Provided with the materials for Agenda Item 18 at the October 27 MBC meeting:

Appendix 2: Medicinal Cannabis Agreement 1

Date: ___________________________

I understand that _______________________ (clinician name) is helping me with the treatment of my medical illness.

In considering the possibility of using medicinal cannabis, it is important to recognize that the risks of medicinal cannabis may be impacted by specific medical conditions and patterns of use. I understand what has been explained to me and agree to the following conditions of treatment:

  1. I understand that the course of treatment will be re-evaluated regularly after I begin treatment with medicinal cannabis.
  2. I may be asked to reduce my intake of sedative-hypnotic medications to avoid excessive sedation due to the combined effects of cannabis and such drugs.
  3. If I am beginning cannabis treatmen for pain relief, and have been taking opioids for pain, I will follow my doctor’s advice on how to reduce the opioid dose so as to avoid experiencing opioid withdrawal symptoms.
  4. I must prevent children and adolescents from gaining access to cannabis because of the potential harm to their well-being. I will store cannabis in locked cabinets to prevent anyone else from using it.
  5. I recognize that some people cannot control their use of cannabis.One example is using cannabis for reasons other than for the indication for which it was prescribed; another is taking higher doses and doing so more frequently than my doctor recommended. I agree to discuss this with my health care provider if this happens to me.
  6. Since the effects of cannabis on a fetus are uncertain, women may wish to abstain from cannabis if they become pregnant or are planning to become pregnant.
  7. Because cannabis use has been associated with changes in heart rate and blood pressure, and there have been case reports linking heart attacks to cannabis use, I will review my heart health with my doctor to determine if taking cannabis is right for me.
  8. Cannabis may not be right for me if I have had a serious menta; illness (e.g., schizophrenia, mania, or a history of hallucinations or delusions). I will discuss my mental health symptoms with my doctor prior to starting cannabis and report any of these symptoms to my doctor if they occur.
  9. Because combining smoking tobacco with smoking cannabis may increase risk of lung disease I should avoid tobacco smoking if I take cannabis in smoked form.

10. I will not drive a car or operate heavy machinery while under the influence of cannabis. The issue of when it is safe to drive after cannabis ingestion is an area of uncertainty, and can be affected by my experience with cannabis, the type of product that I am using, whether I am inhaling it or ingesting it, the dose and strength of the cannabis, among other things. After taking cannabis, I will wait until any impairing effects have subsided before driving or find alternatives to driving.

11. As the strength and potency of cannabis varies widely, I will use the minimum amount of cannabis needed to obtain relief from symptoms. I will follow my provider’s guidance, which will likely include starting with a low dose and increasing it gradually in order to avoid unwanted side-effects.

12. I might notice a withdrawal syndrome for two weeks if I stop cannabis abruptly. Trouble getting to sleep and angry outbursts might be a sign that I ought to lower the dose of cannabis gradually before stopping it completely. I should consult with my doctor if I experience such symptoms.

13. I will be mindful that use of medicinal cannabis in public places may place me in jeopardy with the law.

14. Despite the fact that I may be using medicinal cannabis under a doctor’s supervision in a jurisdiction which permits this, my employer may have a different policy about cannabis use and drug testing. It is possible that I may be denied employment or lose my job as a result of an employer’s policies if I use cannabis for medicinal reasons.

Signed: _______________________________________