Keeping you informed on Cannabis Legalization

 

Introduction

On October 17, 2018, the Cannabis Act and associated regulations came into force. The recreational use of cannabis is legal for adults who are 19 years of age or older, with certain conditions. Access to cannabis for medical purposes, which is currently administered under the Access to Cannabis for Medical Purposes Regulations, will now be administered under the Cannabis Act and associated regulations.

How Does This Impact My Massage Therapy Practice?

The MTAM has put together this FAQ document to help address questions that MTAM members and their clients have raised about cannabis and Massage Therapy.

The two main substances in cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD), and for the purpose of the following recommendations, cannabis refers to plants and products with either or both ingredients. While cannabis is now legal for both recreational use and medical purposes, the regulatory regime for cannabis is very new and government regulations may still be developed. The MTAM has created the following recommendations and FAQs on cannabis (of any form) in Massage Therapy practice situations.

Our current recommendations for all members:

  1. DO NOT USE any products, or apply any lotions or oils, that contain any amounts of CBD or THC (tetrahydrocannabinol), regardless of the source of these compounds, in your clinical environment in the course of providing treatment as a Massage Therapist.
  2. DO NOT SELL any products that contain any amounts of CBD or THC, regardless of the source of these compounds, in your clinical environment.
  3. DO NOT RECOMMEND any products that contain any amounts of CBD or THC, regardless of the source of these compounds, to any persons /clients in your clinical practice.

    The MTAM will keep our members up to date as additional information becomes available.

FAQs - The Cannabis Act and Your Massage Therapy Practice 

Q. What do I do if I think my client is under the influence of cannabis?
A. According to National Standards and MTAM Standards of Practice, clients must be fully informed and able to consent to treatment. RMTs must obtain that informed consent before assessing or treating clients. An RMT should not assess or treat a client who is impaired by a substance that is affecting the client’s ability to provide informed consent regardless of the source of the impairment. In other words, an RMT should view obtaining consent from a client who may have used cannabis the same way they would obtain consent from a client who may have used any other impairing substance (whether legal or illegal). RMTs must use their professional judgement to determine if the client can understand the potential benefits and risks to Massage Therapy treatment as explained, and whether the client’s perception of pain or pressure levels, or indeed of what occurred during the treatment itself, could be impacted.


Q. My client asked me for advice about using cannabis. What can I tell them?
A. Though the Cannabis Act changes how cannabis is managed, it does not change the Scope of Practice for RMTs. Providing advice or recommendations to clients about substances such as cannabis is not within the Scope of Practice of Massage Therapy. If a client has questions about cannabis, an RMT should refer the client to the client’s primary health care provider (such as a physician or nurse practitioner) who can assess the client’s needs and determine a course of action.


Q. Can I offer cannabis oil or a topical product containing cannabis in my treatments?
A. NO - Selling and distributing cannabis is strictly regulated under the Cannabis Act. Therefore, offering treatments using cannabis oil or a topical product containing cannabis is prohibited (by law) for RMTs. Further, as discussed below, RMTs should not administer or apply cannabis in any form to a client during treatment at this time due to insufficient information regarding the potency and quality of topical cannabis applications and the possibility of interaction with other medications the client may be taking.


Q. Can I treat clients using the client’s own cannabis oil or topical product containing cannabis?
A. NO - While using cannabis recreationally is now legal, little research on topical products exists to inform health implications and outcomes (risks, benefits and contraindications). If a client requests the use of their own topical cannabis product during Massage Therapy treatment, current research and regulations do not address the potency or quality of the product. Without such information, the risk to clients cannot be determined.

To obtain informed consent, an RMT must understand and be able to explain health implications to a client before administering a treatment. For this reason, at this time RMTs should not administer or apply cannabis in any form to a client during treatment. The MTAM's current position is consistent with the Canadian massage therapy regulatory colleges. The MTAM will continue to monitor the changing climate around cannabis and review this position as appropriate.

Q. Recreational or Prescribed Use of Cannabis by RMTs
A. The MTAM Code of Ethics states that RMTs must be competent, conscientious and empathetic practitioners. If the RMT's ability to practice is impaired by any substance it may prevent them from acting in a competent, conscientous and empathetic manner and is therefore considered an act of professional misconduct. This means RMTs must not practice under the influence of cannabis (or any substance that may impair their judgement).


The MTAM will monitor regulatory changes involving cannabis, and will provide updates on new developments. Please contact the MTAM with questions at tweid@mtam.mb.ca | 204.927.7977 | 1-866-605-1433.

References:
College of Massage Therapists of Ontario 
College of Massage Therapists of British Colombia
Government of Manitoba

Additional resources about cannabis, please see:

Government of Canada – https://www.canada.ca/en/services/health/campaigns/cannabis.html
Current Cannabis Laws: http://www.justice.gc.ca/eng/cj-jp/marijuana/law-loi.html


 

Keep Learning

A few great sites to get you prepared:

CBC article on CBD Oil: http://www.cbc.ca/news/canada/manitoba/cannabidiol-oil-won-t-get-you-buzzed-but-it-could-get-you-busted-1.4656913

Government of Canada Cannabis site: