Pubdate: Thu, 28 Dec 2017
Source: Telegram, The (CN NF)
Copyright: 2017 The Telegram
Author: Sheryl Ubelacker
Page: B1


Medical users fear legalized recreational marijuana may leave them
behind in puff of smoke

For Mandy Mcknight, the benefits of cannabis oil to treat her son
Liam's debilitating seizures seem almost miraculous - the
nine-year-old has gone from being wracked daily by dozens of the
life-threatening episodes to having days when he experiences none.

But like many Canadians authorized by doctors to use marijuana to
treat a wide range of medical disorders, Mcknight is worried what will
happen when recreational pot for adults becomes legally available
through government-sanctioned retail outlets in July 2018.

Will there be enough product to supply both markets? And how will
medical users manage the cost, which will be subject to the same
excise tax levied on consumers merely looking to get high?

"I'm worried about how are they going to guarantee that his medicine
is in stock every month and it's not going to all be bought up by the
recreational users," says Mcknight, of Constance Bay, Ont., near
Ottawa, whose son has dramatically improved since he began taking oral
doses of an oil high in CBD (cannabidiol), but low in marijuana's
psychoactive component THC (tetrahydrocannabinol).

"Before we started the cannabis oil, he was having upwards on a bad
day of maybe 80 seizures a day," the mother of four says of Liam, who
has Dravet syndrome. "There were times when we were calling an
ambulance a lot, and he was actually even airlifted into the
children's hospital quite a few times.

"It hasn't freed Liam from disease, but it has certainly improved his
quality of life by 1,000 per cent," she says of cannabis oil, which
the family purchases through a licensed producer for $60 per bottle
plus GST/HST and shipping costs.

Liam's pediatrician has prescribed 22 bottles per month to treat his
seizures, but MCKnight says she and her husband, Dave, can afford only
half that number.

And when the excise tax comes into force once recreational marijuana
is legalized, it will add to the financial burden of providing a
medicine for their son that isn't covered under private or provincial

"We're not low-income," she says, "and we cannot even come close to
affording Liam's medicine."

Canadians for Fair Access to Medical Marijuana ( CFAMM) has been
lobbying the federal government to nip the idea of taxing therapeutic
cannabis in the bud, arguing that no other prescription pharmaceutical
is subject to taxation.

"Affordability is the No. 1 barrier to access for medical cannabis
patients and any kind of taxation or price increases will affect
patients' health and fundamentally isn't how we treat medications from
a tax policy perspective in Canada," argues Jonathan Zaid, founder and
executive director of CFAMM.

The federal plan would add $1 of excise tax per gram of cannabis or 10
per cent of the final retail price, whichever is higher.

MP Bill Blair, the Liberals' point man on legalizing marijuana, has
said his government is committed to maintaining a functional medical
marijuana system. But "at the same time, we do not want the taxation
levels to be an incentive for people to utilize that system
inappropriately and so we propose that the taxation levels for both
non-medical and medical will be aligned."

Zaid, who began using medicinal marijuana about four years ago to
treat a condition called daily persistent headache, says the
government seems to think some people may fake illness to get access
to cheaper pot.

"While we acknowledge that price differential could be a potential
concern, we don't see that as a reason to disadvantage the
200,000-plus Canadians who legitimately access cannabis for medical
purposes," says Zaid.

Health Canada predicts medicinal marijuana users will grow in numbers
to 400,000 by 2024. At a time when Canada is battling an opioid
dependency and overdose crisis, CFAMM maintains Ottawa shouldn't be
financially penalizing patients who are using a safer alternative to
treat their pain - an alternative the organization also believes
should be distributed through pharmacies.

For Daphnee Elisma of Montreal, cannabis is the only drug that has
helped relieve her suffering.

A 2010 operation for a brain aneurysm left her with incapacitating
migraines, while the removal of lymph nodes during breast cancer
surgery in 2014 resulted in the development of complex regional pain
syndrome in her right arm.

"We've tried so many drugs, including opioids," says Elisma, 42, who
spends about $500 a month on oil and dried cannabis, which she
primarily ingests through vaping.

Unlike recreational users, "I'm not using cannabis on the weekend just
for fun and mixing it with alcohol," she says, balking at the idea
that she and other therapeutic users should be hit with the excise
duty, which she calls essentially another "sin" tax like that levied
on alcohol and tobacco.

"I use it out of medical necessity, and that's what we need the
government to understand, to make that clear distinction."

Medicinal users are also concerned about supply, given that many of
the country's licensed producers have indicated they plan to grow and
distribute weed for both patients and the recreational market.

"Patient groups have expressed concerns that some companies might
pivot away from the medical system and focus solely on the consumer
system," says Cam Battley, executive vice-president of Edmonton-based
producer Aurora Cannabis Inc.

"So we've made a commitment that our medical patients come first," he
says, noting Aurora is part of the industry organization Cannabis
Canada, which also wants to see the double taxation on medicinal pot
go up in smoke.

"It's morally wrong, in our view, to tax people who already have a
chronic illness and many of whom are already in income-constrained

Minimal insurance coverage - by both private and provincial drug plans
- - also has medical cannabis users fuming.

With the exception of limited coverage for veterans and patients with
health spending accounts - discretionary funding that covers such
services as chiropractic and massage therapy, for example - most
private insurance plans don't reimburse the cost of medical cannabis.
And no province or territory covers the drug under public plans.

"There's less coverage in terms of public-sector coverage, which is
extremely unfortunate, given that most patients eligible for coverage
by provincial formularies are generally people who have low incomes or
are on disability," Zaid says.

"So these are people who really need coverage the most and they're
getting the least support right now."

Mcknight says since Liam started taking cannabis oil, he's been weaned
off all other anti-epileptic medications and has not once been rushed
to hospital or admitted due to seizures.

"So I think overall we are saving the health-care system thousands of
dollars," she says. "It feels to me as if we're being punished."
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