Minimizing Harm for Medical Cannabis

Patient Safety
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Cannabis in the shape of a medical cross

After a spate of harmful errors come to light, ISMP encourages practices to minimize harm

After becoming aware of the occurrence of harmful errors related to cannabis, the Institute for Safe Medication Practices Canada (ISMP) is recommending health care professionals adopt practices to minimize harm for those patients who use medical cannabis.

In a recent newsletter, ISMP stated Canada’s consumer reporting program, SafeMedicationUse.ca, received reports about errors related to the accidental selection of the wrong cannabis product online, delivery of an incorrect cannabis product and use of the wrong product at home. Potential harms include serious interactions with other medications, or unanticipated adverse health effects.

ISMP is suggesting health care professionals follow its tips in an effort to minimize injury to their patients. The tips, which align with the guidance provided in CPSO’s Cannabis for Medical Purposes policy, include:

Discuss the following topics during consultation with patients about use of cannabis for medical purposes. It may be helpful to capture some of this information on the patient’s medical authorization document to help in the selection of products:

Route of administration (e.g., oral, inhalation, topical);
Form (e.g., ingestible extract [oil, capsules or spray], dried, edible, topical);
Strength (i.e., amount of the cannabinoids delta-9-tetrahydrocannabinol [THC] and cannabidiol [CBD] in the product);
Dose (i.e., amount of the product to take each time; titration instructions, if any);
Frequency of use (e.g., daily), including timing of administration; and/or
Special instructions or precautions, as appropriate, to optimize the safe use of cannabis (e.g., information about the use of cannabis by patients with certain medical conditions and other precautions or risks; use of cannabis concurrently with other medications; monitoring of certain parameters and other information for vulnerable subpopulations who may need additional instructions for use [e.g., children, elderly]).

Develop a monitoring plan, in collaboration with the patient and/or their caregivers.

Report adverse reactions and cannabis errors to improve the safe use of cannabis for medical purposes:

Suspected adverse reactions to Health Canada’s Canada Vigilance Program.
Medication Incidents to the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

For more information, please refer to the College’s policy, Cannabis for Medical Purposes.