State of the Nation: Medical Cannabis in Canada

There seems to be some confusion as to what the current state of cannabis in Canada is, especially when it comes to medical cannabis. The following is an attempt to clarify this confusion, especially for patients in need of medical cannabis.

When we speak of the cannabis markets, both here in Canada and abroad, there are two main categories. First medical cannabis, and second recreational cannabis. Medical cannabis is medicine and used by people to treat a medical condition. Recreational cannabis is used socially for the enjoyment of it. While there is a case to be made that these two categories can be fluid, for the purposes of the following, we will maintain the medical \ recreational duality.

Recreational cannabis, in Canada, is currently illegal, however, plans are afoot by federal and provincial governments to establish a legal, recreational market in cannabis. This new framework is scheduled to be implemented in the third quarter of 2018. Currently, provinces, in cooperation with the federal government, are devising production and distribution strategies which will vary from province to province.

In contrast, medical cannabis has been legal in Canada since July 2001. In fact, Canada was the first nation in the world to legalize medical cannabis. It was decided by the Canada Supreme Court that access to medical cannabis was a constitutional right for patients. Since then medical cannabis has been legally accessible to patients.

So, you are Canadian and cannabis is an effective treatment for your medical condition, how do you go about getting this medicine? It is all regulated by the “Access to Cannabis for Medical Purposes” also called the ACMPR.

The first step is to get licensed to use medical cannabis. Physicians in Canada are legally allowed to license their patients to use medical cannabis. So, in theory, an appointment with your family doctor, or specialist, should be all you need to start using cannabis as a medicine. Unfortunately, the reality of patients getting access to this medicine in Canada is not as simple. While doctors are legally allowed to license patients to use medical cannabis the majority of Canadian doctors do not have the knowledge to properly advise patients on the use of this medicine. Therefore most doctors will refuse to license patients. Physicians are within their rights to refuse if they feel they are not competent to license patents for medical cannabis. This problem is further exacerbated by the Canadian College of Physicians and provincial colleges being very resistant to medical cannabis and largely pressuring physicians to stay out of the medical cannabis realm.

Now, after all this, do not despair, there are options, besides your current doctor, to get licensed for medical cannabis in Canada. There are a handful of doctors at the cutting edge of clinical medical cannabis in Canada, and the number is growing every day. Depending on which province you live in there are several options to connect with a variety of specialized cannabis clinics. These clinics have a variety of staff trained in determining which cannabis or cannabis products is best for you. In addition, they know which Licensed Producers (LP's) are the best choice for obtaining your medicine.

Wait! Licensed producers... LP's? What is that?

Licensed Producers are a classification of business which produces and sell medicinal cannabis to patients (with a license ) in Canada. Once you have obtained your license, you will qualify to sign up with an LP and obtain your medicinal cannabis in the mail. These LP's are highly regulated by Health Canada. Cannabis plants are tracked from seed to sale, tested for potency and contaminants and grown under sterile conditions. Currently, some of the largest legal cannabis grow operations in the world are located in Canada.

In Canada, your medical cannabis license, issued under the ACMPR, allows you to store a certain amount of cannabis at your house, as well as, transport (a smaller amount) on your person when you are in public. So if you are stopped by police and produce documentation of your license, your cannabis will not be confiscated and you will not be charged with possession.

So, to review, the process of obtaining legal medical cannabis in Canada is:

1. Obtain a license from a physician (family doctor, specialist, cannabis clinic, etc.)
2. Choose a Licensed Producer (LP) and sign up
3. Order your medicinal cannabis, which you will receive in the mail.

While this process seems fairly straight forward, there is a market sector which can confuse all this. This sector is the “Dispensary” market sector. In Canada, a dispensary refers to a retail store, or e-commerce site, which sells cannabis. Several cities in Canada allow cannabis dispensaries to operate, despite Canadian federal law which prohibits them. Now, think back to the duality we established at the beginning. Some dispensaries are strictly medicinal, only allowing people to buy cannabis if they can prove a medical need. While other dispensaries and most e-commerce sites only require that you prove that you are 19 years or older.

So let's take a look at dispensaries in the “medical only” category. These dispensaries have a long history in Canada. The oldest medical dispensary, the BC Compassion Society is located in Vancouver and opened its doors in 1997! These dispensaries provided a very important service to patients. They recognized and advocated for the use of medical cannabis in Canada and are an important part of our cannabis tradition.

Fast forward to modern day, medical cannabis dispensaries have proliferated and can be found in jurisdictions across Canada. These dispensaries require that you prove that you have a medical need. While a license from a doctor, as discussed previously, would certainly be accepted, in contrast to Health Canada regulations, many other methods are also accepted. Notes from a varied number of practitioners (TCM practitioner, massage, and physio therapist, etc.) you may also be able to use a recent prescription bottle. Some have a well-trained staff that can help with medical need while other may not. As there are no regulations guiding these dispensaries, the quality varies.

So where do dispensaries, specifically medical dispensaries, get their cannabis and cannabis products from? Some of their supply comes from black market cannabis, however, probably the majority of the supply is from “gray market” sources. So what makes it gray market? Technically speaking, the cannabis is legally grown. In addition to patients being able to purchase medical cannabis from LP's, they are also able to obtain a license to grow their own medicine. Or, they are able to designate someone else to grow for them. Therefore gray market cannabis in Canada is grown using combined patient designations. It is gray and not fully legal because the sale of cannabis grown under this license is not permitted. In addition, cannabis grown under these licenses are not subject to inspection by Health Canada or testing for potency and contaminants.

There is a place for both LP's and dispensaries in the medical cannabis realm in Canada, each have roles to play in helping patients access cannabis. The following is a list of some of the advantages and disadvantages of Licensed Producers and Dispensaries.

LP Cannabis

Advantages
Allows you to legally possess and transport medical cannabis
Quality controlled and regulated by Health Canada
Mailed to our address
You can obtain license to grow your own cannabis (or have someone else to do it for you)
Access to several different companies and many different products

Disadvantages
Can be difficult to find a physician to issue a license
Can be cost prohibitive
LP's can only sell cannabis flower (bud) and oil tinctures

Medical Dispensary Cannabis

Advantages
Easier to access medical cannabis
Large variety of cannabis products
Local brick and mortar location to visit
Personalized one on one care and advocacy
Can be more cost effective medicine
Lots of choices, especially in populated urban areas (eg. Vancouver)

Disadvantages
Technically selling cannabis to you is not legal in Canada
Can not legally transport or store cannabis bought from a dispensary
Production facilities are not inspected and products are not quality controlled by Health Canada.

I hope this has helped you better understand the current state of medical cannabis in Canada. Thanks for reading.

References

1. https://www.canada.ca/en/health-canada/services/publications/drugs-health-products/understanding-new-access-to-cannabis-for-medical-purposes-regulations.html
2. https://www.cfpc.ca/uploadedFiles/Resources/_PDFs/Authorizing%20Dried%20Cannabis%20for%20Chronic%20Pain%20or%20Anxiety.pdf
3. https://thecompassionclub.org/
4. http://greenleafmc.ca/
5. http://www.aurahealthstudio.com/
6. https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/licensed-producers/authorized-licensed-producers-medical-purposes.html
7. https://en.wikipedia.org/wiki/Cannabis_in_Canada
8. http://www.marijuanalaws.ca/plant-calculator.html