Dr. Danial Schecter Talks About Cannabis Oils
Our Director of Medical Education, Amanda Daley, had a chance to sit down with Dr. Danial Schecter to discuss the recent Health Canada changes to the Marihuana for Medical Purposes Regulations (MMPR) to allow Licensed Producers to produce and sell cannabis oils.
You've been a leader in the field of cannabinoid medicine, tell us what it means to you to hear that Licensed Producers will be allowed to make and sell cannabis oils.
It’s very exciting that Licensed Producers are now able to produce extracts. It gives practitioners a whole new range of possibilities with regard to what we are able to provide to our patients, and opens up this class of therapy to an entire patient population who might not otherwise be open to it.
What will it mean to patients?
It allows them to use cannabis in ways that are often more acceptable and familiar to them. In the past they were forced to inhale herbal cannabis without other options and now they are able to use cannabis in other methods that might be more familiar, appropriate and acceptable and appropriate under certain medical conditions. They can use it as a tincture or even in edibles if they are more established users. Some patients who might benefit from this method of delivery over inhalation include those who are either very young or very old, those who are unable to inhale on their own, or those with underlying respiratory issues. Another significant patient population that we often see in our clinic, are patients who have concerns about using herbal cannabis because of the stigma associated with inhaling herbal cannabis, whether it be through vaporization or smoking it with joints, bongs or pipes. Allowing them to use it as a tinctures, edibles or in other methods will increase their acceptance and allow them to use it in situations where they would not otherwise be able to self-medicate. I believe that many patients will improve their quality of life and be able to do more activities with improved symptom control.
What will you tell your patients who want to use extracts rather than dried cannabis?
Ultimately it’s very similar to herbal cannabis just that it is in a different form.. The difference with taking cannabis orally in an oil is that unlike inhaled cannabis where a patient will feel the effects within minutes following an inhalation, taking it orally often means the onset of action isn’t seen until 30-60 minutes after or longer. As well, when a patient inhales dried cannabis, the effects last generally about 4-6 hours and for the oral route the effect can be much longer. It’s important to start with a low dose and monitor the impact that dose has before consuming a higher dose. For those who will be ordering it from licensed producer as opposed to having to make it at home on their own, the same benefits of getting herbal cannabis from a licensed producer will apply: standardization, knowing what the concentration will be in the oil, and potentially having access to a variety of products. This allows the ability to use it much more safely. Unfortunately it’s not ready at the moment, but the medical community and patients alike are very much looking forward to having a product that is consistent and ready to be delivered to our patients.
In your experience have you seen any specific conditions that are better treated with cannabis oil over dried cannabis that's inhaled?
Cannabis oil will benefit any condition that herbal cannabis could be used for, but really benefits those individuals who don’t want to, or are unable to, use herbal cannabis in a traditional way. I see a huge opportunity for the use of oils in the institutional setting – specifically in hospitals and long-term care settings. This opens the possibility of providing a new therapy to an underserviced patient population that may benefit. Previously patients in hospitals and long term care settings were unable to take advantage of herbal cannabis because of the format it is supplied. Most institutions do not have a policy to handle herbal cannabis, but if it comes in pre-packaged doses or comes as a tincture or oil, then it can be easily administered in the institutional setting.
As a speaker at conferences educating other doctors, what do you tell them about extracts?
It will be important to educate doctors about what products will be made available. I tell them that extracts are just another form of herbal cannabis and it’s another way that cannabis, as a medication, can be used by patients. It offers another option for those who are cannabinoid naïve or are not good candidates for inhalation. The saying “start low and go slow” definitely applies here. If it’s a tincture, it can even be dosed drop by drop. Because it will come in a standardized form it will be easier to start low and go slow.
Colorado and Vancouver have both seen increases in the number of visits to the hospital for edibles and oils consumption. How can people ensure they are using this drug safely?
The new regulations put out by Health Canada limits the concentration of THC in oil, which will limit the quantity of psychoactive substances that patients will ingest at any one time. Health Canada is not allowing it to be put into pre-made baked goods before being sold. That was one of the things that has been an issue in Vancouver as well as Colorado for example- brownies are appealing to children. It’s a positive step that Health Canada has allowed the regulations to be amended to provide oils and extracts. Although this is a conservative beginning it will allow us to see what we’re doing right and what we’re doing wrong with this class of therapy and amend the rules as needed.
Dr. Danial Schecter is co-founder of the Cannabinoid Medical Clinic (CMClinic) and a practicing family physician. After working along side some of Canada’s leading researchers in the field of medical marijuana, Dr. Schecter developed a strong interest in the therapeutic use of cannabinoids. As a recognized medical expert in the field of prescription cannabinoids and medical marijuana, Dr. Schecter has given numerous presentations to fellow physicians and developed educational programs on this subject.
In addition to cannabinoid medicine, Dr. Schecter’s clinical interests include delivering a high standard of care to at risk elderly and palliative care patients, prompting him to establish his own house-calls service in Georgian Bay, ON. Dr. Schecter completed a fellowship in Hospital Medicine and is an active hospitalist at the Royal Victoria Regional Health Centre in Barrie, Ontario.
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