Guest Blogger: Carolyn Rocca, Occupational Therapist
The current legislation on medical marijuana use in Canada greatly shapes our role as health professionals. Under the Access to Cannabis for Medical Purposes Regulations (ACMPR), Canadians who have been authorized by a physician to access cannabis for medical purposes can purchase safe, quality-controlled cannabis from the 52 authorized licenced producers in Canada (Health Canada, 2017). With the legalization of marijuana in Canada being on the horizon, we can anticipate that many more of our clients may turn to it when seeking relief.
But first, it is important to consider why people are turning to cannabis for medicinal use. While some risks do exist, evidence suggests that the use of marijuana can offer several benefits including: reductions in nausea, decreased pain intensity, and improved sleep quality (Health Canada, 2013; Whiting, et al., 2015). Additionally, some clients report experiencing reductions in anxiety, increased relaxation, and relief from tension, headaches, and migraines. With these benefits and relatively mild side effects, this paints quite an enticing picture for those who may be consuming much more potent medications with more serious risks and side-effects.
If more clients are beginning or continuing to turn to cannabis as a source of relief, we as healthcare providers need to identify what role we play in supporting their decision to do so, including the role of Occupational Therapy which is explored as follows:
- Focus on safe use of cannabis: As part of the OT role, it is important that we ensure that clients are utilizing medicinal cannabis under the care of a physician, and are using it within the parameters set out in their prescription. Clients should be advised to discuss their cannabis use with her physician, as they would with any medication, as this falls outside of our OT scope. However, OTs can be involved in the process of helping clients track their relief from symptoms and potential side effects, according to the strain, dosage, and time of day and can help people to direct certain questions / concerns to their physician as appropriate.
- Monitor the impact of cannabis on daily activities: Our role is to be aware of the potential risks and benefits of medicinal cannabis use, to identify when cannabis use may be impacting clients’ abilities to perform day to day activities, and to subsequently provide strategies as needed. For example, if a client typically becomes drowsy when taking cannabis which may then impact their safety in the kitchen, an OT may be able to recommend strategies such as the use of kitchen timers, or help to schedule cannabis use at safer times of the day.
- Review available pain management strategies: As cannabis use is only one option for pain management, our role is to ensure that clients are aware of other available pain management strategies. Some strategies include: pacing activities to conserve energy, resting, massage, exercising, stretching, other medications, staying active (counterintuitive but true!) as well as compensatory strategies. Our focus as OTs is on helping clients to resume increased function by utilizing the pain management strategies they are open to given all the options available and the training we can provide for each.
- Assist in navigating resources: For clients who wish to produce medicinal cannabis for personal use, our role is to ensure that clients are aware of the guidelines set out in the ACMPR. We may also have a role in assisting clients in completing required application forms (found here) and planning for safe production, use, and storage of cannabis if they become registered to do so with Health Canada. Further, under the ACMPR, it is a client’s responsibility to make sure that all medicinal marijuana plants or cannabis products in their possession are secure, and that other people, including children, cannot access them. Therefore, OTs can assist in developing strategies to ensure they can meet the grow, safety and storage requirements.
- Consider affordability: As clients can expect to spend about $7-$12 per gram of medical marijuana (Medical Marijuana, 2016), it will be important to consider if their prescribed cannabis is covered under insurance funds, or whether they require budgeting strategies for this expense. An OT can also assist in this process, along with ensuring that the affordability is monitored and budgeted for long term.
Considering how imminent changes to Canada’s cannabis legalization are, being aware of the legislation changes in our society is highly valuable in our line of work. The OT profession is well-positioned to support clients in navigating their medical marijuana options in the most safe and functional manner possible. Seek the assistance and guidance of your healthcare team, including an OT, if you are thinking about, or currently incorporating, medicinal cannabis into your healthcare routine.
Resources & References
Government of Canada (2016). Information bulletin: safety and security considerations when producing cannabis for your own medical purposes. Retrieved from https://www.canada.ca/en/health-canada/services/information-bulletin-safety-security-considerations-producing-cannabis-for-own-medical-purposes.html
Health Canada (2013). Information for health care professionals: Cannabis (marihuana, marijuana) and the cannabinoids. Retrieved from http://www.hc-sc.gc.ca/dhp-mps/alt_formats/pdf/marihuana/med/infoprof-eng.pdf
Health Canada (2016). Drugs and health products: Information for health care practitioners. Retrieved from http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/index-eng.php
Health Canada (2017). Authorized licensed producers of cannabis for medical purposes. Retrieved from https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/licensed-producers/authorized-licensed-producers-medical-purposes.html
Medical Marijuana (2016). Frequently asked questions. Retrieved from https://medicalmarijuana.ca/resource-center/faq-2/
Minister of Justice (2017). Access to cannabis for medical purposes regulations. Retrieved from http://laws.justice.gc.ca/PDF/SOR-2016-230.pdf
Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., … & Schmidlkofer, S. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. Jama, 313(24), 2456-2473. doi:10.1001/jama.2015.6358