Cannabis For Medical Purposes

Note: a glossary of terms can be found at the end of this document. Glossary terms are indicated in teal with a ^“G” throughout this document.

Preamble

Health Canada registers individuals to use cannabis for medical purposes based on a medical document or written order from a physician or nurse practitioner. Regulated members are not obligated to authorize cannabis for medical purposes, but declining this treatment must be done in accordance with the Code of Ethics & Professionalism^G.

Regulated members must be aware of and comply with the Cannabis Act and the Cannabis Regulations^G, as well as all other relevant federal and provincial laws regarding the use of cannabis. Part 14 of the Cannabis Regulations outlines the legal requirements for a regulated member issuing a medical document or written order for cannabis for medical purposes. The Cannabis Regulations only allow a medical document or written order to be issued by a regulated member to an individual under their professional care.  For an individual to be under the professional care of a regulated member within the meaning of section 273 of the Cannabis Regulations, a regulated member must comply with the requirements outlined in this Standard of Practice.

Standard

1. A regulated member must notify CPSA’s Cannabis for Medical Purposes (CMP) Program^G prior to issuing a medical document or written order for cannabis for medical purposes by submitting their name, registration number, contact information and address of the location where the regulated member consults with patients.
2. A regulated member who issues a medical document or written order for cannabis for medical purposes must only do so if it is a clinically appropriate treatment^G for the patient’s identified medical condition or symptom(s).
3. A regulated member who issues a medical document or written order for cannabis for medical purposes must:
   1. evaluate the patient directly and in person annually;
   2. evaluate the patient at least once every six months to assess the benefits and risks of cannabis as treatment for the identified medical condition or symptom(s);
   3. provide ongoing care to the patient for the underlying medical condition or symptom(s) for which cannabis has been authorized and assess for any emerging substance use disorder(s); and
   4. review available prescription databases (e.g., Alberta Netcare, Pharmacy Information Network (PIN), Tracked Prescription Program (TPP)) at least once every six months to obtain the patient’s medication profile.
4. A regulated member must:
   1. discuss the risks of using cannabis with the patient and document the discussion in the patient’s record^G;
   2. obtain informed consent^G in accordance with the Informed Consent standard of practice;
   3. assess the patient’s risk of developing a substance use disorder using a standard risk assessment tool^G;
   4. retain a copy of the medical document^G issued for cannabis for medical purposes in the patient’s medical record; and
   5. document in the patient’s record:
      1. a direct, in-person comprehensive medical assessment of the condition to be treated with cannabis, including a history, a physical examination by the regulated member and appropriate clinical investigations;
      2. the rationale^G for treatment and daily quantity of cannabis to be used by the patient; and
      3. any previous treatments or therapies that were not helpful in treating the patient’s identified medical condition or symptom(s).
5. A regulated member must not:
   1. apply to become a licensed producer or holder of cannabis;
   2. accept any incentives or rebates for providing a medical document or written order for cannabis for medical purposes; or
   3. charge patients or licensed producers or holders of cannabis for activities associated with issuing a medical document or written order for medical cannabis for a patient.

Glossary

Cannabis for Medical Purposes (CMP) Program: the Cannabis for Medical Purposes Program provides physicians with supportive resources and education for safe use of medical cannabis in Alberta patients. Physicians who wish to authorize medical Cannabis for a patient are required to notify the CMP program. To notify CPSA of your authorization of cannabis for medical purposes, please use the form on our website or email your name, registration number, contact information and address of the location where the regulated member consults with patients to CMPInfo@cpsa.ab.ca. Review the CMP Program information.

Cannabis Regulations: the Government of Canada’s Depart of Justice laws and regulations about cannabis, process of legalization, cannabis in provinces and territories and driving laws. Review the Cannabis and Legalization and Regulation.

Clinically appropriate treatment: the Government of Canada’s Cannabis Regulations allow health care practitioners to authorize cannabis for medical purposes if it is required for the condition for which their patient is receiving treatment; this requires regulated members to use their clinical judgment to determine whether medical cannabis is appropriate for the patient’s medical condition or symptom(s).

Code of Ethics & Professionalism: outlines ethical expectations, so physicians can provide the highest standard of care, while fostering patient and public trust in physicians and the profession. Review the Canadian Medical Association’s Code of Ethics & Professionalism.

Informed consent: a regulated member must obtain consent and ensure the patient is fully informed and understands any medical examination, procedure or treatment before it takes place. Review the standard of practice on Informed Consent. More information can be found in the Informed Consent for Adults Advice to the Profession document.

Medical document: this refers to the document authorizing the use of cannabis for medical purposes as required by Health Canada. Review Health Canada’s Information for Health Care Practitioners – Medical Use of Cannabis and Sample Medical Document.

Patient record: all regulated members must maintain accurate, up-to-date records of all their patient interactions; documentation must be done in accordance with the Patient Record Content standard of practice. Review the Patient Record Content standard of practice.

Rationale: an explanation of how and/or why the regulated member made the clinical decision to authorize cannabis for medical purposes.

Standard risk assessment tool: a standard risk assessment tool helps analyze and evaluate factors which have the potential to cause harm to a patient.