The Walrus- Pot Is Legal. Is It Time to Redefine Sobriety?

“There’s a huge stigma,” for people who are interested in using things like cbd in their recovery, says Caroline MacCallum, a doctor and the medical director of Greenleaf Medical Clinic in Langley, British Columbia, which helps assesses patients across Canada for their eligibility under Health Canada’s Access to Cannabis for Medical Purposes Regulations. She explains that some research has shown cbd is not addictive and notes that many addictions play on the brain’s reward system. cbd doesn’t do that. Since that’s the case, MacCallum asks, could it be as benign as an antidepressant? “Some people would say sobriety is zip, zero, nothing. But that’s a tough act to follow,” says MacCallum, adding that a person’s recovery journey is between them and their physician to decide. “I think it’s really important to treat the whole person, and if somebody’s struggling.…I would want to set [my patients] up to win.”

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Maclean's- Are there any after-effects or hangovers to cannabis?

So who’s right? “It all depends on how you’re using it and if you’re using too much,” says Dr. Caroline MacCallum, medical director of Greenleaf Medical Clinic in Vancouver. A medical patient, for example, will likely start with 1 to 2.5 mg dose of THC, slowly build up their tolerance and never experience a weed hangover. “But it’s different for a recreational user,” she says, “because they’re targeting a euphoric state and using more THC to get there.” You can’t dose any product if you don’t know what’s in it, she warns, and while most strains’ THC level falls between two and 20 per cent, others like the infamous shatter can contain up to 80 per cent. Oils and edibles are worse—both in their excessive potency and because impatient users tend to re-dose before effects kick in. MacCallum recently saw a brownie with 400 mg of THC, which is 200 times what she’d prescribe.

Just like every other hangover, the more you consume, the more likely you are to suffer after-effects. Though she’s only encountered it a handful of times, MacCallum says patients complain of mental fog, slowness and fatigue. Compare this to pounding headaches and vomiting caused by alcohol, however, and maybe a stoned-over is not so bad. “It’s not the same as alcohol, it’s not even the same as Benadryl,” says MacCallum, who notes many patients prefer cannabis to other sleep meds.

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CBC- Phasing out medical cannabis would leave pediatric patients in the lurch

By: Jenna Valleriani & Caroline MacCallum, September 8, 2018 for CBC News

Physicians in Canada are prescribing cannabis. They have been doing so for years, and will likely continue to do so after recreational cannabis is legalized this fall. But the Canadian Medical Association (CMA) says that doctors in Canada want to see the phasing out of the medical cannabis access program once pot is legalized. And no doubt, some do…

The CMA's position on cannabis for medical purposes is that there is "insufficient evidence on risks and benefits, the proper dosage and potential interactions with other medication." However, this view ignores thousands of peer-reviewed journal articles and studies that provide evidence of the efficacy of cannabis use for some medical conditions — chronic pain, as one example. While we do not deny that more clinical studies are needed, surely the publishing of over 10,000 peer reviewed articles signals that the use of cannabis in medical treatment is not some fringe endeavour.

There are numerous risks in eliminating a medical stream of cannabis access — risks that include things like the loss of guidance around dosing and administration, contraindications to cannabis use, screening for dependency risk and potential drug interactions. Essentially, it ignores the realities physicians are facing on the ground.  

But there's one critical topic that has been left completely out of consideration regarding the issue of narrowing cannabis access to just the recreational stream: youth under the legal age of access…

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Canadian Living- 5 common myths and misconceptions about cannabis use

As cannabis is legalized in Canada, we know you have questions—and we know there’s a lot of misinformation out there. We sat down with two doctors to chat about cannabis usage. 






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How Canada legalising recreational marijuana could vault country to forefront of cannabis research

Medical marijuana studies are set to explode in Canada after the use and sale of cannabis become legal in October. It is only the second country, after Uruguay, to fully legalise the drug for recreational purposes

Caroline MacCallum, a Vancouver-based internal medicine specialist, has focused on complex pain at a number of hospitals. She is a clinical instructor at UBC’s faculty of medicine, and the medical director for Greenleaf Medical Clinic, where she’s assessed and developed cannabinoid treatment plans for more than 2,000 patients using legal medical cannabis approved by Health Canada.

MacCallum says she embraced marijuana when she was working as a pharmacist, noting that patients with complex chronic diseases had sometimes tried between 10 and 20 different medications looking for relief.

“There is very little, if any, education about cannabis in most medical schools,” she says. “I think that is changing, or will need to. I have medical students, residents and fellows who spend a few days with me in the clinic to learn about medical cannabis.

“But there’s definitely a place to learn more formally about the science of the endocannabinoid system, and also practical clinical knowledge about [cannabinoids] CBD and THC dosing, routes of administration, evidence, contraindications (withholding treatment because it’s harming the patient), monitoring, side effects, product safety and consistency, and more.”

July 15, 2018 as seen on South China Morning Post.

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Arthritis Society to launch employer toolkit for medical cannabis coverage

As a forward-thinking advocate for the needs of Canadians living with arthritis and related chronic pain conditions, the Arthritis Society today announced that it is leading the way by introducing a program and toolkit to help employers cover the costs of cannabis for medical purposes for employees through their company-sponsored employee benefit plans.

The Arthritis Society has worked with a team of well-recognized patients, physicians, benefits consultants and other experts in the field to help develop the program. As of February 1, 2018, the Arthritis Society is providing medical cannabis coverage for its employees, their spouses and dependents, under its employee health benefits plan. Under the program, the Arthritis Society will provide coverage up to $5,000 per year, which is a meaningful level of reimbursement for a broad range of health conditions including chronic pain.

Dr. Caroline MacCallum prescribing physician:

I am optimistic that other employers will follow the Arthritis Society’s lead by adopting similar, inclusive, medication benefit programs. This will continue to reduce the stigma of medical cannabis, and more importantly improve access and affordability for safe supply of medical cannabis for those living with chronic pain.

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