Marijuana, a Friend to Crohn’s Patients Everywhere

I am 33 years old, married, a university graduate, and a business professional. I also have Crohn’s Disease, and I have used marijuana to treat ongoing symptoms such as pain, nausea, lack of appetite, and low energy. I do not use “medical” marijuana, but rather the dispensaries that currently fall under a grey area of legality in BC. I take no other pharmaceuticals for my Crohn’s Disease, and am able to control it with diet and a healthy lifestyle. I have chosen to write this blog as anonymous because unfortunately, there is still a fair amount of stigma, stereotypes and misinformation surrounding the “typical” marijuana user (and I think my parents would kill me).

I started using marijuana as part of my treatment when I was 26. My doctor informed me I was underweight and needed to gain about 15 lbs. The problem was, I couldn’t eat. My stomach would turn at the thought of eating, and I would often throw up after meals. I started smoking a very minuscule amount of weed before dinner so that I could not only eat, but enjoy eating again.  It worked like a charm.

However, I struggled to find a reliable source of marijuana. I did not like the idea of going to a dealer. It was shady and illegal and I was never quite comfortable with it (though it was never very difficult to come by). My GP at the time was not open to prescribing medical marijuana to me, and I felt extremely judged! She was very closed minded about the medical benefits of marijuana despite the living proof standing right in front of her, 15 lbs heavier and healthier than before.  

In 2011, a friend took me to a medical marijuana dispensary in downtown Victoria. She was a member there due to ongoing and severe debilitating back pain, which would put her on the floor for days at a time. To become a member at the dispensary, I simply needed proof of my condition and photo ID. Crohn’s is classified as Category 2 symptom on the Health Canada info page on medical marijuana. I brought in proof of my condition, sat through a 45-minute orientation and happily became a full-fledged member of the Victoria Cannabis Buyers Club. The role of the dispensary is to serve those who have legitimate conditions that can be treated by marijuana, but whose doctors will not prescribe it. They offer an incredible selection of products, including dried smokeables, edibles, oils, creams, compresses, and capsules. I tend to favour their Cannoil, which is made specifically to treat upper gastrointestinal disorders, and has provided me relief from not only nausea, but also severe cramping and bouts of diarrhea. The staff is friendly and knowledgeable on recommending the different strains to best suit your specific needs. As for the clientele, you’d perhaps be surprised to know that more often than not, it’s other “normal” people, business professionals, moms and grandparents seeking relief from what ails them.

Will I seek eligibility for medical marijuana? Perhaps one day, though I feel less inclined to now. I am a light user, and I like the convenience and selection of products that are on offer at the dispensary. I will probably also start growing my own, when I have suitable space to do so, so that I may control exactly what is in my medicine.

Though currently not using, marijuana will always be a part of my wider treatment plan. It’s enabled me to avoid harsh pharmaceuticals that are, in my opinion, far worse for me than something that has been grown naturally from the earth.

Further information on Crohn’s and Marijuana can be found here:

Treatment of Crohn’s Disease with Cannabis: An Observational Study

Cannabis Alleviates Symptoms of Crohn’s Disease

Medical Marijuana for Crohn’s Disease

Medical Marijuan & Crohn’s Disease—Getting your Doctor to Sign Health Canada’s Paperwork

*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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Author: Anony Mous 

 

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