A survey of Canadian doctors conducted in 2009 by Mark Ware identified the major barriers doctors considered in regard to prescribing cannabinoids and Cannabis. The highest observed concern was the potential for patients to abuse their prescription. While this concern is valid on a case-by-case basis, the instance of abuse of any prescription is on the rise in Canada. In the most extreme case, deaths due to opioid use doubled between 1991 and 2004 according to the Canadian Centre on Substance Abuse. Although this argument does not directly involve the use of Cannabis, the growing trend of prescription abuse is of great concern.
With this in mind, and the need to provide adequate care and treatment for patients, it is important to understand all of the potential safety issues that may arise from prescribing a narcotic controlled under Canada’s Narcotics Control Regulations. This topic has been examined by medical doctors and academic researchers who have observed that like any other pharmaceutical, Cannabis has the potential to be an addictive substance. However, this observation must be made with the actual incidence of addiction between more common addictive substances in sight. A study in 2005 by Gourlay et al. from the Mount Sinai Hospital in Toronto quantified the relative potential of a patient, with no previous substance dependence, to develop a dependence on various substances. The potential to develop a dependence on Cannabis was valued at 9%; the lowest value when compared to tobacco (32%), heroin (23%), cocaine (17%), and alcohol (15%).
Ultimately, the best practice for avoiding addiction or abuse of a medical Cannabis prescription is the same as with any other high risk prescription: provide adequate screening of patients to determine their potential for abuse or addiction. In addition to adequate screening, talking to patients about low THC strains for their particular condition could also help alleviate some of the concerns regarding addiction.