Cannabis – Page 7 – Matters of Substance

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Marihuana for Medical Purposes Regulations (MMPR), and the existing Marihuana Medical Access Regulations (MMAR) will be repealed as of March 31, 2014.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

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.

On November 18, Washington State will open a thirty-day window for would-be cannabis producers, processors, and retailers to submit applications for licenses that would allow them to begin shaping a new, legal market – under state law – for a substance that remains prohibited under U.S. federal law and throughout most of the rest of the world. Washington voters passed Initiative Measure No. 502 (I-502) on November 6, 2012, with a 56% majority, thereby legalizing, taxing, and regulating cannabis for adults 21 years of age and older. The measure passed in twenty of Washington’s thirty-nine counties, in conservative Eastern Washington as well as the liberal West, and in rural areas as well as urban.

And yet, less than a third of Washington’s electorate expressed positive feelings about cannabis before taking this historic vote. Many expressed concerns about increased use, especially among youth, and increased impairment on roadways and in workplaces. Cannabis prohibition in the U.S., and the use of the criminal sanction to enforce this prohibition, was premised on the idea that making the production, distribution, and use of the substance illegal would promote public health and public safety. How could the state’s voters reject this policy, and seemingly embrace cannabis use, by a double-digit margin?

The answer is that while voters do not necessarily like cannabis, they like the results of cannabis prohibition even less. Much as the U.S. experiment with alcohol Prohibition ended not because people changed their minds about gin but because they changed their minds about the policy approach, I-502 passed because Washington voters believed marijuana prohibition had failed and it was time for a new approach.

I-502 is not a “free the weed” proposal. Several policy features were included to maximize the chances that I-502 would deliver better outcomes than prohibition has. A new excise tax will be dedicated to prevention, education, treatment, research, monitoring, and evaluation. The tax level will be reviewed regularly and adjusted to promote the goal of undercutting the black market while discouraging use among price-sensitive youth. Cost-benefit evaluations, to be conducted by the Washington State Institute for Public Policy in 2015, 2017, 2022, and 2032, will consider factors impacting public health, public safety, the economy, the criminal justice system, and state and local administrative budgets.

The number and location of cannabis stores will be limited, and banned within 1,000 feet of places frequented by youth. Advertising will be restricted to minimize exposure to minors, and cannabis will be packaged in opaque, childproof containers bearing labels that provide information regarding THC concentration and cannabinoid profile. Information regarding chemicals used on the plants during cultivation and harvest must be made available to consumers on demand.

It’s too soon to know how cannabis use will change once stores have opened. The goal is to promote public health and safety without criminalizing consumers and enriching a black market. Undoubtedly, rough patches lie ahead, and adjustments will be necessary. But the outlook is promising.

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

Alison Holcomb, Criminal Justice Director at American Civil Liberties Union of Washington State and primary author of I-502

Tag: Cannabis

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