Pubdate: Sat, 10 Dec 2011
Source: Calgary Herald (CN AB)
Copyright: 2011 Canwest Publishing Inc.
Contact: http://www2.canada.com/calgaryherald/letters.html
Website: http://www.calgaryherald.com/
Details: http://www.mapinc.org/media/66
Author: Glen McGregor, Postmedia News 

PRESCRIPTION NUMBERS FOR POT VARY BY REGION

He is 47 years old and, chances are, he lives somewhere on British 
Columbia's Sunshine Coast.

Under Health Canada's medical marijuana program, he is approved to 
legally consume up to five grams a day of the pot he grows himself at home.

Most likely, his general practitioner signed the forms he needed to 
get the drug.

And on average, he is a "he" - men in the program outnumber women by a 
ratio of about three to one.

As with a great number of medical marijuana patients, he uses the drug 
to treat severe arthritis, although he may suffer from other conditions.

Data obtained by the Ottawa Citizen through the Access to Information 
Act put this face to the typical medical marijuana patient for the 
first time, 10 years after the federal government - under pressure 
from a series of legal rulings - was forced to start allowing 
seriously ill Canadians to apply to use the drug.

As Health Canada moves to overhaul the rules for medical marijuana, 
its own numbers show sharp disparities in the accessibility and use of 
the drug across the country as patients search for doctors willing to 
prescribe the drug.

Although all Canadians are supposed to have equal access to medical 
marijuana, enrolment in the program varies greatly across the country.

Where you live and your doctor's attitude to marijuana will help 
determine whether you receive approval from Health Canada to use the 
drug to treat serious illnesses such as cancer, multiple sclerosis or AIDS.

The geographic patterns contained in Health Canada's data show that 
people from British Columbia are far more likely to have a marijuana 
authorization - about 33 people out of every 100,000, compared to five 
per 100,000 in Manitoba.

Between 2001 and 2007, the V0N postal code zone, which spans British 
Columbia's Sunshine Coast - a ferry ride from Vancouver - Gulf 
Islands, part of Vancouver Island and the area around Whistler, 
generated more applications under the government's Marijuana Medical 
Access Regulations (MMAR) program than any other.

By contrast, in some wellpopulated swaths of Manitoba such as 
Steinbach and parts of Brandon, not a single person has applied to the program.

Marijuana advocates say it is the approach of doctors in different 
parts of the country, not patient needs, that determines who is 
getting medical marijuana.

They point to what they say are more permissive attitudes toward 
marijuana in B.C. and better outreach by cannabis advocates to the 
doctors who must ultimately decide whether to sign a patient's application.

"British Columbia has a bit more laissez-faire attitude to marijuana 
and a very good activist network informing doctors," says Matthew 
Mernagh, 37, a Toronto marijuana user who, this spring, won a court 
decision that effectively has toppled Canada's marijuana prohibition.

After he was arrested for growing pot in his apartment in 2008, 
Mernagh launched a constitutional challenge of Canada's drug laws. 
Mernagh's case was based on a complaint common to many patients who 
seek marijuana: the difficulty he had finding a doctor to sign 
documents to let him legally use the drug - in his case, to treat 
chronic pain and seizures caused by fibromyalgia and other conditions.

At trial, evidence was produced that suggested that less than one-half 
of one per cent of Canadian doctors had signed the 33-page form for a 
patient to apply to Health Canada's program.

"I find as a fact that the physicians of Canada have massively 
boycotted the MMAR and their overwhelming refusal to participate in 
the medicinal marijuana program completely undermines the 
effectiveness of the program," wrote Justice Donald Taliano in his 
April decision quashing the marijuana law. The court agreed that the 
systemic refusal of doctors to approve patients for marijuana was an 
infringement on their rights.

Mernagh was allowed to grow his own pot without Health Canada's 
approval, a decision that - should it stand - effectively overrides 
Canada's marijuana laws.

The court will hear the government's appeal in March.

Mernagh might have had better luck with his doctor had he suffered 
from cancer or even arthritis. Health Canada's data show that severe 
arthritis is now the most common reason for applications to the 
medical marijuana program. This trend is a relatively new one, as 
Health Canada has been deluged over the past three years by 
applications claiming severe arthritis as the medical reason.

But in the first years of the program, it was HIV/ AIDS patients who 
were at the vanguard. Cannabis is an effective appetite stimulant and 
can help curb neuropathic pain and control nausea caused by the 
illness and AIDS medications.

By the end of 2007, HIV/AIDS patients accounted for the largest share 
of applications for the MMAR, even though there were far fewer people 
living with the infection than with cancer.

Estimates put the number of HIV/ AIDS patients in Canada at about 60,000.

With the high uptake among HIV/ AIDS patients, medical marijuana use 
is higher in areas with large gay communities.

Urban doctors who see a lot of HIV/AIDS patients are more likely to be 
informed about new therapies and open to trying new approaches, says 
Lynne Belle-Isle of the Canadian AIDS Society, who wrote a 2007 paper 
on access to the drug.

"Physicians that treat people with HIV are likely a little bit more 
informed and HIV advocates have been involved in the medical use of 
cannabis for a long time," she said.

There is also more research on the use of the drug as a therapy for 
HIV, Belle-Isle said, and the Canadian AIDS Society is the only major 
disease organization that believes patients should have access to the 
drug if it helps them.

But outside the gay communities, the data suggest participation in the 
medical marijuana program is actually lower in urban areas than rural ones.

It is a counter-intuitive trend that is likely due to the fact 
patients in many larger cities have been better served by so-called 
compassion clubs that dispense pot outside of Health Canada's program.

Some doctors are willing to write referrals to a compassion club but 
won't agree to sign the forms required for the Health Canada program. 
The clubs offer a wider variety of marijuana strains that, advocates 
say, give better treatment options, compared to the single strain sold 
for $5 a gram by Health Canada.

Had he convinced his doctor to sign his release, Mernagh, at age 37, 
would number among the youngest approved marijuana patients.

Indeed, the Health Canada data dispatch of the notion that young 
people are applying to the program to score the drug legally. People 
under age 40 accounted for fewer than 20 per cent of the approved 
patients. Those in their 40s made up 38 per cent.

About eight per cent were older than 60.
- ---
MAP posted-by: Richard R Smith Jr.