Exciting Developments in Medical Cannabis Movement - Tanya Blasbalg
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. The Need for Cannabinoid Education
MeSH search term: (Cannab*) AND (“xxxx/1/1” : ”xxxx/12/31"[Date - Publication])
Slide courtesy of Dr. Mark Ware
3. The Need for Cannabinoid Education
USMLE Exam Prep Questions
What cannabinoid produces most of the effects of Delta-9-tetrahydrocannabinol
smoking marijuana?
What type of receptor is associated with the 2 G protein-linked receptors
cannabinoid receptor subtypes (CB1 and CB2)?
- Inhibition of adenylyl cyclase opens potassium
channels and closes calcium channels
CB1 receptor location Brain
- Mediate the psychological effects of THC
CB2 receptor location Immune cells
Name the 2 cannabinoid ligands. Anandamide
2-arachidonylglycerol
Marijuana adverse effects (3/4) Increased heart rate
Decreased blood pressure
Reddening of the conjunctiva
Toxic psychosis at high doses
Dronabinol (Marinol) uses (2) Anorexia associated with weight loss in patients
with AIDS
Nausea and vomiting associated with cancer
chemotherapy (second line)
4. Knowledge Transfer:
How HCPs Keep Up With Science
A Perfect World
Self Study Academia Patients
HCP = Health Care Practitioner, ie physicians, nurses, physicians assistants, etc
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. HCP Resources for Cannabinoid
Education
Slide courtesy of Dr. Jeffrey Hergenrather
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
Mission
To promote evidence‐based education concerning the
endocannabinoid system and therapeutic applications of
cannabinoid agents to clinical audiences
8. CCIC: Providing Accredited
Cannabinoid 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.
10. The Value of CME
• Accreditation
• Funding firewall
• Unbiased
• Evidence driven
• Clinically relevant to HCPs
11. CCIC: Representing the Diverse
Field 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
13. 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
14. 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 Association
American 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.
15. 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…
16. The Canadian Consortium for the
Investigation of Cannabinoids
www.ccic.net
Tanya Blasbalg
US Medical Education Liaison
tanya@ccic.net
Hinweis der Redaktion
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.