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Against marihuana possession and production in terms of those with a serious illness who would benefit from use of cannabis marihauna. I satisfied, from the evidence presented on this application, that marihuana does have a therapeutic effect in the treatment of nausea and vomiting related to chemotherapy or radiation and for muscle spasticity, epileptic seizures and chronic pain. Marihuana also is helpful in stimulating the appetite of those suffering from a wasting syndrome. I agree with the statement of Sheppard, Prov. J. in R. Parker, supra at para. 51 that, "It does not accord with fundamental justice to criminalize a person suffering a serious chronic medical disability for possessing a vitally helpful substance not legally available to him in Canada and
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Travel clinic, which was well regarded by its patients. THS is the only private, for-profit travel medicine practice in the region. However, the health departments of several adjacent counties provide pretravel immunizations to their citizens. THS is based in a seven-member infectious-disease group, with the intensive involvement of three infectious-disease physicians, working with a dedicated Registered Nurse. We are currently making the transition to a combined physician-nurse practitioner model for cost containment reasons without sacrificing the quality of consultation. Strong emphasis is given to the medical history of each patient and to providing both verbal and written advice on key matters. The practice is sited in the University Hill area of Syracuse, within walking distance of three universities and three hospitals and six blocks from the center of the city, with ready access two blocks ; to the interstate highway network. The reasons why THS patients travel reflect the largely noncommercial nature of the region: tourism, 58%; business, 20%; religious or philanthropic, 11%; educational student or educator ; , 11%. Africa is the most common destination 27% 23% of patients go to Central or South America, 22% go to Asia, 13% go to the Indian subcontinent, and 15% go elsewhere. Initially, county health departments were the major source of referrals to THS, but this has shifted toward referrals from primary-care physicians and former patients as our services have become better known. In our attempt to reach the potential traveler, mailings with brochures have been sent to all primary-care physicians, county health departments, travel agencies, manufacturers and exporters, colleges, universities, and high schools in central New York. THS providers use a wide variety of sources in an intensive effort to remain current in travel advice see the sections on information sources and the Internet, below and
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Background: Preferential listing of a single drug is undertaken by many drug benefit programs to control costs associated with a therapeutic class of medications. Despite preferential listing, however, our program has continued to sustain significant expenditures for non-benefit proton pump inhibitors PPIs ; . An evaluation is being performed to identify reasons for this anomalous usage pattern. Methods: A database analysis using pharmacy records information will be performed to evaluate PPI usage patterns in the Canadian Forces since implementation of the current policy. Descriptive statistics will be used to compare demographic characteristics of PPI users who are receiving treatment with the preferred agent as compared to those who are not. The pharmacy records will also be reviewed to identify reasons for non-use of the preferred PPI. If information gleaned from the database review indicates that side effects are significant with the benefit PPI, or, alternately, that the database contains inconsistencies which would compromise the validity of the review, a telephone survey will be undertaken among subjects who received a non-benefit PPI. Results: We hope to obtain information which will inform future initiatives to rationalize drug use. This study should also provide information on the validity of database records, particularly with respect to override codes, as a reflector of drug tolerability in a population. Conclusions: The results of this study may provide further information regarding the effectiveness of preferred listing as a cost-saving measure. The conclusions drawn from our example may also help to guide policy development in other therapeutic classes. Key Words: Anti-ulcer agents, drug utilization review, health benefits.
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