Here’s what you need to know about what it does and how you should speak to your doctor about getting it.
Véronique Lettre hadn’t considered taking medicinal cannabis for anything before she got sick. It was 2009 and she had just been diagnosed with multiform glioblastoma — a very aggressive brain cancer. The then-36-year-old, with two young kids at home, underwent brain surgery, followed by 30 radiotherapy appointments and a full year of chemotherapy. “I suffered many side effects and had to take multiple pills every day — me, who had never been sick before,” she remembers. Medical cannabis was legal in Canada 12 years ago but only prescribed in palliative care situations, which fortunately wasn’t Lettre’s destiny. “Still, I started to read about it, looking for a more natural alternative to replace some of the medication. I was amazed by everything I learned and discovered, but, unfortunately, I couldn’t get access to it,” she says. She eventually recovered from her brain cancer.
Five years later, in 2014, Lettre was shocked to learn she now had breast cancer. Once again, she had surgery and 30 radiotherapy treatments, but no chemotherapy. “This time, I was determined to use cannabis to relieve the pain caused by surgery, and to reduce anxiety and improve sleep.” At the time, Lettre says it was hard to find a doctor who would prescribe medical cannabis — there were few in Quebec. “After months of research, I finally found a doctor. But once I got my prescription, I had absolutely no clue what to use or buy. I randomly tried different products, causing some very bad experiences,” she says. “But somehow, I knew deep down there was more to medical cannabis, so I persisted and continued my search until I found the right products and dosage. And it changed my life. I replaced all my pain medication with CBD oil. I literally felt no more pain with a high dosage of CBD. And I used a small dosage of THC oil to replace my sleep pills. I haven’t touched another pain medication, sleeping pill, or anti-anxiety medication since that day.”
Lettre wasn’t finished. She was a convert. To continue learning about cannabis, she took a master class with a chef in Los Angeles and learned about cannabis cooking. Later, she accomplished an incredible feat. “My mission was to demystify medical cannabis, so I wrote the first French book in Quebec in 2018 about it. This has led me to give many lectures across Quebec and even France.” She didn’t stop there. “I soon realized that to facilitate access to medical cannabis to people who needed it, I had to start a clinic. But not any clinic — the clinic I wish I had when I first started using medical cannabis products: A real medical clinic where the patients would get access to French-speaking doctors, a customized treatment plan, and support from health professionals who have knowledge of medical cannabis throughout their journey,” she says. Nature Médic was born in January 2018 with Lettre serving as general director. The clinic started out with one part-time doctor and a nurse. Today, there’s a team of 15 doctors and nurses who serve more than 2,000 patients in five locations. (Last September, Nature Médic joined The Clinic Network Canada — now Pathway Health — to continue its growth.)
“This time, I was determined to use cannabis to relieve the pain caused by surgery, and to reduce anxiety and improve sleep.”
Medical cannabis isn’t new — using cannabis for health-related issues is thousands and thousands of years old. “There’s written evidence from ancient civilizations using cannabis as medicine. It has been super important to human beings for most of our human history,” says Dr. Mark Kimmins, a physician in Courtenay, BC, and the author of Medical Cannabis in Canada: From Historical Lows to the Current High. While there’s nobody old enough today to remember the mid-1800s to early 1900s when cannabis was used medicinally all the time, says Dr. Kimmins, “there was a blip in the history of cannabis over the last 80 to 100 years — there’s been a stigma. This was a highly established medicine. Had prohibition not occurred, we’d all just see cannabis as another medicine that’s used for health and wellness.”
“People think of cannabis as a drug to get high, but that’s recreational cannabis. The goal of medical cannabis is to get rid of symptoms without impairment,” he says. The most common use for medicinal cannabis in Canada — without question — is for chronic pain. Dr. Kimmins says pain is by far the biggest reason why so many people turn to cannabis — whether it’s for arthritic knees, low back pain or migraines, most are using cannabis to get relief of aches and discomfort. The second reason is anxiety and depression, and the third is sleep disturbances. “You can see how these things tie together,” he says. “If you have chronic pain, you’re more likely to be anxious or depressed, and you’re probably not sleeping very well.” Other proven areas of relief include nausea and vomiting from chemotherapy, relief of spasticity and pain in multiple sclerosis, and the relief of symptoms associated with palliative care, especially as it relates to cancer. CBD has even proved effective in reducing epileptic seizures in drug-resistant pediatric cases of epilepsy. It’s a muscle relaxant and has been shown to lessen tremors in patients with Parkinson’s disease. “The problem with cannabis is that people think of it as a brand new medicine and don’t acknowledge that it has been an established medicine for a very long time.”
Dr. Kimmins says cannabis is a plant with a history of efficacious use.
“It has a safety profile that’s unparalleled to other medications. Most of the medications we use today have dangerous toxicity when used in large amounts, but not cannabis — it has a remarkable safety profile. For instance, cannabis has no known deaths from overdose. When used efficiently under the guidance of a healthcare provider, it has minimal side effects. Plus, another benefit is patients have been able to come off other medications when they use cannabis.”
"Trained medical professionals are needed to guide you in the right direction."
How it’s used
There are lots of ways to use medical cannabis — it depends on what you’re comfortable with. Some people choose to smoke it as a dried plant or brew it into their tea or food, while others use it topically or inhale it as a vapour. How long it takes to feel the effects of cannabis depends on how it is taken. For example, it will take longer to feel the effects of cannabis baked in magic brownies than it would if you were to inhale it while smoking.
Should I try it?
Don’t go rogue and try to treat yourself; you really need to speak with your doctor first. And the good news, says Dr. Kimmins, is we’re increasingly going to see physicians who are more versed or trained in cannabis. “There’s a reason you need to see a doctor who specializes in it. You need a medical document — it’s like a prescription that gives you authorization to use medical cannabis sold from licensed producers in Canada,” he says. If you don’t speak to an expert first, Dr. Kimmins offers this comparison: “Imagine a patient going into a pharmacy and wading through the shelves trying to figure out which product to use and the pharmacist isn’t allowed to help him. That’s the case in recreational dispensaries across the country. Salespeople are prohibited to provide medical or health-related advice. Recreational cannabis is sold like recreational alcohol — to produce some form of intoxication. Trained medical professionals are needed to guide you in the right direction.”
Seek expert advice
If your doctor doesn’t have experience in medical cannabis and you’re interested in seeing if it’s for you, Dr. Kimmins says it’s key to go in with the facts and get educated. “It’s a doctor’s job to guide the patient to make the best decision for them, based on analysis of risks and benefits. Come prepared and broach the topic as you would with any other medication. Have the conversation with your doctor and ask how experienced they are with cannabis.” What’s more, don’t feel embarrassed — be open and honest with your expectations. If they’re not experienced with cannabis, ask if they’d be comfortable with you having a consultation with a physician who uses cannabis to treat patients. “Because we lack precise dosing and other information, working with a doctor who’s engaged in your progress — while you’re keeping a journal to document your experience — will certainly help you find the product that’s right for you.”