Exciting Developments in Medical Cannabis Movement - Tanya Blasbalg


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  • This is an issue you’ve been hearing about during the conference. I’m here to discuss a solution
  • 2036 Cannabinoid science is lagging behind other medical sciences Lipid chemistry took longer to develop than hydrochemistry The endocannabinoid system is harder to study than other physiological systems
  • USMLE 1/3 of HCPs live in states with medical marijuana laws. Arguably, none of them learned how to administer cannabis in medical school http://quizlet.com/12565059/psychiatry-pharmacology-usmle-flash-cards/
  • We’d like to think that this is how all our HCPs learn everything
  • But this is the truth of it Mainstream, speak their language, my role and expertise Accreditation Requirements for CME Providers Requirements for Recognized Accreditors Enduring Materials: Definition and Requirements Because there is no direct interaction between the provider and/or faculty and the learner, the provider must communicate the following information to participants so that they are aware of this information prior to starting the educational activity Principal faculty and their credentials; Medium or combination of media used; Method of physician participation in the learning process; Estimated time to complete the educational activity (same as number of designated credit hours); Dates of original release and most recent review or update; and Termination date (date after which enduring material is no longer certified for credit). Providers that produce enduring materials must review each enduring material at least once every three years or more frequently if indicated by new scientific developments. So, while providers can review and re-release an enduring material every three years (or more frequently), the enduring material cannot be offered as an accredited activity for more than three years without some review on the part of the provider to ensure that the content is still up-to-date and accurate. That review date must be included on the enduring material, along with the original release date and a termination date. Sometimes providers will create an enduring material from a live CME activity. When this occurs, ACCME considers the provider to have created two separate activities – one live activity and one enduring material activity. Both activities must comply with all ACCME requirements, and the enduring material activity must comply additionally with all ACCME policies that relate specifically to enduring materials.   ACCME Note:  This policy describes ACCME requirements with regard to the ACCME-defined activity type, enduring materials. The ACCME defines enduring materials as CME activities that are printed, recorded, or accessible online and do not have a specific time or location designated for participation.  Rather, the participant determines where and when to complete the activity. Examples: online interactive educational module, recorded presentation, podcast.
  • Local resources developing in different areas
  • DOH, exec director of medical society 35 cannabis-niaive physicians
  • Accreditation = motivation
  • State governments ar our natural partners
  • Nice thing about HCPs is they are often open to sound, rational perspectives supported by data. I’ve come out of the closet What I have been finding is that HCPs sometimes think they have an informed opinion, and those opinions keep them from getting in the door to hear the evidence Smoked cannabis causes lung disease and cancer Euphoria is an adverse side effect
  • Despite all the data, at the end of the day every physician must rely on their own clinical judgment for their treatment decision. That judgment is formed by weighing not only the scientific evidence, but also personal clinical experience and guidance from colleagues. For some reason, to many physicians the art of medicine doesn’t apply when in comes to cannabis.
  • When pharma has a problem, you better believe we put our heads together and come up with unique, creative solutions, and lots of them. There is no reason we can’t do the same for cannabis.
  • Exciting Developments in Medical Cannabis Movement - Tanya Blasbalg

    1. 1. Exciting Developments in the Medical Cannabis Movement:Continuing Medical Education Tanya Blasbalg, M.S. US Medical Education Liaison Canadian Consortium for the Investigation of Cannabinoids
    2. 2. The Need for Cannabinoid EducationMeSH search term: (Cannab*) AND (“xxxx/1/1” : ”xxxx/12/31"[Date - Publication])Slide courtesy of Dr. Mark Ware
    3. 3. The Need for Cannabinoid Education USMLE Exam Prep QuestionsWhat cannabinoid produces most of the effects of Delta-9-tetrahydrocannabinolsmoking marijuana?What type of receptor is associated with the 2 G protein-linked receptorscannabinoid receptor subtypes (CB1 and CB2)? - Inhibition of adenylyl cyclase opens potassium channels and closes calcium channelsCB1 receptor location Brain - Mediate the psychological effects of THCCB2 receptor location Immune cellsName the 2 cannabinoid ligands. Anandamide 2-arachidonylglycerolMarijuana adverse effects (3/4) Increased heart rate Decreased blood pressure Reddening of the conjunctiva Toxic psychosis at high dosesDronabinol (Marinol) uses (2) Anorexia associated with weight loss in patients with AIDS Nausea and vomiting associated with cancer chemotherapy (second line)
    4. 4. Knowledge Transfer:How HCPs Keep Up With Science A Perfect World Self Study Academia PatientsHCP = Health Care Practitioner, ie physicians, nurses, physicians assistants, etc
    5. 5. Knowledge Transfer: How HCPs Keep Up With Science The Real World: Pharma Sponsorship Medical Continuing Promotional Communications Medical•• Drug Representatives Journal Ads • • Peer-to-peer programs Dinner meetings Education• Conference booths • Publications • Conferences• E-detailers • Newsletters • Symposia• Direct mail • Monographs • Enduring materials• Brand websites • Advisory boards • Online programming HCP = Health Care Practitioner, ie physicians, nurses, physicians assistants, etc
    6. 6. HCP Resources for CannabinoidEducationSlide courtesy of Dr. Jeffrey Hergenrather
    7. 7. CCIC: Bringing Credibility to Cannabinoid Medicine • Non-profit organization, formed in 2000 as an interdisciplinary research consortium • >200 members, primarily clinicians and scientists • Registered in Canada; global reach & membership MissionTo promote evidence‐based education concerning theendocannabinoid system and therapeutic applications ofcannabinoid agents to clinical audiences
    8. 8. CCIC: Providing AccreditedCannabinoid Education to Clinicians• >50 live CME programs – Dinner meetings, workshops, clinical symposia in Canada, Europe, and the US• Reached nearly 2000 health care practitioners• Feedback overwhelmingly positive
    9. 9. The Value of CME• Accreditation• Funding firewall• Unbiased• Evidence driven• Clinically relevant to HCPs
    10. 10. CCIC: Representing the DiverseField of Cannabinoid Therapeutics Expert Faculty• Multidisciplinary board of in the fields of: directors – physicians and Oncology scientists Pain management• Collaborations with HIV/AIDS professional societies and Neurology academic institutions Multiple Sclerosis• Management staff with Pulmonology experience in medicine, Psychology science, business, and Pharmacology education Family Medicine Anesthesiology
    11. 11. Challenge: Funding• No multi-billion dollar pharma company• State governments are broke
    12. 12. Challenge: Getting HCPs in the Room HCP Objections• There is no data• Cannabis must be smoked – “I would never tell my patient to smoke something”• Cannabis = THC – “They can just take Marinol”• Cannabis gets you high• I have no intention to recommend, therefore this doesn’t affect me• I can get arrested for recommending cannabis
    13. 13. Challenge: The Art & Science of Medicine • The folly of evidence-based medicine Effective patient care requires the free and unfettered exchange of information on treatment alternatives… - American Medical AssociationAmerican Medical Association. AMA Policy: Medical Marijuana. Report 10 of the Council on Scientific Affairs.Available at http://medicalmarijuana.procon.org/sourcefiles/AMA09policy.pdf. Accessed 23 Feb 2013.
    14. 14. Limitless Opportunities• Live meetings (half day, full day)• Online CME• Grand rounds presentations (hospitals)• Medical school cannabinoid curriculum• Patient education materials• Risk evaluation and mitigation strategies• And on…and on…and on…
    15. 15. The Canadian Consortium for the Investigation of Cannabinoids www.ccic.net Tanya Blasbalg US Medical Education Liaison tanya@ccic.net