カナダ

医療カナビス・クラブ・ガイドライン


  目次
I. 背景
II. ディスペンサリーへのアクセス
III. 顧客研修
IV. カナビスの処方
V. カナビスの仕入れ
VI. ディスペンサリーの責任範囲
VII. 情報



II. ACCESS TO DISPENSARIES



1. Eligibility Requirements

a. Age/Parental Permission

Community-based dispensaries should only distribute cannabis to those 18 years old and over, unless applicants have written consent from a parent or legal guardian.5 This age-based restriction reflects the legal age of adulthood, while also recognizing that some people under the age of 18 may also need access to a safe source of medical cannabis. In recognition that the legal status and stigma of cannabis use may pose particular difficulties for those under 18 in accessing medical cannabis, dispensaries will continue to monitor the political and legal climate regarding this requirement.
Compassion clubs may chose to require a higher age of entry in recognition of provincial or community norms.

b. Healthcare Practitioner Support

Clients of compassion clubs must have the support of an appropriately licenced healthcare practitioner to verify their medical condition and the therapeutic nature of their cannabis use. Medical cannabis use generally refers to applications that alleviate the suffering of specific symptoms and medical conditions, and to improve the overall sense of well-being.
It should be noted that while many legitimate medical cannabis users choose to use cannabis after hearing of and/or experiencing its therapeutic benefits, self-referral is not sufficient for access to compassion clubs in the current legal climate.
Despite resistance from their provincial and federal regulatory bodies, an increasing number of physicians support the medical use of cannabis by their patients, and are the main source of patient recommendations for access to medical cannabis.

Given that cannabis is an herbal medicine, recommendations for its use may also be permitted from doctors of Traditional Chinese Medicine and Naturopaths. These health care practitioners are experienced with herbal medicine and have licensing bodies and governing associations necessary for legal recognition and to ensure a certain quality of care and expertise.


c. Recommendations and Confirmation of Diagnosis

Obtaining support from healthcare practitioners for therapeutic cannabis use can be problematic, particularly in rural areas of the country. Many health practitioners refuse to recommend the use of cannabis, even if they believe that it may be therapeutically beneficial to their patients. Although some refusals are due to potential medical concerns, many are the result of the illegal status and social stigma of cannabis, pressure from professional associations and colleges, fear of liability and pressure from insurers, a lack of awareness of the latest clinical research, and general discomfort with the prescription of herbal medicines.

In recognition of this problematic political/legal/regulatory situation, many dispensaries have found it necessary to accept a simple proof of condition for certain ailments rather than requiring an actual recommendation for the use of cannabis. This can help balance both the dispensary’s and the local community’s need to ensure the legitimacy of the patient’s medical claim, while also addressing the patient’s need for safe and timely access to medical cannabis.

Therefore, in order to not unduly restrict availability of cannabis to persons who may receive health benefits from its use, a confirmation of diagnosis from an approved health care practitioner is the base requirement for access to a compassion club for those suffering from the following conditions:

HIV/AIDS, ADHD, Arthritis, Brain/Head Injury, Cancer, Colitis, Chemotherapy, Crohn’s Disease, Epilepsy, Fibromyalgia, Glaucoma, Hepatitis C, Irritable Bowel Syndrome, Migraines, Multiple Sclerosis, Muscular Dystrophy, Nausea (chronic and debilitating), Pain (chronic), Paraplegia/Quadriplegia, Parkinson’s Disease, Radiation Therapy, Seizure disorders, Sleep Disorders, Substance Addiction and Withdrawal.

The above list of conditions is not comprehensive and should be reviewed and modified periodically in light of emerging research or changing social/legal conditions. Any other condition requires an actual recommendation for the use of cannabis from a healthcare practitioner. It should be noted that some health care practitioners refuse to even confirm their patient’s diagnosis, highlighting the necessity for legal reform and professional education. In the meantime, dispensaries must facilitate this process a much as possible to assist their clients in getting the care that they require.


d. Documentation

Ideally, each compassion club will have a form for health care practitioners to fill out. The form will provide health care practitioners the opportunity to both confirm the diagnosis and recommend the use of cannabis. It will also allow them to indicate if they do not recommend the use of cannabis and to state their reasons.

Since experience suggests that some health care practitioners will not feel comfortable filling out these forms, the conditions that require a diagnosis only (see above section c) may be written on prescription pads or practitioner letterhead. In some cases, other government forms that indicate a medical diagnosis supported by a practitioner signature (i.e. disability forms) may be acceptable to confirm an applicant’s condition. Prospective clients can also sign release of information forms, requesting that their practitioner release relevant medical information to the compassion club for the confirmation of a health condition.

To ensure the legitimacy of medical documentation, all forms must be faxed to the dispensary directly from the health care practitioner’s office, and the dispensary must confirm the origin of the fax. Additionally, the legitimacy of health care practitioners must be verified with their respective licensing bodies. e. Special Consideration: Mental Health Conditions

Mental health conditions may be the primary or secondary medical reason for the use of cannabis. Some compassion club clients have recommendations for the use of cannabis for mental health conditions such as bi-polar, schizophrenia, and PTSD. Many clients suffering from critical or chronic physical conditions also experience mental health problems such as depression and anxiety.

Research suggests that cannabis can be extremely effective in alleviating the symptoms of many mental health conditions. However, in some cases, cannabis use may not be beneficial and may prove deleterious to mental health. Therefore, it may be of benefit for the clients’ healthcare provider to be aware of their use of cannabis through the compassion club, so that all parties can work together to effectively monitor and treat the client’s condition.

As such, it is recommended that compassion clubs strive to get a recommendation for the use of cannabis in addition to a confirmation of diagnosis for mental health conditions. Clubs should also have a system in place to carefully assess and monitor clients with severe mental health conditions to ensure cannabis is of continued benefit to them. Tailored advice on strain selection and drug interactions should also be given to clients with mental health conditions.

Dispensaries should track current research in this area, and adjust assessment and treatment protocols accordingly.


2. Registration Requirements

a. Personal Information

Upon registering with a compassion club, specific personal information must be collected from the client in order to maintain the highest quality of service possible.
  • Personal information and emergency contact info.
  • Detailed information regarding conditions, symptoms, and use of other medications.
  • Previous use of and experience with cannabis.
  • Other relevant info: pregnancy, eating and sleeping habits, allergies, use of other drugs including tobacco, alcohol, cocaine, heroin and methadone.
  • Photo ID

b. Consent Form

Clients must sign a witnessed consent form designating the Club as their agent to procure cannabis on their behalf, and agreeing that this cannabis is for their personal use only and that they are aware that redistribution will result in expulsion.


c. Rights and Responsibilities

Documents or contracts detailing the clients’ rights and responsibilities within the organization promote a safe, friendly and secure environment for all clients and staff, encourage respect for the neighbourhood and local community, and ensure consistent daily operations around the distribution of cannabis. Dispensaries should develop clear repercussions for infractions of these rights and responsibilities, and a process for their implementation and enforcement. There should be no tolerance for redistribution, and any evidence of re-sale of medications procured from a compassion club should be grounds for an immediate loss of membership privileges.

(See Section VII. 2 for links to forms)