HTTP/1.0 200 OK Content-Type: text/html Federal Smoke Clears, A Little
Pubdate: Tue, 15 May 2001
Source: Canadian Medical Association Journal (Canada)
Copyright: 2001 Canadian Medical Association
Issue: CMAJ 2001;164(10):1397
Bookmark: (Cannabis - Medicinal - Canada)


Fourteen years after narcotics police arrested Terrance Parker (who had 
discovered that smoking marijuana reduced the frequency of his grand mal 
seizures), and a year after the Ontario Court of Appeal ruled that Canada's 
discretionary regulation of the medicinal use of marijuana was "unfettered 
and unstructured ... [and] not consistent" with the principles of 
fundamental justice,"1 our federal government has taken the bold little 
step of drafting new regulations.

In Canada, even the simple possession of small amounts of marijuana for 
personal use is a criminal offense, unless you are one of the roughly 40 
Canadians who have obtained a special dispensation to use cannabis to 
relieve the symptoms of cancer, AIDS, multiple sclerosis or epilepsy. The 
program is unduly restrictive. The new regulations promise more 
transparency in the review of applications to grow or possess medicinal 
marijuana, a broader definition of medical necessity, and greater latitude 
for physicians in determining the needs of individual patients.

There are no persuasive randomized trials of marijuana therapy for the 
relief of symptoms such as pain and nausea. Such trials are extremely 
difficult to do. But the ratio of drug effect (however subjective that 
effect may be) to drug harm is large: there are no reported cases of fatal 
marijuana overdose. The risks of lung cancer (from the tars in the smoke) 
or the very weak (and perhaps nonexistent) risk of addiction are mostly 
irrelevant to patients with terminal disease or severe chronic conditions. 
About 400 000 Canadians use cannabis for medical reasons.2 Professional 
organizations such as the CMA must move quickly to issue guidelines for 
physicians who, increasingly, will be asked for advice by their patients.

Health Canada's decision to legitimize the medicinal use of marijuana is a 
step in the right direction. But a bolder stride is needed. The possession 
of small quantities for personal use should be decriminalized. The minimal 
negative health effects of moderate use3 would be attested to by the 
estimated 1.5 million Canadians who smoke marijuana for recreational 
purposes.2 The real harm is the legal and social fallout. About half of all 
drug arrests in Canada are for simple possession of small amounts of 
marijuana: about 31 299 convictions in 1995 alone.4 Many lead to jail terms 
or fines and all result in that indelible social tattoo: a criminal record. 
This means that for anyone who's ever been caught with a stash in his or 
her pocket, the question "Have you ever had a criminal conviction?" during 
a job application or medical school interview can force higher aspirations 
to go up in a puff of smoke.

The decriminalization of marijuana possession for personal use does not 
mean making marijuana "legal" or letting it be sold in every schoolyard. It 
does mean that possession of small amounts for personal use would become a 
civil offense, like a traffic violation, not a criminal one. The provisions 
of Canada's Contraventions Act make this a relatively simple legislative 
task. Mr. Justice Minister, let's decriminalize the possession of small 
amounts of marijuana for personal use. - CMAJ


1. R v Parker (31 July 2000). (Ont. C.A.). (accessed 2001 Apr 19).

2. Ogborne AC, Smart RG, Adlaf EM. Self-reported medical use of marijuana: 
a survey of the general population. CMAJ 2000;162(12):1685-6.

3. Hall W. The cannabis policy debate: finding a way forward [editorial]. 
CMAJ 2000;162(12):1690-2.

4. Single E, Fischer B, Room R, Poulin C, Sawka E, Thompson H, et al. 
Cannabis control in Canada: options regarding posession. Ottawa: Canadian 
Centre on Substance Abuse; 1998.  (accessed 2001 Apr 18).
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