OTTAWA - Health Canada has been contacting doctors who prescribe medical marijuana for their government-approved patients, advising them to keep the dosages low.
Some users say that not only violates doctor-patient confidentiality, it's also wrong for bureaucrats to make judgments about the medical needs of people they've never seen.
"A person's medication should be between him and his doctor,'' said Tony Adams, 60, a medical marijuana user in Victoria.
"There shouldn't be some bureaucrat in Ottawa that's never met me. Everybody has different needs for medications.''
Adams, a licenced user who's been smoking seven grams of marijuana daily, recently applied to Health Canada to increase the dose to 10 grams, with his doctor's authorization. Official approval from Ottawa is needed so that Adam can legally grow the appropriate number of marijuana plants, set by Health Canada at five plants for each daily gram.
But a program official in Ottawa challenged Adams' doctor in a telephone call, saying most patients need no more than five grams. Adams, who has severe arthritis and degenerative disc disease, later received a new licence for just five grams a day.
"I'm just really pissed off about the whole situation. ... I need to get to the bottom of this.''
Similarly, Alison Myrden in Burlington, Ont., says her doctor was challenged by Health Canada bureaucrats about her 20- to 28-gram daily dose.
"They asked to lower it more than once, and my doctor and I both refused,'' said Myrden, 43, who uses marijuana for multiple sclerosis and another painful condition. Her message to Health Canada: "Back off -- leave our doctors alone.''
The department's recent campaign to keep doses to five grams or less includes postings on its website referring to external surveys and studies indicating most medical users need only one to three grams daily, "whether it is taken orally, or inhaled or a combination of both.''
Another posting indicates more than 85 per cent of Canada's licenced users take five grams or less each day.
And a fact sheet mailed to doctors warns that "an elevated daily dosage of more than five grams may increase risks with respect to the effect on cardiovascular, pulmonary and immune systems and psychomotor performance, as well as potential drug dependency.''
Health Canada also sent a letter recently to the Canadian Medical Association advising doctors about appropriate daily amounts.
A spokesman for the department said dosage decisions are always left to doctors.
"Occasionally, Health Canada contacts physicians to verify or clarify some of the information provided in the application,'' Renee Bergeron said.
"As part of this discussion, Health Canada provides the opportunity for medical practitioners to obtain more information about the program, including information available on the website with regards to daily amount.''
Recent efforts to restrict dosage levels may be related to concerns about criminal activity. Last fall, for example, the department received a letter of complaint from someone in Agriculture Minister Chuck Strahl's riding of Chilliwack-Fraser Canyon, B.C.
"The constituent expresses his concern that an individual in his neighbourhood is cultivating a large number of marijuana plants for medical purposes, thereby potentially endangering his family and the neighbourhood in general,'' says Nov. 20 memo to Health Minister Tony Clement, obtained under the Access to Information Act.
The memo describes the department's efforts to reduce dosages, and says "the initial reaction from physicians ... has been positive and it may indirectly have an impact on the number of marijuana plants produced.''
The department is also hiring eight compliance officers across the country to monitor licensed users and growers, the document indicates. Bergeron says five have already been hired, and the rest -- for Ontario and Alberta -- will be hired shortly. The officers have the authority to make site visits and alert police to problems.
As of last month, 1,774 patients were licensed to use medical marijuana, about a thousand of whom grow it themselves. Another 166 have someone else grow it for them under licence, and 538 are approved to order government-certified marijuana grown in Flin Flon, Man., by a firm under contract with the department.
Health Canada, which has been compelled by the courts to develop its medical marijuana program, has said that sometime after 2007 it plans to require all users to order government dope -- perhaps through pharmacies -- rather than be allowed to grow it themselves.
