Now that recreational cannabis is legal in Canada, Ontario physicians can expect to receive more questions from patients about both recreational and medical cannabis. The OMA has consulted with the CPSO and CMPA to summarize physician responsibilities regarding this emerging practice issue.
The CPSO has not released any new or updated physician guidance specifically addressing recreational cannabis but has released a brief article on the subject. 1 The CMPA issued an eBulletin to its members in October 2018. The CPSO indicates that physicians should continue to ask patients about tobacco, recreational drug, and alcohol use as they would have prior to cannabis legislation.
The CMPA notes that the extent of changes to physicians’ practices owing to the legalization of recreational cannabis is difficult to predict at this time. Physicians may, however, experience a short-term increase in the number of police requests for blood samples. Physicians may also encounter more situations in which they must consider whether they need to report patients unfit to operate a motor vehicle due to the patient’s recreational use of cannabis.
The expectation on the part of the physician providing care does not change in any significant way now that recreational cannabis is legal. It is expected that physicians will remain up to date on emerging issues and maintain a level of knowledge required to have meaningful discussions with their patients.
The legal framework for access to medical cannabis, under which physicians can sign medical documents authorizing access (i.e. prescribe) for patients, was previously outlined in the Access to Cannabis for Medical Purposes Regulations (ACMPR), under the Controlled Substances Act. 2,3 This legal framework remains the same after the legalization of recreational cannabis use, however it is now outlined in the new Cannabis Regulations under the Cannabis Act. 4,5
It continues to be up to each individual physician to decide whether or not to provide a medical document to a patient for medical cannabis. Cannabis is not a Health Canada approved therapeutic product and has not been issued a Notice of Compliance or Drug Identification Number.6
Those physicians who authorize cannabis as a treatment option are expected to have the necessary knowledge to do so. The CPSO has provided an outline of expectations for Ontario physicians who are considering completing medical documents for medical cannabis (see Cannabis-Related Guidance From the CPSO section).
1 College of Physicians and Surgeons of Ontario. Legalization may see more patients discuss marijuana use. Dialogue. 2018;2 cited 20 Sep 2018.
2 Access to Cannabis for Medical Purposes Regulations, SOR/2016-230.
3 Controlled Substances Act, 1996, S.C.1996, c. 19.
4 Cannabis Regulations, SOR/2018-144.
5 Cannabis Act, 2018, SC. 2018, c 16.
6 Health Canada. Consumer Information – Cannabis (Marihuana, marijuana). Ottawa, ON: Health Canada; 2016 cited 2018 Sep 17.
7 Canadian Medical Protective Association. Medical Cannabis: Considerations for Canadian doctors. Duties and Responsibilities . Ottawa, ON: Canadian Medical Protective Association; 2016 cited 2018 Sep 9.
8 US Customs and Border Protection. CBP Statement on Canada’s Legalization of Marijuana and Crossing the Border. Washington, DC: Department of Homeland Security; 2018 [cited Oct 12, 2018].
9 College of Physicians and Surgeons of Ontario. Policy Statement: Cannabis for Medical Purposes. Toronto, ON: College of Physicians and Surgeons of Ontario; 2019 [cited May 27 2019].
Updated: May 27, 2019