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Cannabis Campaigners' Guide News Database result:
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'It helps me get through the pain' Jodie Sinnema, Postmedia News Times Colonist Saturday 10 Dec 2011 Ian Layfield in Victoria swallows cannabis-infused oil capsules he makes himself, frying olive oil with pot leaves, then straining it with cheese cloth and pouring it into gel caps. He also mixes cannabis into a topical cream he rubs into his left foot and ankle, which was crushed in October 2006 after being rolled over by a grader. Margaret Marceniuk of Edmonton inhales her medical marijuana through a pharmaceutical puffer and a head-shop pipe. Tamara Cartwright vaporizes her pot with a machine called a Volcano, then inhales three to four bags of the vapour while locked away in her bedroom, away from her toddler. Todd Kaighin, an HIV patient in downtown Toronto, largely smokes traditional joints, while Janice Cyre outside Edmonton presses her marijuana leaves into steeped tea. Many users also nibble on the odd brownie or cookie baked with cannabis leaves, pot-infused oil or canna-butter. All have their federal licences to legally take medical marijuana to help dull pain, boost appetite and curtail nausea or diarrhea associated with multiple sclerosis, colitis, severe arthritis, HIV or fibromyalgia. But all laugh disdainfully at the dried marijuana grown by the federal government in a mine in Manitoba, describing it as "dust" or "catnip in a bag" that has little therapeutic benefit and brings headaches. They either buy their medical pot illegally through compassion clubs or legally grow their own plants in their basements, with some occasionally and reluctantly forced to buy from street dealers when their supply runs low. Marceniuk, who recently moved to a small community west of Edmonton, has never smoked cigarettes and didn't rebel as a teenager by getting high on pot. She refused to try medical marijuana for her constant pain while working as a schoolteacher and wasn't keen on using it while her two sons were still living at home. But since she's been on disability for seven years, Marceniuk has slowly incorporated marijuana into her daily routine to help her with the debilitating effects of multiple sclerosis. She's one of 108 with the disease in Alberta - 480 across Canada - who can legally use marijuana under Health Canada's medical marijuana program, according to 2001 to 2007 data. Diagnosed with MS at age 28, Marceniuk has experienced blindness, migraines, balance issues, chronic pain and fatigue. At 55, conventional medications only hold the pain at bay for so long. "I have breakthrough pain," said Marceniuk, who is currently on 13 medications, including one conventional painkiller. About seven years ago, she started using marijuana, first with Sativex, a legal synthetic marijuana she inhales in a puffer form similar to an inhaler for asthmatic patients. Her doctor prescribes it like any other pharmaceutical and doesn't have to apply to Health Canada for a medical marijuana licence or use triplicate subscriptions, which are needed for opiates and narcotics such as morphine that have the potential for misuse or abuse. A vial of Sativex lasts about one month for Marceniuk, who inhales four puffs for each daily treatment. Three to four hours later, the associated high brings relief and dulls the pain. But the Sativex didn't seem to help that much until Marceniuk began smoking dried marijuana in a pipe, about once a week. The relief from smoking was almost immediate, and the doctor believes the smoked leaf opened pathways that allowed the synthetic compound to work better. "It doesn't get rid of the pain completely. As my son says, it makes me not care about the pain," she said. "It helps me get through the pain." Marceniuk can legally take both forms of marijuana, since she has received approval from the federal government, but it took her two years to find a doctor willing to spend the time to fill out the lengthy forms for a licence. In January 2010, figures from Health Canada suggested 153 Alberta physicians supported marijuana prescriptions, compared with 685 in B.C. and 939 in Ontario. Marceniuk smokes her pipe only at home, occasionally supplementing with cannabis-infused brownies made with special oil. When out with friends, she takes Sativex, a more socially acceptable option that can be discreetly used in the washroom and leaves no odour. She purchases her pot illegally from a compassion house in Vancouver she visits once or twice a year. "The stuff coming from the government is literally just dust," Marceniuk said. "I'm not impressed by it." Nor are others, who say when the government harvests its crop, workers separate the cannabis leaves and buds from the crystals, the snowflake-like compounds that grow on the bud and contain most of the active ingredient called tetrahydrocannabinol, or THC. The extracted THC is then made into a tincture or liquid form, and sprayed back onto the plant so that the THC levels are standard in all the product, at about 12.5 per cent, according to the Health Canada website. But critics say tests have shown levels far lower, at 6.0 per cent. They suggest variety in strength and plant types is important for patients with different medical needs. Marceniuk doesn't know how many grams she uses each day, but likely an amount that falls safely inside the Health Canada guidelines of one to three grams of dried marijuana. A typical joint contains between 0.5 and 1.0 gram of cannabis plant matter, Health Canada states. But the guesswork is part of what troubles physicians like Edmonton's Dr. Rufus Scrimger, who has worked as an oncologist for 25 years. Scrimger said he doesn't feel comfortable prescribing medical marijuana for his cancer patients because doctors are given no training to understand the different strains, strengths or types of marijuana they should be prescribing for each ailment. Nor can doctors control the supply, which could be tainted with other ingredients. "There's not a lot of good medical data out there to support its use, evidence that says it's better than all the other medications that we have available to us for nausea or pain," said Scrimger, the Alberta Medical Association's section head for oncology. "We don't know how to prescribe it. There's no real accepted dose. There's no standardized strength. There's an ignorance, I guess, on the part of most doctors, to prescribe it even if they wanted to." The College of Physicians and Surgeons of Alberta recommends physicians not prescribe medical marijuana because scientific research hasn't proven its clinical benefits. The Alberta Medical Association strongly urges doctors to "think twice" before prescribing or dispensing marijuana, a stance laid out in association president's letters in 2001 and 2003. Palliative doctors, who may be more likely to consider medical marijuana as a final option to reduce pain in the last weeks of life, are also advised against prescribing pot. Dr. Brian Knight, an anesthetist with expertise in chronic pain medicine, said he wouldn't call marijuana an important tool, but his "third-line option," largely prescribed only after his patients have had little success managing chronic pain through physiotherapy, psychology, antidepressants, anticonvulsants and opioids, which are controversial themselves. Knight also prescribes the pharmaceutical pill or inhaler before trying the leaf variety of cannabis, even though the synthetic marijuana doesn't usually work for patients, or brings more side effects than smoking a joint, he said. The problem, Knight said, is that even though an estimated 30 per cent of the population suffers from chronic pain, there aren't sufficient resources such as therapy to help them to the same extent as for those with other chronic health issues such as diabetes. "We don't have a lot of tools available to us," he said. And patients already wait about one year to see him in his pain clinic at the Misericordia Hospital in Edmonton or at the HealthPointe Medical Centre. Most of the patients for whom Knight authorizes legal marijuana use are those he has seen for several years who arrive one day saying they shared a toke with a friend and felt pain relief. Such personal stories are what encouraged Knight to try marijuana for patients in the first place. At the time, he said he worked at a different Edmonton hospital pain clinic under a director who prohibited physicians from prescribing the drug. "After a while, I said, 'These guys found something that works for them and what am I doing prescribing medications that are making them sick and not helping them,' " Knight said. Now, he estimates about 20 of his 100 to 200 patients use medical marijuana. He knows at least two other pain doctors in Edmonton who are open to it. When Cartwright, 41 and a mother of four, couldn't find a sympathetic local physician in 2007, she flew to Ontario and paid $100 to a doctor known for providing authorizations for medical marijuana. Some doctors in B.C. now do the authorization via Skype, but charge $400 for the service. Cartwright's Ontario doctor required proof from a medical specialist that Cartwright had a diagnosis of colitis with debilitating symptoms untouched by conventional medical therapies. "I didn't want to be a doctor hopper," Cartwright said. But she had tried prednisone, codeine and other steroids that are known to soften teeth and bones over time. Nothing but marijuana cut down the inflammation of her intestine that doubled her over in pain, or stimulated her appetite without causing subsequent terrors she would have "pucker butt," a notso-funny sensation right before Cartwright started having diarrhea running down her leg. In her teens, Cartwright's disease wasted her away to 80 pounds. Now, the 4-foot-9 hairdresser weighs about 103 pounds and lives in a rented ranch house in east-central Alberta. Yet even though she's legally allowed to grow 39 plants in her basement, and use eight grams of pot each day - she has her pink authorization forms in plain view - Cartwright still worries about children's services somehow becoming involved. She has a toddler at home, who isn't allowed downstairs or in Cartwright's locked bedroom, where she keeps dried marijuana and a vaporizer, which grinds the leaves, then fills three to four bags full of vaporized cannabis rather than the burned, toxic smoke from a joint. Cartwright's son, who turns two on Dec. 12, once thought mommy was playing with a balloon machine, so Cartwright hides the vaporizer, and inhales only when her son is napping or busy watching television in a separate room. Neighbours and friends don't always understand the subtleties. "That's my medicine," said Cartwright, president of the southern Alberta Cannabis Club, which advocates on behalf of medical marijuana users. "It's no different than using insulin for diabetes." Read more: http://www.timescolonist.com/helps+through+pain/5843710/story.html#ixzz1gDYfPGzs
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