicit drug used in the United States. After a period of decline in the last decade, its use has been increasing among young The Facts Cannabis, commonly known as marijuana and by numerous other names, is a preparation of the cannabis plant intended for use as a psychoactive drug and now as medicine. Marijuana also refers to

More information

Medical Cannabis. Danial Schecter, MD, CCFP. Vocational Rehabilitation Association November 7th, Executive Director Cannabinoid Medical Clinic

Medical Cannabis. Danial Schecter, MD, CCFP. Vocational Rehabilitation Association November 7th, Executive Director Cannabinoid Medical Clinic Medical Cannabis Danial Schecter, MD, CCFP Executive Director Cannabinoid Medical Clinic Vocational Rehabilitation Association November 7th, 2014 Conflict of Interest This program has not received financial

More information

Medicinal cannabis. What is medicinal cannabis? What are cannabinoids? The endocannabinoid system

Medicinal cannabis. What is medicinal cannabis? What are cannabinoids? The endocannabinoid system Medicinal cannabis What is medicinal cannabis? Broadly speaking, medicinal cannabis is cannabis prescribed to relieve the symptoms of a medical condition, such as epilepsy. It is important to make the

More information

HEALTH WELLNESS COMMUNITY

HEALTH WELLNESS COMMUNITY HEALTH WELLNESS COMMUNITY As with all modern medicines, our understanding of cannabis and its benefits has deepened over time thanks to groundbreaking advancements in research and technology. At Trilogy

More information

Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses. Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C

Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses. Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C 1 Marijuana/Cannabis Marijuana use is growing in popularity

More information

PATIENT QUESTIONNAIRE

PATIENT QUESTIONNAIRE PATIENT QUESTIONNAIRE Personal Information please include all requested information Date Name Date of Birth* Age Address* City State Zip* Home Phone Cell phone* E-mail address* SSN*: - - *required information

More information

Questionnaire 1 of 5: Cannabis Plant and Cannabis Resin. Introduction

Questionnaire 1 of 5: Cannabis Plant and Cannabis Resin. Introduction Introduction This is one of five questionnaires that Member States are invited to complete ahead of the 40th WHO Expert Committee on Drug Dependence. This questionnaire will ask you about cannabis plant

More information

PATIENT QUESTIONNAIRE

PATIENT QUESTIONNAIRE PATIENT QUESTIONNAIRE Personal Information Date Name Date of Birth Age Height Weight Address City State Zip Home Phone Cell phone Work phone E-mail address SSN: - - Medical History - you must enter information

More information

ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP

ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP ADVANCED CLINICAL CANNABINOID PROVIDER EXAM ACCP Page 1 1. In what year did the possession and transfer of cannabis for recreational use become illegal in the United States? A. 1937 B. 1941 C. 1933 2.

More information

Recent trends in medical cannabis use in Canada

Recent trends in medical cannabis use in Canada Recent trends in medical cannabis use in Canada Paul Grootendorst Faculty of Pharmacy, University of Toronto Department of Economics, McMaster University Cannabis therapeutic effects Cannabis has been

More information

Act 16 and Medical Cannabis in Pennsylvania

Act 16 and Medical Cannabis in Pennsylvania Act 16 and Medical Cannabis in Pennsylvania Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP Associate Provost and Professor of Emergency Medicine Director, Institute of Emerging Health

More information

James McCormack BSc (Pharm), PharmD Professor Faculty of Pharmaceutical Sciences University of British Columbia Vancouver, BC, Canada

James McCormack BSc (Pharm), PharmD Professor Faculty of Pharmaceutical Sciences University of British Columbia Vancouver, BC, Canada James McCormack BSc (Pharm), PharmD Professor Faculty of Pharmaceutical Sciences University of British Columbia Vancouver, BC, Canada My Agenda Discuss the best available evidence Put the evidence into

More information

Medical Cannabis use in the Older Patient

Medical Cannabis use in the Older Patient Medical Cannabis use in the Older Patient Dr. Amanjot Sidhu Division of Geriatric Medicine McMaster University Audience Poll What is the fastest-growing demographic of cannabis users? a) Ages 14-23 b)

More information

Doctor Discussion Guide

Doctor Discussion Guide Doctor Discussion Guide Getting the pain relief you need to stay active is important. Keeping track of your symptoms can help you and your healthcare provider determine if there is a need to adjust your

More information

March 12, Medical Marijuana Preliminary Consultation Online Survey Report and Analysis. Introduction:

March 12, Medical Marijuana Preliminary Consultation Online Survey Report and Analysis. Introduction: March 12, 2014 Medical Marijuana Preliminary Consultation Online Survey Report and Analysis Introduction: The College s current Medical Marijuana policy is under review. As part of this review, the College

More information

99 SOUTH ALCANIZ STREET SUITE B PENSACOLA, FL

99 SOUTH ALCANIZ STREET SUITE B PENSACOLA, FL KEVIN M. HOGAN, DC DEBRA HEMPHILL, ARNP ROBERT SAYRE, MD Clinic Director Advanced Registered Nurse Practitioner Medical Director Name: Address: City/State/Zip: Phone number: First Middle Last How did you

More information

Cannabis for Medical Purposes

Cannabis for Medical Purposes College of Physicians and Surgeons of British Columbia Cannabis for Medical Purposes Preamble This document is a standard of the Board of the College of Physicians and Surgeons of British Columbia. College

More information

SUBOXONE (buprenorphine and naloxone) sublingual film (CIII) IMPORTANT SAFETY INFORMATION

SUBOXONE (buprenorphine and naloxone) sublingual film (CIII) IMPORTANT SAFETY INFORMATION SUBOXONE (buprenorphine and naloxone) sublingual film (CIII) IMPORTANT SAFETY INFORMATION What is the most important information I should know about SUBOXONE Film? Keep SUBOXONE Film in a secure place

More information

MEDICATION GUIDE. ACTIQ (AK-tik) CII (fentanyl citrate) oral transmucosal lozenge 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg

MEDICATION GUIDE. ACTIQ (AK-tik) CII (fentanyl citrate) oral transmucosal lozenge 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg MEDICATION GUIDE ACTIQ (AK-tik) CII (fentanyl citrate) oral transmucosal lozenge 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg IMPORTANT: Do not use ACTIQ unless you are regularly using another

More information

MEDICAL CANNABIS PATIENT COUNSELING. Krissy Bernazani, RPh Clinical Director Zen Leaf

MEDICAL CANNABIS PATIENT COUNSELING. Krissy Bernazani, RPh Clinical Director Zen Leaf MEDICAL CANNABIS PATIENT COUNSELING Krissy Bernazani, RPh Clinical Director Zen Leaf DISCLOSURE Krissy Bernazani is a paid employee of Freestate Wellness, dba Zen Leaf Maryland, a medical cannabis dispensary.

More information

Home Phone Cell Phone

Home Phone Cell Phone Patient Assessment Form For patients seeking ACMPR Access to Cannabis for Medical Purposes General Information First Name D.O.B YEAR MONTH DAY Last Name Gender Male Female Age If female, are you Lic. Producer

More information

History Of Medical Cannabis

History Of Medical Cannabis History Of Medical Cannabis Historical and archaeological evidence of widespread use in ancient times as medicine, food, textiles & for sacraments, rituals Possibly first domesticated crop Introduction

More information

MEDICAL CANNABIS IN MINNESOTA

MEDICAL CANNABIS IN MINNESOTA MEDICAL CANNABIS IN MINNESOTA MINNESOTA ACADEMY OF PHYSICIAN ASSISTANTS MARCH 18, 2016 TOM ARNESON, MD, MPH MDH OFFICE OF MEDICAL CANNABIS 2014: Minnesota becomes 22 nd state with a medical cannabis program

More information

Medication Guide. Medication Guide. Lazanda (La-ZAN-da) CII. (fentanyl) nasal spray 100 mcg, 400 mcg

Medication Guide. Medication Guide. Lazanda (La-ZAN-da) CII. (fentanyl) nasal spray 100 mcg, 400 mcg Medication Guide Medication Guide Lazanda (La-ZAN-da) CII (fentanyl) nasal spray 100 mcg, 400 mcg IMPORTANT: Do not use Lazanda unless you are regularly using another opioid pain medicine around-the-clock

More information

TRIPROLIDINE. Please read this leaflet and the packaging of the medicine you purchased, carefully before you start using triprolidine.

TRIPROLIDINE. Please read this leaflet and the packaging of the medicine you purchased, carefully before you start using triprolidine. TRIPROLIDINE New Zealand Consumer Medicine Information What is in this leaflet The medicine you have purchased contains triprolidine. This leaflet is intended to provide information on the active ingredient

More information

420 ADVISORY MANAGEMENT

420 ADVISORY MANAGEMENT THE CANNABIS ACT: WHAT DOES IT MEAN FOR CANADIANS? 420 CLINIC, LTD. OBJECTIVES At the end of the session, you will be able to: 1) Understand the ramifications of recreational cannabis legalization 2) Understand

More information

WHO Expert Committee on Drug Dependence Pre-Review: Extracts and tinctures of cannabis. Expert Peer Review 2

WHO Expert Committee on Drug Dependence Pre-Review: Extracts and tinctures of cannabis. Expert Peer Review 2 WHO Expert Committee on Drug Dependence Pre-Review: Extracts and tinctures of cannabis Expert Peer Review 2 1. Comments based on the review report a. Evidence on dependence and abuse potential Extracts

More information

THE COMPLETE CBD GUIDE

THE COMPLETE CBD GUIDE THE COMPLETE CBD GUIDE WHAT IS CBD (CANNABIDIOL)? 2 WHERE DOES CBD COME FROM? 3 HOW DOES CBD WORK IN THE BODY? 4 HOW MUCH CBD DO I TAKE? 5-6 CBD OIL VS. HEMP OIL 7 CBD NOT THC 8 THE BENEFITS OF CBD 9 PETS

More information

Steven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University

Steven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University Steven G. Kinsey, PhD Associate Professor, Department of Psychology West Virginia University sgkinsey@mail.wvu.edu Any opinions expressed are my own and do not reflect any official position of WVU beanpot.co

More information

CANADIAN CANNABIS CRAZE (AND CONUNDRUM) Dr. Melissa Snider-Adler Chief Medical Review Officer DriverCheck Inc. Addiction Medicine Physician

CANADIAN CANNABIS CRAZE (AND CONUNDRUM) Dr. Melissa Snider-Adler Chief Medical Review Officer DriverCheck Inc. Addiction Medicine Physician CANADIAN CANNABIS CRAZE (AND CONUNDRUM) Dr. Melissa Snider-Adler Chief Medical Review Officer DriverCheck Inc. Addiction Medicine Physician AGENDA THC IMPAIRMENT A deep dive into THC vs. CBD Signs and

More information

Dr. Meldon Kahan. Women s College Hospital. with PIA LAW

Dr. Meldon Kahan. Women s College Hospital. with PIA LAW with PIA LAW and Toronto ABI Network Dr. Meldon Kahan Women s College Hospital Dr. Meldon Kahan is an Associate Professor in the Department of Family Medicine at University of Toronto, and Medical Director

More information

Less pain in my life helps me get back to living.

Less pain in my life helps me get back to living. Eligible patients pay as little as $0 for BELBUCA Less pain in my life helps me get back to living. BELBUCA is: RETHINK RELIEF A strong prescription pain medicine that contains an opioid (narcotic) that

More information

Cannabis. Member of the Cannabaceae family of flowering plants (along with hops) Cannabis sativa (v. sativa, indica, afghanica, ruderalis)

Cannabis. Member of the Cannabaceae family of flowering plants (along with hops) Cannabis sativa (v. sativa, indica, afghanica, ruderalis) Member of the Cannabaceae family of flowering plants (along with hops) sativa (v. sativa, indica, afghanica, ruderalis) Only females flowers contain high concentrations of psychoactive oils (cannabinoids)

More information

The Effects known & unknown of Marijuana in Older Adults. Danielle Fixen, PharmD, BCGP, BCPS University of Colorado School of Pharmacy

The Effects known & unknown of Marijuana in Older Adults. Danielle Fixen, PharmD, BCGP, BCPS University of Colorado School of Pharmacy The Effects known & unknown of Marijuana in Older Adults Danielle Fixen, PharmD, BCGP, BCPS University of Colorado School of Pharmacy Learning Objectives 1. Review various dosing strategies for medical

More information

AGENDA. 9:00 Sign-in and introductions 9:15 Marijuana 10:30 Break 10:45 Opioid Prevention 11:30 Discussion & Wrap-Up

AGENDA. 9:00 Sign-in and introductions 9:15 Marijuana 10:30 Break 10:45 Opioid Prevention 11:30 Discussion & Wrap-Up AGENDA 9:00 Sign-in and introductions 9:15 Marijuana 10:30 Break 10:45 Opioid Prevention 11:30 Discussion & Wrap-Up Marijuana: Preventing Youth Use Juliet D Alessandro, Healthy Communities Specialist Today

More information

MEMBERSHIP OVERVIEW. To become a member at Warmland, you must provide documentation confirming you fall into at least one of the following categories:

MEMBERSHIP OVERVIEW. To become a member at Warmland, you must provide documentation confirming you fall into at least one of the following categories: MEMBERSHIP PACKAGE MEMBERSHIP OVERVIEW Welcome to Warmland Medicinal Cannabis Centre. Our aim is to provide a consistent, safe, local and dependable source of medicinal cannabis for people suffering from

More information

Meet the many faces of pain

Meet the many faces of pain Meet the many faces of pain WWW.PRIALT.COM N O W M E E T Ziconotide is a synthetic equivalent of a naturally occurring conopeptide. Distributed by Elan Pharmaceuticals, Inc. (EPI). PRIALT is a registered

More information

July 15 TH, ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine

July 15 TH, ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine MEDICAL CANNABIS FOR NEUROLOGICAL DISEASES July 15 TH, 2017 ANDREW MEDVEDOVSKY, M.D. Board Certified Neurologist & Pain Medicine Specialist Director New Jersey Alternative Medicine GOALS AND OBJECTIVES

More information

READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION. (Pentazocine Lactate Injection, USP)

READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION. (Pentazocine Lactate Injection, USP) READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION N Talwin (Pentazocine Lactate Injection, USP) Read this carefully before you start taking Talwin. This leaflet is a

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Legal 1. Can I use cannabis? You can legally use cannabis if you are 21 or older. You can also use cannabis if you are 18 or older and have a current qualifying physician s recommendation

More information

MEDICATION MANAGEMENT AGREEMENT Pain Management Program Participation Agreement and Consent

MEDICATION MANAGEMENT AGREEMENT Pain Management Program Participation Agreement and Consent MEDICATION MANAGEMENT AGREEMENT Pain Management Program Participation Agreement and Consent Pain may be effectively managed through the use of controlled substance medications (referred to below as opioids

More information

Medical Marijuana. 1. is a plant species, variety known as hemp. 3. Tetrahydrocannabinol is an aromatic with low water solubility.

Medical Marijuana. 1. is a plant species, variety known as hemp. 3. Tetrahydrocannabinol is an aromatic with low water solubility. Medical Marijuana Questions from Part 1: 1. is a plant species, variety known as hemp. a. Cannabis sativa Linnaeus b. Cannabis sativa c. Cannabis indica d. Cannabis Lemark 2. The major psychoactive compound

More information

PART III: PATIENT MEDICATION INFORMATION READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION

PART III: PATIENT MEDICATION INFORMATION READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION PART III: PATIENT MEDICATION INFORMATION READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICINE PATIENT MEDICATION INFORMATION N HYCODAN (hydrocodone bitartrate) Tablets and Syrup Read this carefully before

More information

Elements for a public summary

Elements for a public summary VI.2 Elements for a public summary Part VI.2 Elements for a public summary is applicable for all products that are covered by this RMP, except from the important potential risk of Medication error with

More information

MEDICATION GUIDE Morphine Sulfate (MOR feen SUL fate) (CII) Oral Solution

MEDICATION GUIDE Morphine Sulfate (MOR feen SUL fate) (CII) Oral Solution MEDICATION GUIDE Morphine Sulfate (MOR feen SUL fate) (CII) Oral Solution IMPORTANT: Keep morphine sulfate oral solution in a safe place away from children. Accidental use by a child is a medical emergency

More information

Medical Marijuana Martin P. Eason MD, JD Associate Chief of Staff for Education Mountain Home VA Medical Center. Disclosure.

Medical Marijuana Martin P. Eason MD, JD Associate Chief of Staff for Education Mountain Home VA Medical Center. Disclosure. Medical Marijuana Martin P. Eason MD, JD Associate Chief of Staff for Education Mountain Home VA Medical Center Controversies in Pain Management Conference Johnson City, TN November 13, 2015 Disclosure

More information

Medicinal Cannabis Dosage Forms in California

Medicinal Cannabis Dosage Forms in California Mica Gross President Sante Botanica / COO MDBioLogics Medicinal Cannabis Dosage Forms in California An Overview of Cannabis Dosage Forms Forms of dosage are the specific vehicles by which cannabis, or

More information

CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE

CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE 1 CANNABIS AND CANNABINOIDS: 2017 REPORT, U.S. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING AND MEDICINE The Health Effects of Cannabis and Cannabinoids. The Current State of Evidence and Recommendations

More information

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure Faculty/Presenter Disclosure Faculty: Philippe Lucas Relationships with commercial interests: Philippe Lucas is a Research Affilliate with the Centre for Addictions Research of BC, as well as VP, Patient

More information

Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicine or street drugs.

Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicine or street drugs. MEDICATION GUIDE Daytrana (day-tron-ah) (methylphenidate transdermal system) CII Only Use Daytrana on Your Skin Important: Daytrana is a federally controlled substance (CII) because it can be abused or

More information

INTRODUCTION WHAT IS MARIJUANA 2/28/2018

INTRODUCTION WHAT IS MARIJUANA 2/28/2018 INTRODUCTION AT THE END OF THE SESSION, YOU WILL ASSESS THE USE AND IMPACT (SIDE EFFECTS) OF MARIJUANA ON PATIENTS EXPLORE CANNABIS THERAPY LEGALITY AND PRACTICALITY POSSESS STRATEGIES TO PROVIDE PSYCHO-EDUCATIONAL

More information

MEDICATION GUIDE SUBOXONE (Sub OX own) (buprenorphine and naloxone) Sublingual Tablets (CIII)

MEDICATION GUIDE SUBOXONE (Sub OX own) (buprenorphine and naloxone) Sublingual Tablets (CIII) MEDICATION GUIDE SUBOXONE (Sub OX own) (buprenorphine and naloxone) Sublingual Tablets (CIII) IMPORTANT: Keep SUBOXONE in a secure place away from children. Accidental use by a child is a medical emergency

More information

IMPORTANT: PLEASE READ

IMPORTANT: PLEASE READ PART III: CONSUMER INFORMATION Pr BACLOFEN Baclofen Tablets 10 mg and 20 mg This leaflet is part III of a three-part "Product Monograph" published when BACLOFEN was approved for sale in Canada and is designed

More information

MEDICAL MARIJUANA: WHAT S THE EVIDENCE?

MEDICAL MARIJUANA: WHAT S THE EVIDENCE? MEDICAL MARIJUANA: WHAT S THE EVIDENCE? L A U R A A. M A R K L E Y, M D B O A R D - C E R T I F I E D I N P E D I A T R I C S / G E N E R A L P S Y C H I A T R Y / C H I L D & A D O L E S C E N T P S Y

More information

MEDICATION GUIDE Morphine Sulfate (mor-pheen) (CII) Oral Solution

MEDICATION GUIDE Morphine Sulfate (mor-pheen) (CII) Oral Solution MEDICATION GUIDE Morphine Sulfate (mor-pheen) (CII) Oral Solution IMPORTANT: Keep Morphine Sulfate Oral Solution in a safe place away from children. Accidental use by a child is a medical emergency and

More information

Medical Marijuana and the Workplace: Human Rights Considerations for ONA Members

Medical Marijuana and the Workplace: Human Rights Considerations for ONA Members Medical Marijuana and the Workplace: Human Rights Considerations for ONA Members Presented by: Pauline Lefebvre-Hinton, HRE/RTW Specialist Alyssa Lane, Legal Counsel October 2, 2018 Agenda 1. What is cannabis?

More information

Important Information

Important Information Important Information Please work through the following pages with your patient or the patient s chart as necessary. Fax completed documents to 1 888 629-4722. Keep the original in your chart / file. Fee:

More information

THEXANAX THREAT 1 THE XANAX THREAT. iaddiction.com

THEXANAX THREAT 1 THE XANAX THREAT. iaddiction.com THEXANAX THREAT 1 THE XANAX THREAT 3 6 9 11 SOCIETAL IMPACT OF XANAX RECREATIONAL VALUE OF XANAX THE PHYSICAL, MENTAL, AND EMOTIONAL EFFECTS OF XANAX ADDICTION AND DEPENDENCE Societal Impact of Xanax Since

More information

Therapeutic Cannabis in New Hampshire. Number to text: Goals/Objectives. Survey. WMUR Granite State Poll (February 2013) 3/29/2018

Therapeutic Cannabis in New Hampshire. Number to text: Goals/Objectives. Survey. WMUR Granite State Poll (February 2013) 3/29/2018 Therapeutic Cannabis in New Hampshire Goals/Objectives Lisa Withrow, APRN, FNP-C, ACHPN Palliativity Medical Group LLC Brief History of the NH Therapeutic Cannabis Law Certification Process Therapeutic

More information

Cannabinoids: access and symptom management in cancer

Cannabinoids: access and symptom management in cancer Cannabinoids: access and symptom management in cancer Appetite stimulation Anecdotal reports suggest marijuana stimulates appetite AIDS/HIV dronabinol 2.5 mg bd v placebo (n=88) increase in appetite 38%

More information

Introduction: You now have better information 2. What, How, Why?: CBD Basics 3 What is CBD? How does CBD work? Why take CBD?

Introduction: You now have better information 2. What, How, Why?: CBD Basics 3 What is CBD? How does CBD work? Why take CBD? Introduction: You now have better information 2 What, How, Why?: CBD Basics 3 What is CBD? How does CBD work? Why take CBD? Getting Started: How will you feel 5 How will I feel after I take it? What if

More information

PATIENT EDUCATION GUIDE

PATIENT EDUCATION GUIDE PATIENT EDUCATION GUIDE Table of Contents General Information About Treatment With MMJ 4 Availability, Strength, and Effects of Medical Marijuana Strains and Products 5 Methods, Forms, and Routes of Administration

More information

Clinical Education Initiative MEDICAL MARIJUANA 101. Speaker: Patricia Reed, PharmD

Clinical Education Initiative MEDICAL MARIJUANA 101. Speaker: Patricia Reed, PharmD Clinical Education Initiative Support@ceitraining.org MEDICAL MARIJUANA 101 Speaker: Patricia Reed, PharmD 8/2/2017 Medical Marijuana 101 [video transcript] 00:00:12 - So we'll get started. Disclosures

More information