I have begun to believe my mind is full of tiny little topics that act like pimples.

No one can predict the order they start to fester in, or when they’ll get ripe and burst.

Friday, 11 April 2014

The Risk Research Assessment Program A Proposal for Peace!

The Risk Research Assessment Program
A Proposal for Peace!

The Canadian Medical Association and the Provincial Colleges of Physicians and Surgeons have finally succeeded in sticking their heads all the way up where the sun doesn’t shine. 

The Doctors have now taken the initiative and in return for their signature want total control of the Doctor/ Patient relationship. They accompany this with an exorbitant ever escalating scale of fees in the hundreds of dollars. We have a profession that, after admitting that they don’t know shit from shinola about any of the aspects of Medicinal Cannabis use or treatment, are demanding complete control of a patients treatment under threat of terminating their prescription for disobedience.
That is not going to fly. There is no way that a patient who has spent years developing a mode of treatment that suits his complaint is going to surrender control over his treatment and obey a dumb-fucker on a learning curve from nowhere.
What is most surprising to me is that I advised them to take the exact opposite approach and give the patient control of his treatment and teach the doctor out of his dumb-fucker state. I made this in the form of a proposal for a joint research project to Dr. Louis Francescutti after his appointment to the CMA Presidency. I was ignored as is standard practice for the CMA.
Since then I have watched the profession fester with resentment and they are now in an impossible situation making unreasonable demands that cannot be met because they have destroyed all confidence in their role as a trustworthy source of help.
I may be a fool or simply overly optimistic but I believe that there is a way to break the current impasse if only the profession will listen and understand that they need to show some humanity and understanding and above all negotiate a middle ground to establish a workable Doctor/Patient relationship in Cannabis Treatment and establish its benefit on a factual basis.

So where does that leave us now?

In a position where we can ignore Government influence and resolve the differences in goals of Doctors and Patients by partnering to a new instructional model and eliminating the shortage of information that so plagues Doctors in the assumption of the risk of treatment. To this end I now repeat the proposal I made the CMA to establish a joint Program to collect the missing information.

The Risk Research Assessment Program

We have two groups interested in the Medical aspect of the problem but at extreme ends of the treatment scale. The CMA wants good information regarding all aspects of Cannabis therapy and the Potential Patient population has all the answers. There is no communication between the two and unless that gap is eliminated there will never be a solution found.

The complexity of the problem becomes even more convoluted when the number of variables to be considered is magnified a thousand times. A large number of the patients most concerned are those who over the course of years have devised a personal treatment that works for them. They have selected hybrids as a source crop, and complex processing procedures to make the medications they use to successfully alleviate their symptoms. As a collective they possess all the knowledge the CMA needs and they need the CMA for a signature to purchase and possess their raw materials.

I am no doctor but I am a damned good statistician, a superb analyst and I’ve got excellent common sense. Combine that with humility that is exceeded only by my good looks and you wind up with brilliance or a fool. I believe that there is a way to break this impasse and I am now proposing it to you for your judgment of its merit. It will need polishing but it could work but only if the CMA assumes its proper role as a leader of a profession devoted to the welfare of patients. At the moment they are paralyzed by an obsession with risks and are blockading effective treatment and that must stop.

The risks they fear can neither be qualified nor quantified: What are the risks and how serious are they? They don’t know what they fear and my proposal is that they start doing some Research to find out what the Bogeyman is. The CMA is the only one who can! They have mistakenly interpreted the MMPR as requiring them to authorize the use of marijuana as a medical treatment. It does no such thing.

The responsibility of the physician under the MMPR limited to the same declaration required by the MMAR. Whatever steps taken to establish grounds for a signature, all the attending Physician is doing is certifying an applicant has symptoms of a disease that requires further treatment. There neither is any recommendation as to what that treatment shall be, nor is it a prescription for medication. It merely establishes the right to purchase and possess as much cannabis as required for the patient’s medical needs. The origin of the Cannabis purchased, legal or illegal, is none of the physician’s concern nor is the quantity purchased. All his signature accomplishes is giving the Patient immunity from arrest and prosecution for possessing his medication: If he elects to buy pot instead of a stereo.

Let’s Make A Deal and use our Combined strength against Harper for leverage

The one thing that is certain is that Stephen Harper wants his Commercialization of Marijuana to succeed. A continuing blockade to Customers by Doctors is not to be desired when the doors to his Marihuana Monopoly scheme open for business. The CMA should have a really good look at the huge pile of money he’s talking about. A billion and a half?

Gee? I wonder what our Fearless Leader would pay for Doctors to wholeheartedly agree to support his program in the interests of speeding up the supply transfer to Licensed Growers and no shortages to patients.
Minimum 10% Max? plus immunity from risk. Not too much to ask:
This is risky business so the CMA should request financing to start a Research Program to assess that risk. There is a risk of a completely unknown probability and any Doctor participating as a researcher and dealing within the program must be exempted with no liability that for outcome under both Criminal or Civil jurisdictions.

The Program would allow any licensed physician to participate as a researcher subject to guidance regarding the Doctor/Patient relationship that will be established per protocol.

This is a simple trade. Any doctor feeling qualified to do so can establish a legally binding relationship with a Patient that exchanges
access to cannabis for complete disclosure of the patient’s treatment regimen and detailed follow ups to assess progress.

The CMA wants data related to both the short and long term use of marijuana regardless of method of use or product used and dosage. There is none. Gather some! Get off your ass and gather some

Patients want maintenance of the level of medication they are currently using for relief of their particular symptoms preferably in the same form or better if found. Provide

Create a research project to gather the data you want with a trade.

The Doctor trades his approval for a patient’s medication requirement because he is participating in research, supplying an experimental drug and recording the treatment progress in order to assess its effects. Because it is an assessment of risk there must be no responsibility or liability for an unexpected bad outcome. Ensure that factor with Health Canada.

The Doctor must be in control of the relationship and its procedural requirements but the patient retains control over what is done with the marijuana after purchase. The patient trades detailed access to his treatment regimen and medical progress and any changes made for the right to obtain or create his own medication, He agrees to periodic reports and/or assessments to be determined. At this point there are 30,000+ potential research subjects waiting for the opportunity to share their knowledge for weed. All they need to know is that some doctor is going to look after their interests instead of their own and the flood gates will open.

As a statistician I am astounded by the immense pool of information about cannabis medical utility that can be extracted from 30000 users and the speed that it can be now be analyzed and understood.
With an intelligent first examination by the doctor and a structured interview, his physical symptomology and its severity is known, and a baseline established that can be expanded to include:

1.    A complete history of the patient’s use and treatment mode
2.    A marijuana sample to be used for genetic and pharmacological analysis
3.    A sample of any creams, oils, teas, or any product ingested
4.    An identification of the method of use

If all 30000 of the growers responded for just that first interview you could pull complete knowledge about every hybrid plant’s genetics and its potential as a producer of whatever cannabinoids are the effectors in any product used. You now have an established baseline: with a reasonable repeat assessment and interview schedule and the help of the patient you can measure whatever is changed in the treatment regimen and the THC and CBD composition in whatever product they are using and a verbal follow up on physical benefits.

One other point that should be noted by the CMA re their role in the matter: opposing is simply inflicting aggravation on patients who already have enough to worry about with the loss of personal and designated growth. Your signatures are of diddly shit importance to any potential grower who is in the position of having to grow his own because he cannot afford purchase it at current price levels. They are doomed to grow criminally under threat of arrest by the Cops and ruination from misguided building inspectors if their medication source is discovered.

That is a sourdough ending to what I think is a reasonable path to reconciliation and the restoration of a Doctor/Patient relation based on respect and trust. That is a far better outcome than a continuation of the current Doctor/Patient relationship based on lies, paranoia, fear and contempt. It can’t get any worse for the CMA image as seen by the Medical Marijuana Patient Community: They’re an arrogant collection of unsympathetic liars who don’t give a damn about their patient pool. These ethical cretins are primarily interested in their own professional and financial security, not in our patient welfare. The CMA does not represent doctors: It is simply a lobbyist representing the commercial interests of a ridiculously intertwined snarl of corporations owned by Doctors that owns and controls the Canadian Medical System.

Nasty and unwelcome as this professional image has become, it’s completely warranted by the twelve years of obstinacy, opposition and misinformation accorded Medical Marijuana by the CMA that prompted me to write this.

Thanks for your interest
Blaine Barrett