Ottawa Is Shirking Its Responsibility In Allowing Access To MMJ
Réjean Hébert, Quebec’s health minister, says Ottawa’s proposed new regulations on medical marijuana is putting doctors in an impossible situation.
Previously, patients who might use medical marijuana for pain relief, those with AIDS, for instance, were allowed to possess or grow marijuana for their own use.
About 30,000 permits to grow medical marijuana were issued starting in 2002 by Health Canada.
The federal government also grew medical marijuana for a time in an underground mine in Manitoba, but its product was criticized for being too weak.
Under regulations announced last month by federal Health Minister Leona Aglukkaq, however, Health Canada will no longer be a supplier and no more permits will be issued to individuals to grow medical marijuana. Ottawa will instead choose private contractors to produce medical marijuana for which a patient must first have a doctor’s prescription.
“The federal government has put us in an impossible situation,” Hébert told reporters. “(Ottawa) is asking doctors to prescribe marijuana but (it does) not recognize marijuana as a medication, properly speaking.”
In a statement, Dr. Yves Robert, secretary of Quebec’s Collège des médecins, said Aglukkaq’s new regulation shifts responsibility to doctors “for the use and acquisition of an illegal product for which no assurance that an effective dosage, safety and standardization is available.”
Hébert said the federal government should rule that marijuana is a medication so that doctors can legally prescribe it. “Because marijuana is not recognized by Ottawa as a drug, there is no drug identification number,” he added. “(Having a number) is the first step for a drug to be prescribed by a doctor.”
And once that first step has been taken, Hébert said, the province’s prescription drugs insurance program could decide to cover medical marijuana prescriptions.
“The federal government is not doing its job in this matter,” he said.
Marc-Boris St-Maurice, director of the Montreal Compassion Centre, said the new federal approach means Ottawa wants out of the business of producing medical marijuana and issuing permits to grow cannabis, a practice introduced by a previous Liberal government. But “the courts have ruled that people who need it for medical reasons, should be entitled to get it, and that preventing their access is unconstitutional,” he said.
On the other hand, the doctors are saying, “We don’t know enough about this substance. We don’t want to prescribe it,” St-Maurice said.
“The doctors don’t want to be responsible for who gets it or not. And we agree with them,” he said.
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Meanwhile, frontline doctors being made to suffer and face bankruptcy for following the rules:
There’s a for sale sign up in front of the medical centre in Coe Hill.
Since 2007 Doctor Rob Kamermans and his wife Mary, a registered nurse, have built the clinic as part of their plan to offer accessible health services in North Hastings. This is an area they call home.
Since the clinic opened it has been slowly growing but the high costs of operating a clinic and employing staff required Dr. Kamermans to also work shifts in an emergency room in Sturgeon Falls and in high need sites for Health Force Ontario.
“I became a doctor to serve the community,” said Dr. Kamermans. “That’s who I am.”
But since part of serving the community caught the eye of law enforcement, the doctor and his wife have been struggling through a nightmare of raids, arrests and confusing charges. With a trial looming and legal bills mounting, their property in Coe Hill had to go up for sale.
“This does not mean I am closing my practice,” Dr. Kamermans said in an interview on June 14. “I’m just unable to meet my financial obligations. We hope to continue renting office space and continue seeing our patients.”
But many of the patients who say Dr. Kamermans and his wife Mary returned their quality of life and brought back hope have been referred to other doctors.
Dr. Kamermans has a passion for alternative therapies and he says he has always supported his patients when they wanted more choice. He encouraged patients to seek out chiropractic care, acupuncture and homeopathy.
Dr. Kamermans also has a strong connection with aboriginal healing methods and he is not a fan of opioids. So it was no surprise in 2009 when Dr. Kamermans was asked to sign a Health Canada B1 form for a patient. The form supports a request by the patient to access medical marijuana through the Health Canada Marijuana Medical Access Regulations program.
Dr. Kamermans was aware of the benefits of medical marijuana so he filled out the form. The patient had one of the illnesses that Health Canada described and other therapies were not working.
Once the form is filled out by a doctor it still has to be screened and approved by Health Canada. The doctor’s role is to assess the patient to determine if there is a medical condition that would fit with the Health Canada guidelines.
“The B1 form is only a recommendation. My signature is not an approval – it is only support,” explains Dr. Kamermans. “My heart is to look after people.”
By 2010 Dr. Kamermans had more sick and injured adults asking for his help. By 2012 he had signed around 4,000 B1 forms.
According to Health Canada’s website there are now more than 28,000 Canadians authorized to possess dried medical marijuana through the MMAR.
With the numbers of medical users on the rise and law enforcement focused on the war on drugs the police wanted names of users. Health Canada refused stating privacy laws.In Ontario patients are protected under the Personal Health Information Privacy Act (PHIPA 2004).
With no access to patient names, addresses and other details an investigation was launched. Dr. Kamermans believes he was the focus of the investigation because, as he says, he was an easy target due to the number of clients he was caring for.
The Organized Crime Enforcement Bureau (OCEB), with the of the Ontario Provincial Police (OPP) Anti-Rackets Branch, Health Fraud Investigation Unit and the Royal Canadian Mounted Police (RCMP) launched “Project Thorne” in November of 2011 that focused on fraud and forged medical forms in relation to Health Canada MMAR documents. And after two months of surveillance, the OPP and RCMP showed up at the Coe Hill clinic.
“The practice was transparent,” Dr. Kamermans says. “This whole thing could have been accomplished by a knock on the door. I would have had a conversation and answered questions.”
And on Jan. 26, 2012, Dr. Kamermans did get to answer some questions after a loud knock on the door.
The knock came from some 20 officers at his home and office who issued a warrant related to trafficking. The doctor does not remember being arrested or charged. He was cuffed and taken in to the OPP station in Bancroft where he was accused of being a drug dealer.
During the raid patient files were removed and to date they have never been returned. A memory stick was sent to the doctor with photocopies but it made treating patients difficult.
“The OPP were obviously fishing,” Dr. Kamermans said. “They took all our charts.”
“We need to treat all patients,” Dr. Kamermans said. “As physicians it is our right and obligation to treat with the safest, most effective means at our disposal. MMAR is Health Canada’s program, not mine. Cannabis has an excellent safety factor and there have been no deaths attributed to the use of medical marijuana.”
After the police raid, Dr. Kamermans made a decision to stop signing B1 forms. He now refers his patients to other doctors who are willing to take the risk of signing. And it is a risk.
On Aug. 15, 2012 the OPP went in to the emergency room of the hospital in Sturgeon Falls and arrested Dr. Kamermans. He was in the middle of treating a patient.
Being cuffed while with a patient, he says, was not only unnecessary but it also cost him his job.
“The OPP could have asked me to come to the station with my lawyer,” Dr. Kamermans said. “They [the hospital] can’t count on the police not coming back. This was all part of the police working very hard to make us look bad.”
Dr. Kamermans was charged with fraud (three counts), utter forged documents (5 counts), possession of property obtained by crime and laundering proceeds of crime. His wife Mary Kamermans, a registered nurse, has the same charges but with one less count for utter forged documents.
“This is both disappointing and ridiculous,” Dr. Kamermans said in an interview in April. “The people who came to us did not want to go to the black market. This program was supposed to make the black market smaller and that’s a good thing right? And we don’t understand how they charged Mary when she wasn’t even able to sign the forms.”
Since the arrest last August Dr. Kamermans has been trying to keep his life together. He still goes in to the clinic every day at 6 a.m. to work on charts and to work with the rest of his patients.
He refers anyone who needs a renewal to other physicians and the patients pay the new doctor the fee for the paperwork. Dr. Kamermans used to charge between $100 and $250 for the B1 form and now the new doctors are charging $600. That’s tough for patients living on pensions or other disability funding.
And other doctors are continuing to support the program. At the end of January 2012 when Dr. Kamermans stopped signing the B1 forms there were 13,781 Canadians authorised to possess dried marijuana. By the end of December 2012 the number had grown to 28,115.
Dr. Kamermans still thinks medical marijuana is an excellent option for some patients.
“I am a reluctant leader of this whole medical marijuana thing,” he says. “It is disheartening to spend this time to clear ourselves.”
And it is disheartening. The patients who felt supported and cared for by Dr. Kamermans spread the word online about the man in Coe Hill who helped them manage pain, get off narcotics and increase their quality of life. Dr. Kamermans thinks this is part of why he was targeted.
“Patients should always have choice,” Kamermans said. “We gave them a choice and Health Canada gave them an approval.”
Dr. Kamermans and his wife will be in court this October facing charges. The legal fees have been massive, with no end in sight. Dr. Kamermans can’t work in the ER and he can’t afford to maintain his property in Coe Hill.
“It is disheartening for us to be put in this situation,” Dr. Kamermans said. “We felt we were making a beneficial impact on the community.”
OPP Sergeant Kristine Rae was contacted for comment on June 24. In a telephone interview she said she did not recall the details of the case and requested an email be sent to her. She did not respond to either of the emails sent over the next week.
Submitted by Barb Shaw
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