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Doctors urge caution on marijuana issue

While the Medical Association of The Bahamas (MAB) supports the decriminalization of medical marijuana for treatment of certain specific illnesses, and acknowledges its potential benefit for others, it strongly warns against long-term use of cannabis.

In a report titled “Position Paper on Medical Marijuana”, which was submitted to Minister of Health Dr. Duane Sands on Friday, MAB called for government to consider the health of its citizens above any potential economic benefit that might result from decriminalization of the drug.

“The Medical Association of The Bahamas believes that there is sufficient evidence to endorse the use of pharmaceutical cannabinoids” for chemotherapy-induced nausea and vomiting (CINV), chronic pain, multiple sclerosis and HIV/AIDS particularly for loss of appetite, nausea and vomiting, the report states.

On the other hand, MAB “believes that more research is needed to determine the role of cannabis in “treating gastrointestinal disease, cancer and glaucoma; and specifically, it “ cannot support the use of ‘whole plant’ cannabis for teas, edibles or any inhalation form for medical purposes at this time, as there is insufficient evidence to determine appropriate dosing for symptom control while minimizing side effects”.

“The MAB acknowledges the potential benefit of ‘whole plant’ cannabis as a therapeutic option for selected medical illnesses,” the association said in its report.

“A carte blanche (unrestricted) endorsement, however, would be irresponsible without a proper regulatory framework for local cultivation and quality control.”

It suggested that physicians should have unrestricted access to several medical marijuana products listed in its report, and that additional regulation is not recommended due to the products’ side effects not appearing to be “any more dangerous than narcotics or other controlled drugs that are currently available”.

But it also urged caution, as while noting that smoked cannabis “in low quantities for medical use may not be harmful…until further research defines accurate dosing for all methods of consumption including edibles, oils and teas, physicians should refrain from making professional recommendations except for compassionate use”.

It noted, however, “Of course, legislation that legalizes cannabis cultivation and possession for personal use would effectively eliminate the need for policies that regulate medical applications.

“If this occurs, the MAB would advise physicians to take a cautious approach when recommending cannabis until current pharmaceutical standards of safety and efficacy are applied.”

The Bahamas National Commission on Marijuana, in its preliminary report, recommended the legalization of medical marijuana and the decriminalization of the possession of up to one ounce of the substance.

That report also noted that more data needs to be explored to enable the commission to come to a consensus on whether to legalize marijuana for recreational use.

Prime Minister Dr. Hubert Minnis has been vocal in his support for the decriminalization of small amounts of marijuana and the legalization of medical marijuana.

However, MAB warned government to consider the impact that could result from decriminalization of both medical and recreational use.

In addition to highlighting the negative health effects of long-term use of cannabis, MAB also suggested that the government should anticipate increased instances of traffic accidents due to users driving under the influence, and that health officials should anticipate increased instances of accidental overdoses due to the use of edibles.

“The Medical Association of The Bahamas wishes to advise the public that frequent long-term cannabis use is not harmless; particularly, when associated with high concentrations of THC (tetrahydrocannabinol),” the MAB report states.

“Habitual use and any practice to increase THC content for consumption should therefore be discouraged.”

It adds, “Local statistics reported by the Public Hospitals Authority show that admissions to the Sandilands Rehabilitation Center for marijuana related illness has more than doubled between 2014 and 2018.

“Physicians are advised to warn their patients about the short and long-term effects of habitual cannabis use and the potential for cannabis withdrawal syndrome.

“A referral for appropriate treatment is recommended when symptoms are present.”

The MAB report did not give figures to support the Sandilands marijuana admission statistics.

As it also urges government to have zero tolerance for “synthetic” cannabis products and also to take every precaution to “prevent cannabis exposure to children and adolescents”, it notes that “claims about the health benefits of cannabis are numerous but strong scientific support is lacking in many areas”.

“A decision to allow cultivation of the cannabis plant for medicinal use must be preceded by a realistic regulatory framework that will demand quality controls and ensure reproducible levels and maximum concentration limits of the main cannabinoid THC,” the report states.

Bahamas National Commission on Marijuana Co-Chair Quinn McCartney said last month that the commission’s final report will be submitted by the end of the first quarter of 2020.

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