Pubdate: Fri, 23 Jun 2017
Source: Chronicle Herald (CN NS)
Copyright: 2017 The Halifax Herald Limited
Authors: Jonathan Zaid and Cam Battley


Approximately 200,000 Canadians have a medical marijuana prescription,
but it isn't covered by most health insurance plans. (File)

Since the implementation of Canada's national medical cannabis system
in 2001, attitudes toward cannabis have changed significantly. What
was once stigmatized as a street drug has come to be understood as a
substance with broad therapeutic uses.

Today about 200,000 Canadians have a prescription to use medical
cannabis under a doctor's care for management of symptoms caused by
chronic pain, bowel diseases, spasticity associated with multiple
sclerosis, certain mental health disorders and a host of illnesses.
Patients use cannabis because it works for them with manageable side

But there's a problem. Medical cannabis is not covered by most health
insurance plans.

Treating cannabis the same as other prescription medications from an
insurance perspective is a matter of pragmatism and basic fairness.
The purpose of health insurance is to ensure people have access to and
can afford medical therapies they need to be healthy and productive
and to help manage costs if people are disabled by injury or illness.
This latter situation has put a potentially precedent-setting court
case in the spotlight.

In August 2010, Wayne Skinner of Halifax suffered a work-related
injury that left him permanently impaired, dealing with chronic pain
and depression. He was initially prescribed multiple medicines,
including opioid drugs, to manage pain. These were all covered by his
health insurance, administered by the board of trustees of the
Canadian Elevator Industry Welfare Trust Fund. But the drug regimen
only partially controlled Mr. Skinner's pain, while causing
significant, disabling side effects and putting him at risk of opioid

Mr. Skinner and his doctor discussed cannabis as a potential
alternative. He received a prescription, and became a Health Canada
registered medical cannabis patient. The cannabis was effective. His
pain was relieved, his depression lifted, he was able to function
again and side effects were minimal.

But the board of trustees of the Canadian Elevator Industry Welfare
Trust Fund denied coverage of medical cannabis. Mr. Skinner took his
case to the Nova Scotia Human Rights Commission. A tribunal decided in
Mr. Skinner's favour, finding the board had discriminated in
disallowing reimbursement for medical cannabis. It ordered them to
cover the cost of Mr. Skinner's medicine.

The board is appealing to the Nova Scotia Court of Appeal. The case
will be heard Oct. 2.

The unfairness of this situation is clear. Mr. Skinner and his doctor
tried first-line treatments, without success and with crippling side
effects. They tried another prescription medicine, cannabis, which
worked and was well tolerated. The former drugs were covered, the
latter was not.

Opioids included in the original treatment come with significant
risks, including addiction and death. Cannabis has a much lower risk
of dependence and has no known level of lethal overdose. The insured
drugs cost over double the expense of cannabis. Denial of coverage for
medical cannabis has caused Mr. Skinner and his family extreme
hardship and has significantly diminished his health.

Mr. Skinner's case illustrates the urgent need to take a rational
approach to medical cannabis for insurance purposes. For many
patients, cannabis works when other medicines do not. It is prescribed
by a doctor. It is produced according to rigorous regulation by
companies licensed by Health Canada. It's time to treat patients
fairly, recognize the medical legitimacy of prescribed cannabis, and
add it to lists of covered drugs. The Nova Scotia Human Rights
Tribunal says it's a human right. Let's hope the Court of Appeal
decides it's a legal right.

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Jonathan Zaid is executive director of Canadians for Fair Access to 
Medical Marijuana (CFAMM), and Cam Battley is executive vice president 
of Aurora Cannabis Inc., a licensed producer. CFAMM and Aurora are 
supporting Wayne Skinner's case at the Court of Appeal.
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