As traditional attitudes about medical cannabis have started to change in recent years, so too has Dr. Daeninck watched the engagement of his audience increase. A medical oncologist, palliative medicine consultant and speaker and educator on the topic of medical cannabis, Dr. Daeninck is currently employing the role of cannabinoids in the treatment of patients with advanced diseases. We caught up with him to discuss the evolution of medical cannabis, his recent presentations on the topic, and the importance of maintaining a medical system when a legal framework is introduced next year.
How did you first get involved in medical cannabis?
A colleague with a national presence in palliative care was asked to get involved with a program but he did not feel that it fit what he was doing, and he asked one of us from our regional palliative care group to look into this. The more and more I looked into it, read the research and looked into the pre-clinical work, the more interested and fascinated I became with the fact that there’s such a rich trove of information here – why isn’t it being more widely distributed? I hooked up with a number of different people, as well as the Canadian Consortium for the Investigation of Cannabinoids, and really saw the benefits and the role that [cannabis] can play in cancer symptom management, as well as in palliative medicine.
You mentioned clinical and pre-clinical trials. Does it surprise you to hear doctors say there’s a void of evidence and information to support cannabis as a treatment option?
Ten years ago you could say that, and you could get away with it. Now, you really can’t, becausethere is a lot of good evidence; there are publications in high level journals; there are systematic reviews looking at these smaller studies and putting them into perspective. You can always stick your head in the sand and say, ‘there’s no 10,000 person randomized control trial that’s being backed by a drug company.’ That’s true, because this is not a drug that’s being put forward by a drug company. It’s a plant that has medical benefits for people. If you take a look at medicine in general, most of it is not evidence-based.
You’ve been giving presentations to colleagues in the medical community for several years. Would you say the nature of what doctors are asking about cannabis as a therapy has changed since the introduction of the MMPR?
I do notice more physicians are interested, partly because there is a demand from the patients who are coming forward that are saying, ‘I’ve got a problem, I’ve used some cannabis and I think that this is working.’ And these may be problems that have been very challenging for the physician. Sometimes the use of medical marijuana brings people back to where they want to be – they’re able to be more active, return to work, enjoy family activities. Whereas, previously, they would have been on the couch or in bed. So I think that this is a reasonable option and many physicians are open to being able to authorize and get their patients on it, in a controlled, supervised fashion.
You were recently in Ottawa for a speaker tour, where you delivered a presentation to doctors: palliative care and family doctors, a psychiatrist, a gastroenterologist and an addictions specialist were also in attendance. Then you presented at the Ottawa Hospital for the oncology department, followed by a more niche presentation to palliative care practitioners. Was there a difference between the engagement of, and questions asked by, each audience?
I found the presentation to the mix of physicians very interesting. The range of questions that came out of it really showed that there were some people who were very knowledgeable; there were some people hearing this information for the first time; and some people betrayed that they don’t know what they don’t know… but the engagement was super. The fact that people felt comfortable enough to raise these questions made it feel like an open discussion.
There’s been a large buzz about the recreational market. When you think about the medical program as a physician authorizing cannabis, what do you think the value is in maintaining the medical system?
I think that there has to be some care taken as we move forward into the legalization of recreational marijuana. If we allow patients to self-treat, we’re going to get into some problems. There will be some people who use this as an additive to their food or to feel a little better at the end of the day, and there are definitely some people who abuse it, and that’s how the trouble gets started. By maintaining a medical presence, we’ll be able to have some oversight of patient use. The majority of the patients who use marijuana for medical purposes are just looking for benefits, they aren’t looking to get high.