As solid peer-reviewed evidence continues to accumulate, cannabis is gaining broad acceptance within the medical community as a valuable tool in the treatment of a number of conditions, particularly chronic pain. Unfortunately, there is still a stigma attached to medical cannabis, and for many who could benefit from it, that translates into barriers to effective care.

One of the most significant barriers remains reluctance within the patient population. Decades spent talking about cannabis as a drug of abuse has left many with fears and beliefs about it that are not always grounded in facts. “The biggest misconception is related to danger,” says Michael Kani, a practising pharmacist and medical cannabis educator in Saskatoon. “There is still this old ‘Reefer Madness’ perception when, in fact, there are many other prescription medications that have the potential to cause more significant harm to a patient.”

This stigma of danger carries over into outdated beliefs about addiction and medical cannabis as a stepping stone to drug abuse. “People think of cannabis as a gateway drug,” explains Kani. “They think that if you use marijuana, even medically, that it will lead to using more serious drugs later. But really, there has been no evidence supporting correlation to equal causation.”

Perceptions are changing, but slowly

The good news is that as Canada has progressed to talking about cannabis more openly and even-handedly, the public perception of it is slowly changing. The younger generation is much less likely to view it in a negative light than their parents are, and even the older generations are beginning to come around to the idea that it can be beneficial in the right circumstances.
Unfortunately, even as Canadians become better educated about medical cannabis, persistent views within some corners of the medical community can still produce additional barriers.

“There is still a camp of health care professionals that, due mostly to personal beliefs, are totally opposed to using cannabis medically for any purpose,” says Kani. “And there is another camp that really advocates for cannabis use across many many conditions, perhaps a bit more than the evidence supports. But there is a third camp in the middle, which increasingly represents the mainstream opinion in the health care community, where we now recognize that cannabis can indeed be very helpful for certain conditions and where we are carefully tracking the continuing evidence.”

Health care professionals must play a role

Non-medicinal cannabis remains illegal in Canada, but even if legalization becomes a reality, the fundamental importance of using medical channels to obtain cannabis for therapeutic purposes will not change. Cannabis can be a valuable medical tool but it’s just that: a medical tool. For the best outcomes, you always want your health care providers involved in any decisions regarding treatment. That’s why it’s so important to obtain cannabis legally through a licensed producer, where you can be sure of  the quality and that the dosage and cannabinoid levels are matched to your medical need.

In the eyes of health care professionals like Kani, the temptation for patients who face barriers in obtaining medical cannabis to instead go outside the system is one of the largest concerns regarding access. “My biggest worry is that unless it becomes significantly easier for people to access cannabis through medical channels — including their local pharmacy — then more patients will turn to accessing it through recreational channels, especially as doing so gets easier with changing laws and regulations,” says Kani. “That could lead to much worse health outcomes for these patients. It’s really important to keep your physician and pharmacist involved in your care.”

We still have work to do, especially with regard to education of both the populace and the medical community, if we are going to tear down the barriers that can prevent Canadians from gaining access to a medicine that could dramatically improve their lives. With professionals like Kani fighting that fight, the future looks bright, but it’s particularly important that we not let ourselves assume that the impending legalization of recreational marijuana will solve the access issues that remain with medical cannabis. They are two different worlds.