Since 2001, medical doctors have been the gatekeepers of legal cannabis in Canada. The climate leading up to legalization has piqued interest from patients, but because of prohibition the onus has been on the medical professional to seek out information, which has often been limited to patient’s first-hand accounts, and backed by very few statistics.
Dr. Doris Mitchell is a family physician practicing on Chapleau Cree First Nation in rural northern Ontario, a community 160km east of Timmins. Her practice includes treating patients as a GP, in the emergency department, as well as long-term care. Dr. Mitchell is also an assistant professor at the Northern Ontario School of Medicine.
Dr. Doris Mitchell
MD, Professor at Northern Ontario School of Medicine
We spoke to Dr. Mitchell about how her passion for serving the needs of her patients motivated her to learn more about prescribing THC and CBD-based medicine. She is currently treating many of her patients with cannabis and continues to educate herself about how THC and CBD can be beneficial to patients with pain, fibromyalgia, neuropathies, anxiety and other mood disorders.
Dr. Mitchell belongs to the Brunswick House First Nation, a short distance from where she lives and works.
If doctors are interested in prescribing cannabis to patients, the burden is really on them to do more reading than what’s available through the college or online. We must be diligent in pursuing the best course of care possible. ”
I never partook in the use of any cannabis products as a young person because I was afraid that if I did, I would turn into a drug addict [laughing]. For a long time, I had strongly held beliefs that it was a dangerous drug and negative feelings about what cannabis could lead to.
My opinion didn’t change until my teenage son started experimenting with cannabis. He has ADHD and was struggling on Concerta from the age of four. He didn’t want to take that medication anymore because although it helped him focus, it also made him anxious and depressed. So he substituted Concerta with marijuana and started feeling much more stable almost right away. Cannabis was able to help not only in managing his anxiety but in controlling his ADHD as well. Since then, I’ve started to see things differently. My children and my colleagues told me that I had to learn more about this plant, and so I started reading and trying to educate myself on the medicinal benefits of cannabis. All this while, the number of my patients who were requesting it for pain and neuropathies and depression was growing, mainly women over the age of 50, and so my perspective started to shift.
Post-legalization, more of my patients are asking me about both THC and CBD as options to treat their chronic medical conditions. Their primary concern is with switching out their current medications for something that may have fewer side effects. As a medical professional I believe we have a responsibility to serve our patients’ needs as best we can and without prejudice, and now with more knowledge and plenty of anecdotal evidence, I am confident that cannabis can be beneficial to so many people.
If doctors are interested in prescribing cannabis to patients, the burden is really on them to do more reading than what’s available through the college or online. We must be diligent in pursuing the best course of care possible.
I am currently treating a patient who was addicted to methadone. When he decreased his use of methadone this led to an increase in alcohol intake which resulted in pancreatitis and sent him into the hospital. I recommended that he increase his use of marijuana while he was recovering, and it worked beautifully for him. He’s now stopped drinking altogether because cannabis has helped to curb his cravings. How can you ignore or minimize a story like that? I hear more of these testimonies day after day. I probably have at least one patient asking about cannabis every day, and like I said, the majority are older women, up to patients in their 80s! They’ve read about cannabis in the news or heard about how it’s working well for a friend, and so many have never tried it before, they are curious, and they are hopeful.
I am a doctor in Ontario, but I’m also Indigenous and have been raised and taught to honour a holistic approach to well-being. Wellness incorporates your entire self. Physical, mental, and emotional health are all connected. When we focus on improving the health of one of those aspects of us, the other parts of us will benefit too.
If you’re curious about trying cannabis, consider talking to your doctor about it. While you can obtain recreational cannabis products legally now, THC and CBD work differently with every individual’s endocannabinoid system. Dosing and the preferred method of consumption will differ from person to person. For instance, the entourage effect talks about ‘whole plant medicine’ and means that you need at least a low dose of THC to get the greatest benefit from CBD, depending on the patient. There’s a lot to consider, and I feel especially strongly that if someone is considering using cannabis as a replacement for or an aid to their current prescriptions, this decision should be a part of a discussion with a family doctor.
It’s important to remember that many doctors are extremely new to discussing cannabis with patients, and not all doctors support prescribing it. If you are curious about cannabis and your doctor discourages you from learning more, ask them to refer you to a specialist. Patients have a right to speak to a medical professional who has experience prescribing cannabis for a wide range of conditions, and they have a right to be proactive about their health. If you are interested in trying cannabis and your family doctor can’t answer questions about THC, CBD, how to microdose, options of consumption, where and how you can obtain cannabis products, don’t give up. Find a doctor who can!