Nuts and Bolts of Cannabis Regulation in Canada

At the Canadian Drug Policy Coalition (CDPC) one of things we’ve noticed is that any blog we publish on cannabis regulation attracts more attention than any other topic. This is because there’s widespread interest in discussion of changes to the laws that govern cannabis. Unfortunately when it comes to the nuts and bolts of cannabis regulation – in other words – the how of regulation, interest tends to drop off. This is because regulation is actually rather tedious. This is borne out by the length of the proposed regulations for legal recreational cannabis markets in the U.S. states of Washington (43 pages) and Colorado (72 pages). That’s why I’m making a special plea to you our dear readers to stay with me as I say a few words about what regulation might actually entail.

I think it’s fair to suggest that both the CDPC and the Centre for Addictions Research of BC favour a model of regulation that draws on the best evidence from public health regulation of alcohol and tobacco. But when it comes to cannabis regulation the devil really is in the details. There’s no magic bullet that will make all the current problems with cannabis prohibition disappear. But thanks to the Health Officer’s Council of BC, some of the heavy lifting when it comes to creating models for drug regulation has been done. If you’re curious, check out their 2011 report. As you can see from the diagram drawn from that report, regulations for cannabis should not be so loose that they create a free and unregulated market for cannabis; nor should regulations be so overly restrictive that we end up reproducing the negative aspects of the current underground economy (control by organized crime, etc.). 

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At the same time we need to be clear about the goals we hope to achieve with a legal regulated market for cannabis. Ideally our regulations will help protect and improve public health, reduce drug related crime, protect the young and vulnerable, protect human rights and provide good value for money. So what are some of the things we’ll need to consider? How about we start with the basics.

Presumably legalization would entail the removal of cannabis from Schedule 2 of the federal Controlled Drugs and Substances Act, followed by its inclusion in the Food and Drug Act. It seems like the next logical thing to do would be to turn over the regulation of cannabis to the provinces, in the same way that alcohol is currently regulated. We would want to ensure that there is at least some consistency across the provinces so that means somebody at the federal level will have to oversee the regulations as they emerge. That’s the easy part because legalization would ALSO entail consideration of at least the following issues: production, product, packaging, vendor and outlet controls, marketing controls, creation of a system of regulators and inspectors as well as on-going research and monitoring.

For this blog post, I want to focus on production and product controls. Future blog posts may consider the other items on the long list noted above. My comments meant to stimulate discussion of regulation rather than to propose firm rules for how a legal recreational cannabis market might operate.

In Canada, marijuana is currently produced in one of two ways – under existing legal medical marijuana guidelines or in illegal circumstances. Growing marijuana takes places in a vast array of situations ranging from a few plants grown for personal use all the way to large-scale industrial size operations with 100’s of plants.

Thus regulating the growth of marijuana for a legal recreational market will not be simple. Many people are very attached to their small-scale gardens, and it would be difficult to impossible (as well as undesirable) to eliminate growing marijuana for personal use. And it’s important not to turn the whole thing over to heavily capitalized large scale commercial producers who main motivation is profit, especially since the range of available strains of marijuana has been the result of innovation by many small-scale growers. Thus, we need to ensure that the best practices in indoor, outdoor, personal, commercial production are preserved while ensuring that cannabis is produced in safe and clean facilities.  We will also need to decide who is the appropriate authority for regulating growing operations: municipalities or provinces or some combination of both. Neither seems overly keen on this role so they will require some convincing.

Okay if your head doesn’t hurt yet lets turn our attention to product controls. Product controls include issues like price, age limits, potency, permissible preparations (edibles, tinctures, etc.), quality control, and labeling and packaging requirements. Price is a key issue when it comes to meeting public health goals. Price can help shape sales and thus use of cannabis, so we want to ensure that pricing reflects what we’ve learned from alcohol – namely that alcohol consumption is sensitive to price and that price must in some way be related to potency. Related to price is taxation – at what point in the chain from seed to sale will cannabis be taxed and at what rate? And what preparations will cannabis regulations allow? Plant materials, tinctures and oils, edibles? Right now Canada’s medical marijuana access program only allows for the distribution of plant material. Clearly this is a very limited approach given that the medical cannabis dispensaries have created a range of edible and other products that eliminate the necessity of smoking cannabis. We will also need to decide where we stand on potency: in other words will we put limits on how potent products can be, and given that there are over 100 cannabinoids, how will we decide which ones we want to measure and regulate? 

Okay so I haven’t covered other essential issues like vendor controls, marketing and evaluation and monitoring but I think you get the picture. Regulation is by no means a simple matter, but it can be done. In fact, experience from legal recreational markets in Washington and Colorado will provide valuable insights that can inform Canada’s approach. And regulation has the potential to create conditions where cannabis production and use is a whole lot safer than the current prohibition approach.

 

*Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

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Connie Carter, Senior Policy Analyst, Canadian Drug Policy Coalition

 

The New “Marihuana for Medical Purposes Regulations”: Will they improve access?

Between 420,000 and a million Canadians use cannabis (marijuana) for medical purposes to alleviate symptoms such as pain, nausea, appetite loss and muscle spasms associated with medical conditions such as cancer, HIV/AIDS, arthritis, multiple sclerosis, glaucoma, migraines, and epilepsy, to name a few. In 2001, the Marihuana Medical Access Regulations (MMAR) were established by the federal government allowing Canadians to possess cannabis for medical purposes without fear of criminal sanction. With this authorization to possess cannabis, Canadians had three legal options to obtain a source of cannabis: 1) purchase cannabis grown under contract for Health Canada, 2) obtain a license to produce their own or 3) designate a person to produce cannabis for them.

Since that time, approximately 35,000 Canadians have obtained authorizations under the MMAR. This still only represents a small fraction of the actual number of medical users of cannabis in Canada, suggesting that there are barriers for access in this program. Barriers include difficulty finding a physician to support an application, dissatisfaction with the quality of the cannabis available from Health Canada’s supplier (which only offers only one strain of cannabis), and cost, among others.

As a result, many people rely on unauthorized sources of cannabis such as friends, acquaintances or street dealers for their supply. In addition, Canada has approximately 50 medical cannabis dispensaries (a.k.a. compassion clubs) which currently serve about 40,000 Canadians upon recommendation of a healthcare provider. Despite court decisions which recognized the value of the services provided by dispensaries, they are not included in the legal framework.

In June 2013, the government of Canada enacted new Marihuana for Medical Purposes Regulations (MMPR), and the existing Marihuana Medical Access Regulations (MMAR) will be repealed as of March 31, 2014. So what does this mean for Canadians who wish to use cannabis to alleviate their symptoms?

The good news is that under the new MMPR, people who wish to use cannabis for medical purposes will need to get a much more simplified medical document, similar to a prescription, directly from their physician or from a nurse practitioner. This document will then be submitted to one of several new licensed commercial producers which will provide a variety of strains to several clients. However, physicians continue to be reluctant to support the use of cannabis for medical purposes since their professional associations, colleges and insurers express concerns about the lack of sufficient information on risks, benefits, and appropriate use of cannabis for medical purposes. It remains to be seen whether a simplified process will address this barrier.

The bad news for many is that the 28,000 Canadians who currently are licenced to grow their own cannabis or have a designated grower will no longer be allowed to do so. Of particular concern if people continue to produce their own is the Safe Streets & Communities Act: Increased Penalties for Serious Drug Crime currently in effect in Canada which imposes Mandatory Minimum Sentences of six months to 14 years for the production of six or more cannabis plants. There is already a court challenge brewing to prevent the phasing out of these licenses.

More bad news is that with the new commercialized model of distribution of cannabis for medical purposes, the cost of cannabis will  increase significantly, which will be prohibitive for many. Cost effectiveness is a major consideration for those who produce their own cannabis. Medical cannabis dispensaries, especially the not-for-profit ones, often offer cannabis at a reasonable price, and in some cases will even offer some donations to their lower-income members depending on the supply.

Public support for the use of cannabis for medical purposes is strong and there is international momentum to reform existing laws and policies regarding cannabis in general. How restrictive and commercial should access be? Is reducing options for access to cannabis for medical purposes the best way to reduce barriers to access? How can a well-established network of existing medical cannabis dispensaries with a rigorous accreditation program continue to be left out of the regulations? How much do stigma and a history of criminalization play a role in the direction of these new regulations? Where is the best interest of the patient in all of this?

For more information, please visit:  Canadian AIDS Society & Health Canada

 

*Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

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Lynne Belle-Isle is a PhD candidate in the Social Dimensions of Health Program at the Centre for Addictions Research of BC at the University of Victoria. She is a National Programs Consultant with the Canadian AIDS Society and the Chair of the Canadian Drug Policy Coalition.