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カナダ
医療カナビス・クラブ・ガイドライン
III. CLIENT EDUCATION
Compassion clubs encourage their clients to make informed and educated
choices in regards to their healthcare. It is important that people using
cannabis as a medicine are equipped with all of the information necessary to
medicate safely and effectively.
Upon registering at a compassion club, clients should be given a thorough
orientation session that is tailored to their personal healthcare needs. It is
recommended that this session include the following areas of information:
1. Introduction to the Plant
Providing medical cannabis users with information about the cannabis plant and
cannabinoids will promote an understanding of this medicine, allowing them to
use it more effectively.
2. Strain Selection and Effects
Strains of cannabis from the Indica or Sativa genus have very different effects
(as do many sub-species). These differences must be explained in order for a
client to relieve their symptoms effectively and to be aware of potential side
effects, both desirable and undesirable, associated with different strains. It
must also be acknowledged that these are general tendencies and that effects
vary from person to person. Clients may be given “tracking sheets” to keep
track of the strains they have used and their effects.
3. Dosage
Since there is no threat of lethal toxicity from cannabis use, self-titration is the
most efficient and effective method of dosage selection. Dispensaries should
counsel clients on how to achieve the proper dosages for different modes of
administration. Emphasis should be on using the smallest amount possible
to achieve the desired effect. This allows the client to reduce costs, as well as
achieve maximum therapeutic potential with the lowest amount of potential
side effects.
4. Potency
Potency is an important factor in the overall efficacy of cannabis. Choosing a
strain with the desired potency allows a client to ingest the smallest amount
possible to achieve a desired effect.
5. Tolerance
With some cannabis users, tolerance to cannabis may develop through prolonged
use of the same strain. Using a variety of strains will minimize therapeutic
tolerance. Taking a treatment “holiday” from cannabis use altogether will also
reduce tolerance.
6. Dependence and Withdrawal
When using any substance it is important to be aware of potential for
dependence and withdrawal. There is no physical dependence from either
chronic or periodic administration of cannabis. There are no significant
withdrawal effects when cannabis use is ceased or decreased, however some
people may experience sleeplessness, irritability, and loss of appetite. These
symptoms are usually mild and short-lived (i.e. 3 days). There may be signs of
some psychological dependence since symptom relief will also be decreased
when use is ceased. Clubs should provide information to clients about these
important considerations.
7. Ingestion Options
Reviewing the various forms of ingestion (i.e. smokeables, edible products,
tinctures and teas) and how they differ from each other in terms of potency,
time of onset, duration, and overall effect will assist clients in selecting the
most effective treatment for their particular symptoms or condition, and help
them to use whole-plant cannabis and bi-products safely and effectively.
8. Safe Smoking Techniques
Smoking cannabis may lead to respiratory irritation, especially with prolonged
and heavy use, which is sometimes the case for those with chronic illnesses.
There are several techniques and tools that can be used to reduce irritation
(e.g. not holding the smoke in, and use of various smoking implements such as
pipes and vaporizers). These should be reviewed with clients
9. Side Effects and Safe Use
There are some potential effects of cannabis that are not therapeutic (e.g.
dizziness, increased heart rate, anxiety, dry mouth). These can be mitigated
through education and awareness. As well there are some practical concerns
(e.g. driving while if impaired, mixing with alcohol, sharing joints) that should
be reviewed to ensure safe use. All clients should be able to make educated and
informed decisions in regards to their medical use of cannabis.
10. Quality
Clients should be informed of the quality standards of each dispensary and how
these are achieved (i.e. lab testing, production facility inspections). Clients
should also be made aware of how to judge quality of products for themselves in
terms of tactile and visual inspections.
11. Contraindications and Drug Interactions
Cannabis has been used for thousands of years without record of a single
related death. However some research suggests that there may be some medical
conditions that could potentially pose concerns in regards to the therapeutic
application of cannabis. Additionally, many medical cannabis users may also be
using pharmaceutical drugs for their medical condition. While some research
indicates that there is the possibility that cannabis may increase or decrease
the effectiveness of other medications, current research from pharmaceutical
companies suggests that there are no significant drug interactions in regards to
cannabis.
On the whole, most cannabis users report no significant interactions,
although many find that they can reduce their dosage of some their prescription
medications with cannabis use, particularly opiate-based painkillers.
Additionally, cannabis can mitigate many negative side effects of prescription
medications or treatments, which in some cases may be the primary reason for
its therapeutic use. Operators of dispensaries have an ethical responsibility to
educate themselves and their clients in regards to potential drug interactions or
contraindications to cannabis use, and to stay up to date with emerging clinical
cannabis research.
12. Political Climate and Legal Risks
It is important to inform club clients of the current state of the laws, which
may be unclear from media and police sources and may be in a state of flux. It
is still illegal in Canada to possess, grow, or distribute cannabis. Clients must
be aware of the risks of criminal persecution in their particular region, and
must know their rights in order to avoid the harmful effects of arrest, cannabis
seizure, imprisonment and criminal record. Client should also be made aware of
Health Canada’s medical marijuana program, which is currently the only legally
sanctioned avenue for access. While clubs do not require clients to have a
Health Canada license, clients should be able to make an informed choice about
participating in the programme.
(See Section VII. 3 for links to more information about the above topics)
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