Registering a Patient

Check for relevant medical conditions

Health Canada does not contain any limitations on the conditions for which a healthcare practitioner can authorize medical cannabis [1]. Based on the recommendation(s) from Health Canada and the National Academies of Sciences, Engineering, and Medicine, the existing scientific and clinical evidence for cannabis and certain cannabinoids in treating various symptoms associated with medical conditions is summarized below [1–3]:

CONCLUSIVE OR SUBSTANTIAL EVIDENCE	MODERATE EVIDENCE
Chronic pain Chemotherapy-induced nausea and vomiting Spasticity associated with multiple sclerosis (MS) Epilepsy	Sleep disorders Fibromyalgia Post-traumatic stress disorder (PTSD)
LIMITED EVIDENCE	INSUFFICIENT EVIDENCE TO SUPPORT OR REFUTE
Anorexia Tourette syndrome Anxiety Alzheimer’s disease and dementia Glaucoma Depression Arthritis and musculoskeletal disorders	Cancer Irritable bowel syndrome Irritable bowel disease Spinal cord injury Amyotrophic lateral sclerosis Huntington’s disease Parkinson’s disease Schizophrenia Wasting syndrome Anorexia nervosa

EVALUATE PATIENT FOR CONTRAINDICATIONS

The risk/benefit ratio of using cannabis (especially THC-predominant cannabis) should be carefully evaluated in patients with the following medical conditions:

History of hypersensitivity to any cannabinoid or to smoke.
Cannabis containing primarily THC should not be used in any person under the age of 25, unless the benefit/risk ratio is considered by the physician to be favorable.
Cannabis containing primarily THC and especially higher levels of THC should not be used in patients with personal history of psychiatric disorders such as schizophrenia, psychosis, bipolar disorders or depression or familial history of schizophrenia.
Patients with severe hepatic or renal disease.
Patients with cardiovascular or cerebrovascular disease because of occasional hypotension, possible hypertension, syncope, tachycardia, myocardial infarction and stroke.
Smoked cannabis is not recommended in patients with respiratory disease (e.g. asthma or chronic obstructive pulmonary disease).
Patients receiving concomitant therapy with sedative-hypnotics or other psychoactive drugs.
Pregnant women or women planning to get pregnant or women who are breastfeeding.
Men who wish to start a family.
History of alcohol or drug abuse or substance dependence; Increased cognitive impairment may be observed when cannabis is consumed along with alcohol or other psychoactive drugs [2].

COUNSELLING AND TREATMENT AGREEMENT

Discuss the potential benefits, risks, side effects (such as possible impact on cognition), proper usage methods and desired clinical outcomes with your patient. Complete the treatment agreement where appropriate.

MEDICAL DOCUMENT

Complete and fax the “Medical Document” with the “New Client Registration Form” (completed by the patient) to CannTrust via secure fax at: 1-844-295-6641

A member from our Customer Care Team will contact you and your patient to validate the submitted information within 1-2 business days.

REFERENCES

[1] National Academies of Sciences, Engineering, and Medicine, “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research”, The National Academies Press, Washington, DC, 2017.

[2] Health Canada, “Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids, 2018”. Available at https://www.canada.ca/en/health-canada/services/drugs-medication/
cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html.

[3] Epidiolex®, FDA Prescribing information. Available at https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210365lbl.pdf.

[4] C. Carroll, P. Bain, L. Teare, et al. Cannabis for dyskinesia in Parkinson disease: A randomized double-blind crossover study. Neurol. 2004;63:1245–1250.

[5] A. Holdcroft, M. Maze, C. Doré, et al. A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management. Anesthesiology. 2006;104:1040–
1046.

[6] A. Vaney, M. Heinzel-Gutenbrunner and P. T. Jobin. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: A randomized, double-blind,
placebo-controlled, crossover study. Mult Scler. 2004;10:417–424.

[7] J. Zajicek, P. Fox, H. Sanders, et al. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): Multicentre randomised placebo-controlled trial. Lancet. 2003;362:1517–
1526.

[8] M. Bergamaschi, R. Queiroz, A. Zuardi et al. Safety and side effects of cannabidiol, a Cannabis Sativa constituent. Curr Drug Saf. 2011;6:237–249.