Pot smoked or used by 12% over a year: StatsCan

About 12 per cent of Canadians age 15 or older said they used marijuana in a year, according to Statistics Canada.

Wednesday's issue of the agency's Health Reports looks at marijuana use in 2012 compared with a decade earlier.

Among those aged 18 to 24, 33 per cent said they'd "used or tried" marijuana in the past year  — the highest prevalence by age group and the group that tended to use it more frequently. About eight per cent of 18- to 24-year-olds said they used marijuana at least once a week and nearly five per cent said they smoked or used daily.  

Marijuana is "one of the most common illicit drugs used in Canada. Significant proportions of the population report having used marijuana in the past year," said report author Michelle Rotermann, a senior researcher with Statistics Canada in Ottawa.

"When you extend it to lifetime, you get 43 per cent of the population."

Rotermann called the literature somewhat mixed on if there are negative health implications of marijuana use.

"Perhaps there are risks associated with marijuana use amongst adolescents and young adults and so were able to produce estimates," for those age groups and older.  

Use in the past year declined by nearly one-third among the youngest Canadians surveyed, 15 to 17, from 28.5 per cent in 2002 to 20.0 per cent in 2012.

In contrast, the figures changed as you got older. Past-year use among those aged 25 to 44 increased from 14 per cent to 15.6 per cent. Likewise for those 45 and older, past-year use increased from 3.0 per cent to 4.7 per cent over the decade.

Overall in 2012, about two per cent of respondents said they smoked or used marijuana daily in the previous year and another three per cent did so weekly.  

In 2012, self-reported marijuana use was highest in Nova Scotia at 16 per cent and British Columbia, 14 per cent, both above the estimates for the rest of Canada. Saskatchewan residents reported lower-than-average use at 10 per cent.

The survey did not include questions about the use of medical marijuana or the age people started using pot or other illicit use.

While self-reported marijuana use may be affected by "social desirability" bias, Rotermann said, the findings are consistent with another national survey conducted by Health Canada, the 2012 Canadian Alcohol and Drug Use Monitoring Survey.

The latest cross-sectional survey data was collected from 25,113 respondents participating in the 2012 Canadian Community Health Survey – Mental Health.

In a statement emailed to CBC News on Wednesday, Health Minister Rona Ambrose said the "evidence is clear" that youth smoking marijuana have an increased risk of developing mental health issues — including psychosis and schizophrenia.

"We will continue to discourage Canadians from smoking marijuana at every step," Ambrose's statement said, citing the Conservative government's national anti-drug campaign.

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Herbal laxative, detox kit recalled over lead levels

A herbal laxative and detox kit are under recall for unacceptably high levels of lead or arsenic.

St. Francis Herb Farm Inc. is voluntarily recalling Buklkax V and All Seasons Detox Kit after the company's product tests showed levels of the heavy metals, Health Canada said Wednesday.

St. Francis Herb Farm Inc. is voluntarily recalling its All Seasons Detox Kit over excessive lead levels. (Health Canada)

Buklkax V is promoted as a herbal laxative for children aged six and older and adults. All Seasons Detox Kit is promoted as a herbal detox kit for use by adults.

"Lead and arsenic are heavy metals and can pose serious health risks when too much is ingested, particularly to children, and pregnant and breastfeeding women," Health Canada said.

Tests started by the Combermere, Ont.-based company showed the herbal laxative had lead at over seven times the acceptable limit and arsenic at double the limit. The detox kit showed lead at over twice the acceptable limit.

Health Canada said ingesting excessive amount of the heavy metals poses serious health risks because the metals may accumulate in our vital organs.

The toxic effects of lead include:

• Abdominal pain.
• Anemia.
• Loss of appetite.
• Constipation.
• Fatigue.
• Sleeplessness.
• Irritability and headache.
• Changes in blood pressure.
• Reproductive effects such as miscarriage.
• Weakness.
• Concentration problems.
• Weight loss.
• Dizziness.
• Kidney and brain damage.

For pregnant women, consuming products with higher arsenic levels may increase risk of pre-term birth, stillbirth and miscarriage. Children and adults who are exposed to arsenic may experience side-effects such as stomach pain, vomiting, diarrhea, muscle cramping, weakness, skin rash, numbness or tingling and loss of movement.

The affected lot numbers and expiry dates are available in Health Canada's advisory. 

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Leafy greens may be linked to E. coli cases across country

Cases in Alberta, Saskatchewan, Ontario and Newfoundland and Labrador under investigation

CBC News Posted: Apr 15, 2015 5:11 PM ET Last Updated: Apr 15, 2015 5:11 PM ET

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(Note: CBC does not endorse and is not responsible for the content of external links.)

Recent cases of E. coli across Canada may be linked to leafy green vegetables, according to the Public Health Agency of Canada. 

The agency said Wednesday it is currently aware of 12 similar cases of E.coli in Alberta, Saskatchewan, Ontario and Newfoundland and Labrador, and that exposure to leafy greens such as lettuce, kale and spinach has emerged as a possible cause. 

No specific product has been identified and the risk to the public is low, the agency said in a statement. 

The Canadian Food Inspection Agency is investigating. 

Canadians are reminded to follow safe food handling practices to reduce the risk of illness, including washing fruits and vegetables before eating them, and cleaning counters, hands and cutting boards. 

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Disneyland-linked measles outbreak close to end

A measles outbreak that began at Disneyland and reignited debate about vaccinations is nearing an end.

The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.

Many who fell ill in the Disneyland outbreak were not immunized or only had one dose of the measles-mumps-rubella vaccine. (Jae C. Hong/Associated Press)

Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. In all, 131 people in California were infected.

The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or only had one dose of the measles-mumps-rubella vaccine.

Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.

The Disneyland outbreak "reminds us that we are part of a global medical community" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.

The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.

Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash.

As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.

Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.

Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.

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Canadian physicians group blames coal power for Edmonton's poor air quality

A group of physicians is cautioning that Edmonton's air quality is worse than that of other larger centres such as Toronto, a fact they blame in part on coal-fired electrical generating plants.

The Canadian Association of Physicians for the Environment has examined a decade's worth of air quality data, which group member Dr. Joe Vipond says show a troubling trend in Edmonton.

Although only about one-fifth the size of greater Toronto in terms of population, Edmonton has significantly higher levels of fine particulate matter in the air, the group's findings suggest.

At a time when most Canadian cities are reducing dependence on coal-fired electrical generation, Edmonton's rose 13 per cent last year, Calgary-based Vipond told CBC news.

"This fine particulate matter has been dropping steadily over the last 10 years in Ontario … as their coal phase-out has occurred," he said ."Overall, the trend is going up (in Edmonton)."

Travel deeply down

A coal-burning power plant in Geisenkirchen, Germany, emits steam and smoke in this file photo from 2009. (Martin Meissner/Associated Press)

The particulates, which are significantly smaller than the diameter of a human hair, are invisible, and can remain suspended in the air for days or weeks.

"When we breathe them in, they can travel deeply down into our respiratory tract and when they deposit and come in contact with tissue, generally they lead to inflammation," said Michael Brauer, a professor in School of Population and Public Health at the University of British Columbia.

Brauer said the particulates have been linked to a number of cardiovascular and respiratory health problems in areas that rely on coal-fired electrical plants around the world, including increased heart attacks, abnormal heart rhythms, heart failure, strokes, lung cancer and emphysema. The substance can also affect fetal health, birth weight and lung development in children.

In December, a report released by Alberta's Environment and Sustainable Resource Development showed two Edmonton regions — Edmonton Central and Edmonton East — exceeded the Canada-wide standards for the amount of fine particulate matter in the air.

Under the Clean Air Strategic Alliance, the province was mandated to notify residents, Dr. Vipond said — however, that report was released at 4:30 p.m. on a Friday with little fanfare.

Coal not only problem, say critics

"I didn't find out about if for 10 days afterwards, and as far as I know there was only one media story ever done about this," he said Tuesday.

After reading the province's report, Dr. Vipond began looking into the air quality numbers himself, first examining the smog alerts issued for Toronto by Air Quality Ontario.

"In 2014, for the first time in over 20 years, they had zero smog days," he said. "That happens to be probably not coincidentally the year that they closed their last coal-fired power plant in April."

Next, the team of physicians looked at air quality data produced by CAPE and Air Quality Ontario comparing Edmonton and Toronto.

"We made some graphs and we noticed that one graph was going up and one graph was going down and about four years ago those lines crossed," Dr. Vipond said.

Coal-fired power

"This is a good news story for Ontario. They can be extremely proud of what they've done for their air quality and pretty safe in how they're feeling walking around in the air — but here in Edmonton, this is a pretty bad news story. We've been neglecting the quality of our air."

Now, Vipond says he'd like to see Alberta begin to lessen its reliance on coal-fired power.

Brauer, however, said it is still too early to make any conclusions from the air quality data collected by CAPE. He also noted the presence of particulates in the air can not be pinned on coal alone.

"A portion of that (Ontario's improving air quality) is likely due to the phase-out of the coal burning, but there are many other factors at play," he said.

Those include improvements made to fuel quality and automobile emissions over the measured time period, he said, which could be responsible for at least some of the decrease seen in Ontario.

And there are factors — including forest fires and weather patterns — that can cause a spike in particulate quantities in Edmonton, he said.

Bob Myrick with the Alberta Environmental Monitoring, Evaluation and Reporting Agency agrees.

Troubling fact remains

"Part of it is automobiles, home heating, the domestic sources — and then the industry sources including the power plants, the refineries east of Edmonton and northeast of Edmonton, they all contribute to the air quality issue that we have," he said.

Regardless of the source, one troubling fact remains.

While most Canadian cities have seen a reduction in airborne particulates over the past decade, Edmonton is a rare exception.

"Basically, it looks like over time we've definitely seen an improvement in air quality in Toronto, and over that same time, air quality in Edmonton has certainly not improved," Brauer said.

"And there's some indication that in recent years it may be getting worse."

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Surgery wait times change little in 5 years

About eight in 10 Canadians received priority surgery such as hip and knee replacements in a timely manner, but large regional variations exist, according to a new five-year report.

Tuesday's report from the Canadian Institute for Health Information focuses on the five priority areas set by first ministers in 2004 using timeframes based on clinical evidence:

• Knee replacement — 182 days.
• Hip replacement — 182 days.
• Hip-fracture repair — 48 hours.
• Cataract surgery — 112 days.
• Radiation therapy — 28 days.

"Since 2010, there has been little change in the proportion of people treated within the benchmarks, with the exception of hip-fracture repairs, which increased from 78 per cent in 2010 to 84 per cent in 2014," the report's authors said.

Despite the increase in the number of procedures from more patients needing surgery, wait times remained consistent.

Nationally last year, knee-replacement surgeries were performed within the clinical benchmark 79 per cent of the time on average, down from 80 per cent in 2010.

About 83 per cent of hip-replacement surgeries were done within the benchmark. The median wait time of 87 days with the second lowest among peer countries in the Organization for Economic Co-operation and Development after the United Kingdom at 82 days.

"We spend a lot of time in Canada focusing on whether we've got the appropriate benchmarks, and is eight of 10 patients at the moment good enough," said Tracy Johnson, manager of emerging issues at CIHI in Toronto.

"I think by looking at the countries, we get the perspective that we're in the ballpark and particularly not doing so badly."

British Columbia and Nova Scotia were worse than the OECD average for waits for hip and knee replacements. 

For hip and knee replacements within each province, new data show "considerable variation" in wait times. Quebec, Ontario and British Columbia all had wide ranges, such as a variation of 54 per cent to 98 per cent for hip replacements between the six networks that serve Toronto and its surrounding areas.

Vancouver Island Health Authority and Vancouver Coastal Health also showed variation. For smaller regional health authorities, Johnson noted many are focused on blitzes to clear queues within benchmarks, which could take a year or two to show improvements.

Johnson said information on regional variations could help guide health systems in their decisions about how to organize care. Options include:

• A central intake model in which all patients queue together with the option of waiting for a specific doctor or the first available surgeon.
• Orthopedic assessment centres where multidisciplinary health-care teams ensure the appropriateness of surgery and the right tests are done to free up surgeons' time.
• Removing waste from the system, such as through a lean model common in Saskatchewan and Newfoundland and Labrador.

Cataract surgery patients received their procedure in a timely fashion 80 per cent of the time, compared with 83 per cent in 2010.

Radiation therapy wait times were consistent with 98 per cent of treatments performed within a month.

Demand for specialized care will increase as the population ages and patients with more complex conditions need medical attention, the report's authors concluded.

The institute is working with the provinces to report and compare intravenous chemotherapy wait times.

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Medical marijuana prescription 'gap' challenged

The ability of people to fill medical marijuana prescriptions directly with a government-approved grower, rather than a pharmacist, creates difficulty for physicians trying to keep tabs on a patient, says the registrar of the College of Physicians and Surgeons of New Brunswick.

Dr. Ed Schollenberg, registrar of the College of Physicians and Surgeons of New Brunswick, opposes the medical marijuana dispensing system, approved by the federal government, which gives patients a direct route to the approved drug suppliers. (CBC)

"We end up with a gap in the information that's available to us if there's a problem," said Dr. Ed Schollenberg. "And more specifically, a gap in the information that might be available to a physician if there might be a problem."

A Fredericton family went public on Monday with questions about medical marijuana prescriptions after Steve Saunders, a 53-year-old businessman, husband and father, committed suicide about one year after receiving a prescription for medical marijuana.

The Saunders family challenges a lack of consultation between prescribing physician Dr. Paul Smith and the Saunders family doctor.

They also question the need for a one-year prescription of up to 10 grams of marijuana a day — enough for about 16 joints, as well as the use of marijuana they maintain had a THC concentration of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)

Schollenberg was not prepared to discuss the specifics of the Saunders case, but in general terms he notes the college has always opposed the dispensing system for medical marijuana, which was approved by the federal government, giving the patients a direct route to the approved drug suppliers.

"Unlike going down to the local pharmacy, which the physician will have a long-standing relationship with, the patient may transmit this prescription in any grower in Canada, who will then mail the supplies to this patient on a monthly basis," said Schollenberg. "The physician may not always know where the patient got that prescription filled."

Schollenberg maintains if a medical marijuana prescription was filled through a local pharmacy a doctor is accustomed to dealing with, there would be a greater chance of the physician intervening.

"There could be an intervention saying, `Before you refill the prescription again for Mr. X, please have him come and see me,'" said Schollenberg. "Physicians can do that now because they know the patient gets their prescriptions fills at Shoppers or Jean Coutu down the street. In this case, they may not know where that prescription is filled."

However, Schollenberg doesn't expect the dispensing protocol to change any time soon.

'Physicians just have to be aware of that and mindful there are yellow signs on this road that say slow down and do things differently.'- Dr. Ed Schollenberg, registrar College of Physicians and Surgeons of New Brunswick

"The reality is that's the way it is," he said. "That's not going to change because any changes will have to be done by the federal government, they will be glacial at best.

"Physicians just have to be aware of that and mindful there are yellow signs on this road that say, Slow down and do things differently because you don't have the same controls you might have for actually much more dangerous drugs, like some of the narcotics and some of the sedatives physicians prescribe for patients,'" said Schollenberg.

"Right now, if a pharmacist has any reason to question something about a prescription, they contact the physician and they pass the information along," he said. "We have no idea whether the commercial growers will feel the same obligation, whether they'll even be aware of issues.

"They will be dealing very much at arm's length. It won't be somebody walking into their store to physically pick the stuff up. Everything will be done at a long distance and it's really unclear whether they will be that interested in intervening."

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Brain aging: 5 ways to stay sharp

Keep physically, socially and intellectually active, the Institute of Medicine's brain aging committee chair says. (Eric Risberg/Associated Press)

Those lost car keys that were an annoyance in your 30s can spark major anxiety in your 60s. Turns out it's pretty normal: The brain ages just like the rest of your body, says a new report that urges Americans to take steps to keep sharp in their senior years.

The prestigious U.S. Institute of Medicine examined what scientists know about "cognitive aging," changes in mental functioning as we get older.

This isn't a disease like Alzheimer's but a natural process — and it's not always bad. Wisdom can indeed increase with age, and years of experience can prove invaluable, stressed Dr. Dan Blazer, an emeritus professor of psychiatry at Duke University who chaired the IOM committee.

"The brain ages in all of us. But there's wide variability in the way the brain ages," Blazer said.

Staying cognitively sharp is one of the biggest concerns of seniors, with good reason. Tuesday's report warns that even subtle slowdowns can affect daily life, making seniors more vulnerable to financial scams, driving problems or other difficulties in a technology-driven world.

Indeed, while some people will experience little if any cognitive change, many older adults process information more slowly, and have more difficulty multitasking than when they were younger, the report found. What's called working memory — the brain's short-term storage — often declines with age but typically long-term memory remains intact even if it takes longer to recall someone's name.

That kind of change may not be obvious until, say, someone is faced with a complex financial decision or forced to make a transaction quickly and has trouble, Blazer said. Older adults are losing nearly $3 billion US a year, directly and indirectly, to financial fraud, the report noted.

What's the difference between normal aging and cognitive decline?

"There's no clear line that we can draw here," Blazer cautioned.

Someone experiencing memory difficulty needs to be checked by a doctor, said IOM panelist Dr. Jason Karlawish of the University of Pennsylvania. With Alzheimer's, nerve cells in the brain die. With normal cognitive aging, neurons don't die — they just don't work as well, he explained.

The best advice for staying sharp as you get older: Be physically active. The sooner you start the better, but it's never too late, Blazer said.

The IOM also recommended:

• Control high blood pressure and diabetes, and don't smoke. Those are key risks for heart disease, and what's bad for your heart is bad for your brain.
• Some medications commonly taken by seniors — including certain anxiety or sleep drugs, antihistamines, bladder drugs and older antidepressants — can fog the brain, so ask about yours.
• Keep socially and intellectually active.
• Get enough sleep.
• Be careful of products that claim to improve cognitive functioning. There's no evidence that vitamins and dietary supplements like ginkgo biloba help, Blazer said. And the jury's still out on whether computer-based brain-training games do any good, he said.

The IOM also urged more research into normal cognitive aging, which has been left somewhat behind the study of diseases like Alzheimer's, and more education of doctors about their patients' risks. For example, hospitalized seniors are at increased risk for delirium — sudden confusion and agitation — that can cause lingering cognitive decline after they go home, but there are ways to prevent it.

The IOM also said government agencies and communities should consider cognitive aging as they set policies and programs. It cited a California law to protect older adults who are signing up for reverse mortgages, and a Michigan plan to improve older driver safety through such steps as adjusting traffic lights to counter glare.

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German mother of 13 pregnant with quadruplets at age 65

Any pregnancy of a woman over age 45 has to be considered a high-risk pregnancy, a German obstetrician says. (Dragan Grkic/Shutterstock)

A 65-year-old German mother of 13 is getting ready to give birth again — this time to quadruplets.
 
Annegret Raunigk, a Berlin schoolteacher who is due soon to retire, is expected to give birth to the four babies within the next two months, Bild newspaper and RTL television reported.

She already has children ranging in age from 9 to 44, from five fathers. Raunigk said she decided to become pregnant again because her 9-year-old daughter wanted a younger sibling.
 
Her decision was met with widespread criticism by medical professionals as a risk both to her and the unborn babies.
 
"Any pregnancy of a woman over age 45 has to be considered a high-risk pregnancy; over 60 this is naturally extreme," Dr. Holger Stepan, head of obstetrics at the University of Leipzig, told the dpa news agency.
 
"The 65-year-old body is definitely not designed to carry a pregnancy, not of one child and certainly not of quadruplets," he said.
 
Raunigk told Bild that donated eggs were fertilized and implanted at a clinic outside Germany, which was successful only after multiple attempts.
 
She defended her decision: "How does one have to behave at 65?"
 
"They can see it how they want to," she said, "and I'll see it the way I think is right."

The Canadian Fertility and Andrology Society represents fertility doctors. The society does not have an age limit in its guidelines for IVF, but individual clinics often do.

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Medical marijuana prescription challenged by dead man's family

A New Brunswick family has some tough questions over the prescribing and use of medical marijuana. They believe it may have played a part in the death of a husband and father.

Steve Saunders of Fredericton was prescribed medical marijuana to help him cope with an old shoulder injury and they claim that under its influence he became manic.

He lost control of his life, drove away family and friends, emptied his savings and eventually killed himself.

In March 2014, Saunders was given a one-year prescription for 10 grams a day of medical marijuana, enough for about 16 joints. He started taking the marijuana the following month.

According to his family, it was premium pot with high THC content of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)

'Manic is what he eventually became.'- Jake Saunders

Within four months, Saunders's family says he had become manic. He slept little, hardly ate and was spending a lot of money.

"Manic is what he eventually became," said his son Jake Saunders.

"He went out and he bought a Harley-Davidson. He bought at Porsche. He bought a hotel in Nackawic.

"The spending was just non-stop. Eventually, mother had to freeze the accounts because by that time, everybody knew there was something wrong."

Recreational pot user

Saunders, 54, was as entrepreneur and businessman who ran a bed and breakfast with his wife of 33 years, Kathy, in a Victorian-era home on University Avenue. He was just beginning a new career as a real estate agent.

Saunders's family says he had been a recreational user of marijuana for years, but was always concerned about getting caught on the wrong side of the law.

Saunders and his wife Kathy operated the Carriage House Inn bed and breakfast on University Avenue. (Mynewbrunswick.ca)

"The same way I'd drink a beer on weekends, he treated pot the same way," said Jake Saunders.

Saunders had some residual pain from a shoulder operation he'd had and was being treated for some anxiety he suffered following the deaths of his parents a few years ago.

His family doctor discouraged medicinal marijuana use because of Saunders's background, which included a previous brush with alcohol addiction and anxiety. 

She didn't think it was a good idea and warned Saunders against it.

When Saunders got the prescription from another doctor, Dr. Paul Smith, he sent for a supply of medical marijuana and started using it in April 2014.

"We were all a little shocked when he got the prescription so quick because we thought it was going to be a bit of a process," said Jake Saunders.

'I could tell that he was smoking too much, especially with the strong stuff. You don't need that much.'- Luke Saunders

Luke Saunders said his father lost control of his pot smoking soon after receiving the first two ounces in the mail.

"Smoking joint after joint, three in a row first thing in the morning before anyone is out of bed," said Luke Saunders.

"I could tell that he was smoking too much, especially with the strong stuff. You don't need that much."

Family attempts intervention

Last fall, Saunders's family tried to intervene, setting up appointments with their family doctor and the province's addictions services program.

The family also filed a formal complaint with the New Brunswick College of Physicians And Surgeons against Smith.

Saunders, right, committed suicide in March 2015. (Submitted by Saunders family)

They were upset because they allege the prescribing doctor didn't consult with Saunders's family physician.

Smith told CBC News that Saunders was referred to him by another doctor Saunders had consulted, and not by his family physician.

The family is also upset Smith wrote a year-long prescription without any follow up.

"There's very clear guidelines on how to prescribe medical marijuana and this guy, the doctor did not follow them," said Jake Saunders.

"There was no consultation with our family doctor."

He said his father had been told for so long from his family doctor that he was not a candidate for medical marijuana, so there should have been more follow up after he received the prescription.

"When you prescribe something like this, you can't just give somebody 10 grams a day and go away and just think that everything is going to be fine," he said.

Smith says patients are briefed and coached on the use of medicinal marijuana, but, as with any drug, it's up to the patient to use it correctly.

Smith describes the 10 grams a day as "a ceiling dose," or the maximum amount that can be taken a day and not a prescription to use that amount every day.

Last fall, Saunders was stopped by the RCMP in Cape Breton, N.S., with a quantity of non-medicinal marijuana in his car.

Saunders's behaviour was so alarming he was admitted to the psychiatric unit in Sydney on an involuntary admission and transferred to the Dr. Everett Chalmers Hospital in Fredericton and eventually discharged.

By November 2014, with the help of his wife and family doctor, Saunders had stopped smoking marijuana.

But in January, Saunders received a summons from RCMP in Cape Breton and was informed he'd be charged with possession of marijuana for the purpose of trafficking.

Saunders's condition and behaviour appeared to be improving, but his wife says he was sad.

On March 5, Saunders was found dead in the family home. He had taken his own life.

College responds to complaint

Three weeks after Saunders's death, the College of Physicians and Surgeons responded to the family's complaint about Smith.

Both Smith and the college's complaints committee suggest an undiagnosed condition of bipolar disorder may have been an aggravating factor in Saunders's case. Other drugs that Saunders was prescribed for anxiety may also have played a part.

Smith also says Saunders appeared to be mixing the medicinal marijuana with his own supply.

"The guy was a rare circumstance," states Smith, who also said, "our program was lacking, we have acknowledged that."

The College of Physicians and Surgeons has recommended a number of changes as a result of the complaint:

• The prescribing physician now require that patients for medical marijuana have a witness to accompany the patient to ensure unexpected reactions are reported back to the doctor.
• More vigorous follow up of patients be carried out.
• In the future, most patients be given prescriptions of shorter duration so they have to come back to the doctor for renewals and assessments.
• The above recommendations be made known to all doctors through the college's next newsletter.

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