EDMONTON—Some doctors and patients are questioning a College of Physicians and Surgeons of Alberta requirement to disclose a patient’s diagnosis when prescribing cannabis.

The college does not require a diagnosis disclosure for any other drug.

“That’s highly sensitive information and I don’t see how that’s protecting the public in any way,” said Dr. Michael Verbora, medical director at the Toronto-based Cannabinoid Medical Clinic, which has an Edmonton location.

“All it’s doing is putting doctors who prescribe cannabis under a microscope, potentially, and it’s also creating a database perhaps, of patients, that serves no real purpose.”

The question is on the Cannabis for Medical Purposes Patient Medical Document, which doctors are required to fill out and send to the college when they prescribe cannabis.

The document also asks for the patient’s name, birthdate, personal health number, dosing instructions, duration of authorization and form of cannabis used.

If the doctor does not send in the completed form, they don’t get the prescription.

Verbora, who practises in Ontario, said the mandatory disclosure is discriminatory and shows a lack of respect for patient-physician confidentiality.

He said he had never seen the diagnosis requirement for any drug before he saw the Alberta form this week.

Steve Buick, public policy adviser with the college, said cannabis was added to its triplicate medications list within the last year, joining opioids, ketamine, and others.

Doctors have to fill out similar forms — minus the diagnosis disclosure — for all drugs on that list.

Buick said the college pays special attention to cannabis because there is little scientific proof of its efficacy and it carries a possible risk of addiction.

“Cannabis has some things in common with other drugs that have a risk of addiction, and there is also a very limited evidence base for cannabis so far, so our regulation reflects that,” he said.

Buick said the college uses the information on the forms to monitor medical cannabis, and will contact physicians whose prescription practices appear to be “out of line.”

“We record all the physicians who are authorizing it, we keep a register of them and we monitor the authorizing data to make sure there aren’t issues with overuse or inappropriate use — essentially the same thing we do through the triplicate program for opioids and other drugs,” he said.

Doctors do not have to send forms when they prescribe drugs that are not on the triplicate list.

Natashia Hrushka-Jewett has been taking medical cannabis since February to treat fibromyalgia and other conditions that cause chronic pain. She said she was buying the drug off the black market for six years until she finally found an Edmonton physician to prescribe it in February.

Hrushka-Jewett said she was “absolutely shocked” to hear the level of information her doctor has to send to the college.

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“It’s frustrating that my doctor had to go through all of this, just to get me something that is going to not harm me as much as the other medications can,” she said.

She said she has been prescribed more than 20 other medications since 2007, including Naproxen, Celebrex, Tylenol 3 with codeine, and Lyrica. She said she was plagued with stomach problems and was depressed as a result of her constant pain.

She said illicit cannabis helped her wean off all pharmaceuticals by 2015 and get active again.

Since getting her prescription, Hrushka-Jewett has been taking an oil that is 20 parts CBD, or cannabidiol, to one part THC, or tetrahydrocannabinol, meaning it has almost no psychoactive effect.

“I’ve been able to function a lot better as a mother, as well as just a normal person in everyday life. I feel like I can actually one day be able to go to school again or find a job,” she said.

Verbora said the cannabis paperwork means doctors will see fewer patients, and questioned why it is easier to prescribe drugs with more serious potential side-effects.

He said there are already enough rules and regulations around prescribing medical marijuana in Canada.

“In the time that it takes me to write a prescription for cannabis and authorize it, and fax it to the company and do the form, and then the patient to get it in the mail, I could write 20 fentanyl prescriptions in that time and patients could get fentanyl the same day,” he said.

Verbora shared several screenshot comments with StarMetro that he said are from Alberta doctors who are upset by the disclosure requirement, but were fearful of disclosing their names.

One says, “This is intimidation tactics and it is working,” while another says they have a colleague who was contacted by the college and “asked all sorts of questions about what conditions he prescribes for and why he prescribes cannabis so much.”

Buick said the college is feeling pressure from physicians to let them give out cannabis like it’s a consumer product, and that the organization will not give in to that pressure until the drug is officially regulated as such.

“We will regulate it properly as a medical product for as long as it remains one,” Buick said. “That’s just our job.”

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