MedSask Update

MedSask has had a record year answering health professional medication questions. A huge thank you to all of our callers! We continue to update our website with Drug News regarding various topics. Regarding Drug Shortages, we have listed all drug shortages, as well as predicted length of shortage and documents detailing options for select shortages.

A NEW venture is posting actual questions received. The Healthcare Professional Question Database is searchable so you can search a keyword related to your question and may find your answer in no time! This has only recently started so is not all that robust at the moment but we plan to add content on a monthly basis.

As you know, one topic gaining interest is medical marijuana. We will be publishing a summary of the available evidence-based information in the near future. Here is a sample question that typifies information required in many medical marijuana:

Q: I have a 16-year old female who has been prescribed medical marijuana by another physician for anxiety. Prescription is for 3 g per day. Is this considered a high dose? Is the medical marijuana more or less potent than the street drug?

A: Various surveys published in the peer-reviewed scientific and medical literature have suggested that the majority of people using smoked or orally ingested cannabis for therapeutic purposes reported using approximately 1 to 3 g of dried cannabis per day. While there are no restrictions under the new Marihuana for Medical Purposes Regulations on the daily amount that you may authorize, there is a possession cap of the lesser of 150 g or 30 times the daily amount.1

Illegal marijuana cannot be trusted for purity and dose accuracy.2,3 According to the World Health Organization, a typical joint contains between 0.5 and 1.0 g of herbal cannabis which may vary in Δ9-THC content between 7.5 and 225 mg. The amount of other cannabinoids present, mainly cannabinol (CBN) and cannabidiol (CBD), is usually much lower. The actual dose of Δ9-THC absorbed systemically when smoked is not easily quantified but has been approximated to be around 25% of the total available amount of Δ9-THC in a joint.

The dried marijuana currently provided by Health Canada contains 12.5 ±2% total THC (Δ9-THC and Δ9-THCA), and less than 0.5% CBD and CBN. This would provide approximately 65 to 125 mg THC in a typical joint.1 The Health Canada site: Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids (see references for link) has tables useful for conversion from smoked or vapourized doses to oral and vice-versa.1

 

-Carmen Bell

 

References:

1.Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids [Health Canada, 2013] available at: https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/information-medical-practitioners/information-health-care-professionals-cannabis-marihuana-marijuana-cannabinoids.html – tbl3 |

2. PL Detail-Document, Medical Marijuana. Pharmacist’s Letter/Prescriber’s Letter. December 2014. |

3. CanniMed. [Home page] [cited 07 Jun 2017] Available at http://www.cannimed.ca

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