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カナダ
医療カナビス・クラブ・ガイドライン
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.
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.
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)
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