Seeing that welcoming face first when patients come into the clinic will set the tone for their entire visit.   

Helping is the true nature of an MOA, this could not be truer at a medical cannabis clinic that conducts studies. The research component of our clinic requires special attention to detail in the tasks at hand and providing further assistance to patients and their caregivers. Being a medical cannabis advocate for our research but also for patient access becomes second nature to a Santé Cannabis MOA.   

We asked our team of medical office assistants to share with us their feelings and experiences of working at Santé Cannabis. Let’s look at their work diary:  

“My story at Santé Cannabis began as a patient and over time I was able to manage my illness to a point I could maintain employment. I wanted to give back to a community that gave me so much. Each patient I met needed their own individual support and I felt as if I could be this person to provide that for them.  

We are the first intervention if a patient is overwhelmed with emotions. I remember a past encounter with a patient that left a powerful impression when she told me ‘Today you saved a life, I hope you realize this. I cannot thank you enough for talking me off the ledge today. You are an amazing human being.’ 

We are the first voice of reason when a patient calls because they have lost hope in our medical system. As an MOA, we have a vital role to play in a patient’s care from the moment the clinic receives their referral.   

Not many people realize that the MOA is the glue that holds the clinic together.    

Being an MOA for the last 4 years has brought me so much joy and fulfillment, I am beyond grateful for the opportunity Santé Cannabis gave me.”  

– Rebecca Fogel, MOA 

“Seeing our patients satisfied and confident when leaving the clinic with new information and the ability to pass this information on to others that may be suffering is probably the best part of my job. 

I recently received a phone call from a patient, and the amount of joy, relief, and gratefulness that was coming through the phone was truly inspiring. They felt their treatment had helped them so much and they wanted to express the difference it made in their life. It was what I was here for; to hear that it helped someone to that extent was absolutely rewarding.  

Seeing what our patients have gone through has really opened my heart with much more compassion. The best part is that when the treatment really works for them. This gives me more motivation to push and reach my goals and help the people that need access to medical cannabis.”   

–Tamara, MOA 

“Working at a clinic whose goals are to improve access, educate, and treat patients, and taking part in those projects makes me feel like my time and efforts are worthwhile when compared to previous jobs. It has been eye opening to see the extent that patients must go to be able to acquire medical cannabis. The regulations, laws and policies put forth by our government when it comes to prescribing medical cannabis can really make it hard for patients to get the care they need. It’s not easy, and it needs to be improved.  

There is one anecdote that marked me was when booking an initial appointment for a palliative cancer patient. The patient told me they were about to undergo immunotherapy. Studies have shown immunotherapy treatment is not as effective when taking cannabis: medically or recreationally. In that moment, it hit me how important it is to educate people about the effects cannabis has on the body. Previously unaware of the risks, this patient could have gone to the SQDC and put their health and cancer treatment at risk.”  

– Shant, MOA and Research Assistant 

“I came to Santé Cannabis for a new beginning. My family doctor and I had a conversation about a new clinic that was opening neighboring his practice, and so I applied without hesitation. I knew nothing about cannabis. Since I was a little girl, I have always been there for others. I like to feel useful and no matter how small the help I can provide, I can still make a difference in people’s lives.  

In the early days working during Dr. Watier’s clinic, I asked him to follow a patient with autism, which he accepted. I’m impressed to see how much this young man’s life has changed with his cannabis treatment as well as the life of his parents. He is still a patient with us today.”  

– Manon, MOA 

“I take pleasure and pride in being the first line of contact for people who request our services. Being the first person who ensures each individual feels acknowledged and attended to with the utmost dignity, empathy and compassion is a responsibility that is integral to this position and that I greatly value.  In my work, a moment that always grounds me is the shared conversations with patients during phone calls. Their openness to be vulnerable and to discuss their personal struggles, their view on life and contemplation about the afterlife are always subjects of reflection and empathy that make me appreciate those moments.”

– Jessica, MOA 

“Santé Cannabis allows me to use my skills and experience to contribute to a worthy cause. I am also lucky to work among an incredible team of professionals in a field that’s always striving for improvement and building a standard for patient care, research, and education.  

One of my fondest memories, since I work here; was amid the pandemic; we had all been working from home for months – a difficult time for many – and we were preparing for our virtual Christmas party. I was helping organize our staff events and had to come into the office (a rarity at the time) to assemble care packages that were to be sent out to all the employees. Besides the fact that the packages were particularly generous, it was great to feel part of an organization that truly operated like a family caring for its members during tough times.”  

– David, Clinic Coordinator 

We also asked one of our founders and the manager of our nursing team to write a few words about our team of MOAs whom they work closely with and rely on to complete a successful clinic day. 

“I’m happy to recognize the work that our medical office assistants do on a daily basis.  You should be proud of what you do every day!  

 You are the first contact with the patient. You are there to assist them, to guide them through their journey, to ease their concerns, to respond to their needs. It is because of you that we can provide services to patients.  With your empathy, your kindness, and your listening, you contribute to improve their experience in the process of relieving their symptoms.   

You help both the patients and your colleagues during the course of care.  

It is not uncommon for me to hear patients say, ‘The staff is very welcoming’, ‘I felt taken care of as soon as I arrived’, ‘I had a lot of help from the medical office assistants while filling out the questionnaires’.  

The nurses are proud to work with you.”

 – Naomie Parrot, Nurse Manager 

“This initiative to recognize our team of MOAs is invaluable to building community.   

We are an organization that embraces all the workers as important contributors to the success of its operation. This is at all levels of our mandate: clinical, research, education, and advocacy.  

Our powerfully talented group of MOAs are contributing through their commitment to our vision of relieving the suffering of patients with chronic pain and other diseases that medical cannabis can treat.  

This positive interdependence is appreciated by everyone involved and leads to greater job satisfaction and dedication.  

We all need each other to get the job done.  

I am so grateful to have our MOA team, and to be able to rely on them for the smooth and efficient work that we achieve. ”  

 - Dr.Michael. A. Dworkind, Medical Director and Co-Founder.  

Whether their motivation is to educate, advocate or spread awareness on the importance of medical cannabis treatments and access, we know the empathy of our MOAs help build the patient’s trust. This trust is often the beginning to a long-term relationship. 

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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It would be difficult to deny the impact of the COVID-19 pandemic on anxiety and anxiety disorders in the population. Whether there are new anxiety symptoms or an exacerbation of existing ones, most of us know people who have been affected, if not ourselves. 

Reasons for increased anxiety in 2020/2021? 

Social isolation, monetary stress, sudden major changes, uncertainty about the future, sensation of losing control, fear of illness, etc. Some people have been in extremely close contact with COVID-19: people who have been infected, people who have lost loved ones or who have feared losing them, essential workers and, of course, healthcare professionals in many areas.

According to a  survey by Statistics Canada and the Public Health Agency of Canada conducted between September and December 2020 and published in March 2021, 7 out of 10 Canadians have been negatively affected by the pandemic and 2 out of 5 have experienced distress related to it. 

A survey was also conducted by the University of Sherbrooke on the psychosocial impacts of the pandemic: 

“What we see today is that levels of depression and anxiety in Quebec are currently considerably higher than what was observed pre-pandemic. These numbers are similar to the levels observed in the community of Fort McMurray, 6 months after the 2016 forest fires” (Dr Mélissa Généreux, septembre 2020 – Link available in french)

WHAT IS ANXIETY?

Anxiety is an emotion characterized by feelings of tension, worry and physical changes such as increased blood pressure.

Although this emotion can be useful to us, it sometimes takes on magnitudes that have a negative impact on our ability to function, our quality of life and on our interpersonal relationships. It can even have a significant impact on our long-term health. The effects that anxiety and anxiety disorders can have on a person are real, undeniable and deserve our attention.

According to Anxiety Canada, there are 11 categories of anxiety disorders in adults: Agoraphobia, Separation Anxiety, Health Anxiety, Body-Centred Repetitive Behaviours, Specific Phobia, Generalized Anxiety Disorder, Compulsive Hoarding Disorder, Social Anxiety Disorder, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder and Panic Disorder.

In addition to considering the impact of anxiety on a person, specialists also evaluate 4 broad categories of symptoms and their frequency: 

• Physical responses
• Thoughts
• Emotions
• Behaviors

If you think you may be suffering from anxiety, an anxiety disorder or any other psychological condition, it is important to talk to your doctor. You can also refer to several resources such as those offered by the Government of Canada on their website.

TREATMENTS AVAILABLE AT THIS TIME

• Pharmaceutical Treatments: The main pharmaceutical treatments for anxiety are usually antidepressants. Benzodiazepines may also be prescribed for acute symptoms and/or until the therapeutic effects of the antidepressant are achieved, as antidepressants can take several weeks to have an impact on mood-related symptoms.
• Psychotherapy: Several approaches in psychology are recommended for the management of anxiety, such as cognitive-behavioral therapy and psychodynamic therapy, and can be of great help. 
• Exercise: Experts agree that exercise has great benefits on anxiety. This is because physical activity activates the production of neurotransmitters in the brain. These neurotransmitters include those targeted by many antidepressants such as serotonin, which helps combat anxiety.
• Mindfulness techniques: Often associated with meditation, mindfulness is an approach, an attitude as well as a set of techniques including meditation. Many of these techniques can also be practiced in everyday life, for example, while eating, walking or exercising. These techniques allow you to better understand and identify what triggers anxiety. They allow you to take a step back from these stressors and make it easier to manage them. Moreover, as this approach can be very beneficial both mentally and physically, we have recently partnered with MindSpace to offer opportunities for our patients to practice mindfulness techniques. If you are interested, you can join the mindfulness-based stress reduction program this coming fall. Our patients are eligible to 20% off. You can ask our clinic staff for the promo code!
• Cannabinoids: The endocannabinoid system present in our body also plays a role in the mechanisms related to anxiety. This is why they are also used as an adjunctive therapy for anxiety symptoms.

A treatment that combines several options (e.g., pharmaceutical treatment and psychological therapy) is far more effective than each treatment option alone.

CANNABINOID-BASED TREATMENTS FOR ANXIETY

The human body has an endocannabinoid system that manages many functions, including emotional behavior. This system includes cannabinoids and enzymes produced by this system that bind to various receptors. Cannabis is a plant that includes more than 100 cannabinoids, the main ones being cannabidiol (CBD) and delta-9 tetrahydrocannabinol (THC). We also know that CBD interacts with many receptors/anxiety targets. Indeed, strong preclinical evidence supports the use of CBD as a short-term treatment for generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic disorder (Blessing et al., 2015). The promising effects demonstrated by CBD in the preclinical phase – certainly influencing the “CBD craze” – highlight the critical need for more clinical studies. We recently published an article on this craze, and you can read it here. 

However, it is important to note that, for now, only limited evidence supports the use of medical cannabis for anxiety disorders (Walsh et al., 2015). 

Nevertheless, Santé Cannabis has observed some success with medical cannabis for the treatment of anxiety. In addition, in reviewing our patient data, we have also seen positive results with medical cannabis in patients with unrelieved secondary symptoms of anxiety or depression (chronic pain being the most common primary condition) (Rapin et al., 2021).  

The place of medical cannabis in the treatment of anxiety

On May 5th 2021, Santé Cannabis held a large-scale Conference on Cannabinoid-Based medicine focused on International Research and Innovation. As part of this event, Dr. Howard Mitnick presented a workshop exploring the question regarding the place of medical cannabis in the treatment of anxiety and managed to make this interactive workshop both amusing and incredibly insightful. He delivered powerful arguments starting with stating that cannabis isn’t the only field where evidence-based medicine and it’s usual hierarchy is a challenge. Obstetric and breast-feeding medicine are examples among others and for various reasons. In his clinical practice, particularly in 2016, when many veterans were coming back from Afghanistan, Dr. Mitnick said he was impressed by the very significant impact cannabis had on patients that were struggling with PTSD-related anxiety, grasping at anything to just stop their brain. He humorously pointed out that “if this talk was about what evidence there is supporting the use of medical cannabis on anxiety, it would be a very short talk.” The question then becomes,  how can we, as clinicians and as a community, negotiate with this limited evidence, while clinicians see that medical cannabis helps many patients effectively manage their anxiety?

ANXIETY AT SANTÉ CANNABIS

As clinicians, we have seen first hand the improvement many patients are able to experience with medical cannabis treatment. However, we know that individual success stories are not enough to provide insight into how to prescribe this medicine on a large scale. Through the use of our real-world data, our clinic strives to provide better patient care by advancing science including data regarding the place of cannabis in the treatment of anxiety.

We also offer our patients support groups, presentations and tools including stress management and mindfulness.

The combination of formal training of healthcare professionals and high quality research is essential to increase the selection of anxiety treatments and provide the best care for patients. 

Join us in working to develop the highest quality treatments for people with anxiety.  

Santé Cannabis is committed to advancing knowledge about anxiety and cannabinoid-based treatments, and as such, we offer research services to companies and institutions interested in developing clinical studies. 

For clinicians currently treating people with anxiety who wish to include medical cannabis in their practice, our preceptorships are available to all local and international physicians. For prescribers in Quebec, we also offer a free training program on cannabinoid-based treatments and how to prescribe them.

Author

Andrée Charbonneau, Nurse Coordinator

With thanks to the Research Department

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.