The straight dope

If you had Canada’s top pharmacologist, Dr. Harold Kalant, cornered for 10 minutes, what would you ask him?


What kinds of illnesses require treatment with medical marijuana?
Well, there are none that absolutely require it. There are other medications that are as good or better [for all illnesses]. But some people respond better to cannabis than they do to other drugs.

So what is it good for?
It is quite good for relieving nausea and vomiting due to cancer chemotherapy, radiation and AIDS medications. Those are recognized legal uses. Another use is that it is quite effective as relief for many kinds of pains.

But isn’t it carcinogenic?
Well, there is an apparent contradiction of findings. Smoking cannabis is irritating to the airways the same way smoke of tobacco is. Chronic cannabis users tend to have chronic bronchitis, coughing, wheezing . . . Some studies have claimed [that] among heavy cannabis users there is an increased incidence of types of airways cancer that you don’t ordinarily find in young people. Other studies have reported that when you put cannabis extract into tissue cultures in which cancer cells are growing, it has an anti-cancer effect....I’d say the jury is still out on that one.

So how does one go about getting permission to use marijuana medicinally?
One has to get a medical certificate stating that he or she does suffer from a certain disease, which the doctor certifies in a letter. The thing is, the doctor doesn’t have to say, “I believe cannabis will be helpful for him.” He or she simply has to say that the patient believes cannabis might be helpful. Then the Ministry of Health issues a certificate that protects against the law for possessing and using. And they are allowed to grow enough cannabis plants to provide for his or her own medication.

They have to grow their own?
No, they can buy it from the government. The federal government had a contract with an agricultural firm in Saskatchewan to grow cannabis of uniform quality in an underground grow- op in an abandoned mine in Manitoba, I believe.

How do they regulate sharing?
That is another problem. There is really no way of regulating. It is against the law, but nobody is actually monitoring. I suppose if it became known someone is really growing 10 times as much as needed and selling to friends, police charges would be laid, but otherwise, there isn’t really any actual control on it other than the honour system.

What about side effects?
Regular marijuana use carries the risk of a number of side effects. One, with heavy use there appears to be an impairment of memory, of learning ability and of drive. Regular users have a much higher school dropout rate, dropping out of a job because of loss of mental abilities and loss of drive. Other problems, for example: with impairment of ability to drive properly. And there has been a growing number of [car] accidents due to cannabis instead of alcohol, particularly among kids.

Why is that?
Kids know that there is a Breathalyser that tests for alcohol, but there is no corresponding test for cannabis. So they think they can drive under cannabis with less risk of being stopped on the street. There is also the myth that cannabis doesn’t impair, but many studies show that it does.

So would you say that this program has been successful?
That depends on what you mean by successful. To me, as an academic, successful ought to mean careful results, controlled comparison groups that establish it does work as expected in the great majority of cases and the production of harmful side effects is negligible. But actually nobody is keeping records of that kind.

Do you think this will lead to legalization of marijuana?
I don’t want to confuse medical use with non-medical use. That cannabis can have medical benefits should have no impact on the question of whether or not to legalize. Heroin is legal in Canada to be prescribed by a physician for patients with severe pain from terminal cancer. But nobody is saying, therefore we should legalize heroin.

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