A prescription for controversy: Puffs or pills?

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Excruciating pain radiated through Maria Caporusso’s abdomen. The doctors had no answers. At 16-years-old, Ajax resident Caporusso, was suffering from a chronic pain that only she could feel. The invisible disease had her crippled over. “It got so bad some days I…I couldn’t even walk,” she remembers. The doctors wrote prescriptions for some of the strongest painkillers such as OxyContin, but the pain didn’t subside.

Prescription drug overdose

OxyContin contains oxycodone, which is an opioid drug. Other opioid drugs include morphine, codeine and heroin. Between 1991 and 2004, the death toll related to opioid drug abuse in Ontario doubled, according to the Canadian Centre on Substance Abuse (CCSA). North America consumes 80 percent of the world’s prescription opioids, making Canada the second largest consumer next to the U.S, according to the CCSA website. Campus Health Centre Pharmacist Vijay Pandya, says more education and addiction treatment needs to be available. He also says that addiction is a mental health issue, and needs to be treated as one, not a criminal issue. Standing neutral on medical marijuana, Pandya says the benefits of prescription drugs are that “it enhances the quality of life, keeps people alive longer, and reduces pain and discomfort.”

For Caporusso, however, this wasn’t true. Overcome with pain, she was told by a friend that marijuana could help lessen the pain. Eager for relief, Caporusso began smoking marijuana every once in a while and was astounded by the results. On a scale of one to 10, Caporusso rated her pain relief from marijuana in comparison to prescription drugs she had tried. Without a pause she said, “Ten, I barely feel any pain.”

The history of cannabis

The Canadian Cannabis Clinics (CCC) website says marijuana was originally known as cannabis, and was used to treat migraines, insomnia, and rheumatism throughout the 19th century. Following the Mexican Revolution in 1910, Mexicans migrated to the U.S. bringing what they called ‘marijuana’. Much backlash against the migrants and the drug were brought forward. The director of the Federal Bureau of Narcotics, Harry Anslinger who held the position from 1930-1962, referred to cannabis as marijuana creating a stigma around the foreign drug as it sounded Hispanic. From there the controversy began.

The drug now known more commonly as marijuana has an addiction rate of 9 per cent, according to the National Institute on Drug Abuse (NIDA). This is much lower than drugs such as cocaine, heroine and even nicotine. It is used to treat many chronic illnesses such as: chronic pain, Irritable Bowel Syndrome, depression, anxiety, cancer pain and Crohn’s disease to name a few.

Unfortunately, Caporusso struggled to gain a medical marijuana license, as her doctor like many others, did not believe in prescribing marijuana as a treatment.  Caporusso was 18-years-old when she was hospitalized for 10 weeks as her doctor tried to solve the mysterious disease. The pain in her stomach wasn’t just caused by her disease, but also by the gut feeling she had. “I call myself a hypochondriac, but from day one I knew I had Crohn’s disease… something just told me I had Crohn’s disease,”she said. But because the disease is hereditary and no other family members had it, her doctor ruled it out and refused to test for it. Caporusso clung on to life as her immune system continually attacked her intestines. The doctors worried they couldn’t save her. Becoming desperate to find her some relief, she and her parents managed to convince her doctor to license her for marijuana.

Opposing marijuana

This experience is one many patients face while trying to find relief for chronic illnesses. The Canadian Medical Association (CMA) website says it “is a leader in engaging and serving physicians and is the national voice for the highest standards of health and health care.”  However, the CMA stands against the use of medical marijuana despite the fact it has been legal since 2001. Access to medical marijuana became easier in 2014. Before 2014, users had to apply through a program, but now physicians are the ones who determine who gets access.

In a statement authorizing medical marijuana, the CMA says they have “consistently opposed Health Canada’s approach which places physicians in the role of gatekeeper in authorizing access to marijuana.” With the national ‘voice’ of physicians against medicinal marijuana, it is easy to see why many physicians feel the same.

Canadian Cannabis Clinics

Ronan Levy, now the director of the Canadian Cannabis Clinics (CCC), noticed this trend and decided to do something about it. ““Doctors just didn’t feel comfortable with cannabis because unlike pharmaceuticals, which come in standard dosing… it doesn’t fit neatly into the structure that most medicine is practiced with these days,”Levy said.

After seeing many patients struggle for a license, Levy and other entrepreneurs saw an opening to help people struggling and run a steady business. In 2014, after the laws surrounding medical marijuana changed in Canada, the first Canadian Cannabis Clinics was opened in St. Catherines, Ont. There are now 10 CCC’s in Canada including one in Whitby, with a new one opening in Mississauga this month. “It was an essential part of the industry that was missing that this new medication had come to the market but it really wasn’t being utilized because most doctors didn’t feel comfortable,” Levy said.

CCC takes on patients who have tried conventional medication but have found little to no improvement of their symptoms. A doctor must refer them to the clinic where they are assessed, based on previous medications, and family history. The CCC relies on scientific data and conducts their own studies as well. One of their assessments includes checking for history of schizophrenia in the patient’s family, as science has proven marijuana may accelerate, and/or unmask the disease. Levy estimated about 50 to 60 per cent of the patients are using marijuana for pain, but he also sees a lot of patients with depression, anxiety and cancer.  Levy said he isn’t against conventional medication but he believes that medical marijuana can benefit a lot of people. “The more options people have the better it is, as long as those options are properly regulated,” he said.

True Compassion Toronto

Member and owner of the True Compassion Toronto (TCT), known to the community as Trey Jacksson, sees the benefits of medical marijuana every day. Trey suffers from Multiple Sclerosis (MS) and said growing up he was truly against marijuana. After someone told him to try marijuana for his MS, he did. It worked wonders. “My life is so functional right now, if you were to see me I look really healthy,” Trey said enthusiastically.

Trey said he sees the same changes in patients who come into the centre. “You can see the instant comfort that they go through and that third or fourth time, happiness,” he said cheerily. The joy of seeing these people come over and over again smiling is the best part, he says.

Patients serving patients

The TCT opened in November of 2015, after Trey and other volunteers at another compassion centre in Toronto decided to start their own compassion centre in the west end.  The TCT website reads: patients serving patients. Trey explains that means all volunteers are both owners and members of the centre. They use medical marijuana to treat their various illnesses.

The reason the TCT functions so well is because the community is very supportive of the centre. Like Levy, Trey said he isn’t against prescription drugs. In their view, marijuana is just an alternate way of medicating.

The centre was created to provide a safe and convenient place to medicate, and receive medicinal marijuana easier. “There’s a lot of people who don’t want to be in the public eye of someone who’s medicating such as teachers, so when they come here they want to make sure that this is a safe environment and that there’s no camera use,” he said

Now 22-years-old, Caporusso has seen the stigma first hand. She has been using medicinal marijuana for four years to help treat symptoms of her Crohn’s disease. “I kind of hide it from some people because there’s always going to be some sort of stigma you know, but… at the end of the day it helps me so I kind of just ignore all of that,” she said.

Her medical marijuana license is now expired and no doctor is willing to re-issue it, Carporusso said. This creates issues with her trying to medicate. Unable to afford the $700 fee to see go to a clinic once a year, she has no way of getting medicinal marijuana.

The benefits of legalizing

If Canada legalized marijuana, she says it would benefit her and many others in her position. “At least if I’m not feeling good I can roll myself a joint and I can feel better,” she explained. Currently, she could risk getting charged if she were ever caught with it, as using marijuana without a license is illegal.

With legalization of marijuana, Levy, the owner of Canadian Cannabis Clinics believes there could be fewer stigmas surrounding the drug. If Prime Minister Justin Trudeau follows up with decriminalizing marijuana, it may cause it to be more normalized and accepted in society, he said.

For many, cannabis carries stigma and controversy, and for others it carries hope, and freedom.             The same can be said with prescription medication.  Regardless, Levy says, each has its place. “Each carries its benefits, and each carries its risks. How you balance those is really  subject to everyone’s individual choice.