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Doctors urge tight controls on legal pot

By Lauren Vogel | CMAJ | Aug. 24, 2016

Doctors agree that government should control the strength of recreational marijuana products under new legal regime. (ElizaRex/iStock)

Doctors want the federal government to keep marijuana out of the hands of teenagers and control the strength of products available once the drug is legal, according to the results of a survey presented at the Canadian Medical Association (CMA) General Council on Aug. 24.The association surveyed 788 doctors electronically for their feedback on questions the federal government is mulling over in the lead up to legalizing recreational marijuana in 2017. The results reveal a profession united by concern about the potential harms of ready access to the drug, yet uncertain how to protect public health under a more permissive regime.

There were some clear points of agreement, said CMA Vice-President of Medical Professionalism Dr. Jeff Blackmer. Nearly three out of four respondents (72.2%) agreed the government should regulate levels of tetrahydrocannabinol (THC) in marijuana once the drug is legalized. Most respondents also agreed that non-health care structures like liquor stores should distribute the drug (56.1%), and disagreed with providing the drug through health care settings like pharmacies (57.4%) or by mail (64.9%).

“It sends a message, it’s a product that’s recreational in nature and needs tight regulatory controls,” Blackmer explained.

There was also strong agreement that recreational marijuana should be a private matter, allowed at home (79.6%) but not in designated public places (51.7%), such as compassion clubs in Canada or Amsterdam’s so-called “coffee shops.”

However, Blackmer noted that the cat may already be out of the bag on that point: “Those who walked home along the waterfront last night from our meeting know in Vancouver they hold no such reservations.”

Doctors were divided, however, on the recommended minimum age for purchase and possession of marijuana. Only 19.7% favoured setting the limit at 18, Canada’s legal voting age, compared to 25.4% who recommended age 21 and 20.3% who preferred age 25.

“We know there’s an impact below the age of 25 on the developing brain,” Blackmer said, but setting the minimum age for buying legal pot at 25 “might be a bit ambitious.”  A reasonable middle ground might include setting the legal age at 21 but restricting the dosage for those below age 25.

Respondents were also divided whether marijuana use should be permitted wherever tobacco smoking is allowed, with 43.0% in favour and 43.2% against.

Doctors split on several other issues, including whether to regulate medical and recreational marijuana under a single (42.6%) or dual regime (39.1%). They also disagreed whether recreational marijuana users should be able to grow their own plants, with 39.7% in favour, 37.6% against, and 22.7% unsure.

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