Pubdate: Mon, 13 Jul 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Jenna Valleriani
Note: PhD candidate in sociology and the Collaborative Program in 
Addiction Studies at the University of Toronto
Page: A12

HOW OTTAWA CREATED THE 'WILD WEST' OF MEDICAL MARIJUANA

Federal Health Minister Rona Ambrose can't seem to catch a break. 
First, Kimberley, B.C., grants a business licence to a medical 
cannabis dispensary and then Vancouver City Council votes to regulate 
and license medical cannabis dispensaries. Coupled with the recent 
Supreme Court of Canada ruling that patients can possess all forms of 
cannabis for medical purposes, Ms. Ambrose is left with feelings of 
sheer "outrage."

But that outrage is misplaced. Pushing aside both scientific 
literature and the personal experiences of Canadians, the Health 
Minister still refuses to acknowledge cannabis as a medicine. By 
refusing to take a leadership role and create a medical 
cannabis-access program that could serve the diverse needs of 
patients, the federal government is responsible for what we are 
seeing in the "wild west" of Canada - a disconnect between realities 
on the ground and sound public policy.

While Vancouver has always been known for its local innovation in 
drug policy, the continued existence of dispensaries is really 
premised on the government's failure to create a program that can 
stand up to constitutional scrutiny and the increasingly relaxed 
attitudes of Canadians toward cannabis.

The existence of medical cannabis dispensaries is not new. Long 
before the federal cannabis-access program was initiated in 2001, 
dispensaries operated quasi-legally, or as an act of civil 
disobedience, across Canada. Although the new federal program, the 
Marihuana for Medical Purposes Regulations (MMPR), allows qualifying 
patients to purchase medical cannabis from companies licensed by 
Health Canada, the number of dispensaries in Vancouver has exploded 
from 14 in 2013, to more than 90 dispensaries today.

Taking a common-sense approach, the City of Vancouver decided to move 
forward with regulating dispensaries after four days of public 
hearings, despite strong warnings from the federal government.

The truth is that thousands of Canadians, arguably more than are 
registered with the MMPR, use dispensaries. One of the oldest and 
largest clubs in Vancouver serves more than 6,000 members alone. 
There are even patients registered officially with the MMPR who 
continue to access dispensaries exclusively, or in conjunction with 
their licensed producer (LP).

While the MMPR is a step in the right direction, many issues continue 
to limit patient care and access. Much of this is based on how 
heavily regulated LPs are, operating out of Fort Knox-type facilities 
under Health Canada's rule. LPs are restricted to a mail-delivery 
model and the advertising restrictions are so rigid that LPs are 
essentially muzzled when it comes to speaking about medical benefits 
or effects of particular strains.

On the other hand, dispensaries, lacking inclusion in the federal 
system, offer on-site dispensing, in-person education about strains 
of marijuana, administration and dosing, and allow patients to 
examine different strains before purchasing. The latter is important 
to many patients, particularly those who are from an earlier 
generation of self-taught medical cannabis use. And it definitely 
gives dispensaries an edge in the market.

Existing in what seems a different world, a cannabis consultant said 
recently that many MMPR-hopefuls are "fed up" with the long, slow, 
bureaucratic approval process, and have been in touch about opening 
dispensaries instead.

But the most baffling part about the MMPR has to be the restriction 
to purchasing the dried buds only. At least with the recent Supreme 
Court decision, patients can possess extracts and derivatives such as 
oils and tinctures, but they are not able to purchase these from a 
licensed producer under the MMPR, at least not yet. Last Wednesday, 
however, Health Canada issued a Section 56 exemption under the 
Controlled Drugs and Substances Act, which allows LPs to sell 
cannabis oils and fresh cannabis buds in addition to dried cannabis 
to registered patients.

This is a step forward, but it will take some time to implement - 
with concerns about safe production, packaging, labelling and record keeping.

For many patients who can't make extracts themselves, dispensaries 
are the only way to get these products, which include more than just 
oils. In Vancouver, regulations allow for capsules, tinctures and 
oils, but not food products such as cookies, which authorities worry 
will appeal to youth. Since some patients depend on food products to 
manage their conditions, the regulations leave room for improvement.

But it's a start. While there are justifiable concerns from critics 
about the lack of testing of the products some dispensaries sell, 
there are dispensaries that test their products using the same 
analytical test labs as some LPs under the MMPR.

It is also estimated that fewer than 7 per cent of physicians will 
sign a medical document for cannabis, particularly for diagnoses 
where cannabis use is more contested, such as for anxiety or 
depression. Although admission requirements vary depending on the 
dispensary, becoming a member is fairly straightforward: individuals 
can often submit a statement of diagnosis, a letter from their doctor 
or a signed dispensary-specific application.

More troubling is that Health Canada's promise of 400,000 patients 
over the next 10 years means nothing without physicians who are 
comfortable with, and supported by their governing bodies in, 
prescribing cannabis for medical purposes. Instead, clinics and 
intermediary services that connect patients to doctors for large fees 
are popping up almost as quickly as dispensaries in Vancouver.

While ethics around these organizations are contested, many people 
currently registered under the MMPR would not have been able to 
acquire a medical document any other way.

Of course, some dispensaries in Vancouver operate with recreation 
more in mind. Some justify this in the belief that cannabis should be 
legalized and available to consenting adults.

In a sense, the only available and tolerated discourse is a medical 
one, so under the guise of medical, the distinction between medical 
and recreational becomes less clear.

While Ms. Ambrose is focused on convincing Canadians that cannabis is 
not a medicine, local governments have been forced to address these 
underlying issues with the tools available to them. It is expected 
that other cities, such as Victoria, will follow suit.

Why does the federal government insist on turning a deaf ear to 
science and the solutions Canadians are demanding? If the ongoing 
Allard case (a legal dispute about the preservation of patients' 
right to grow marijuana) is decided in the patient's favour, Ms. 
Ambrose is really going to have a rough year.
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MAP posted-by: Jay Bergstrom