The Leader in Legalization – Medical Marijuana

October 17th, 2018 is a historic day for Canada and the world. As Canadians witnessed the legalization of recreational marijuana use in our country, celebrations were enjoyed and questions were raised. Most citizens agree that decriminalization will assist in regulatory measures and demonetizing criminal organizations who previously profited from the drug’s prohibitive history.

Some claim that the quality of the substance will become more reliable while others wonder if this is supported by any evidence. Some recreational users are going so far as to have their government approved purchases tested against their illicit strains to understand what the administration deems as “good” or approved strains for public consumption. For all purposes this is a necessary check on the government, a bit distrustful in nature, but necessary nonetheless.

Which introduces an alternate history, seemingly less media worthy, of medical cannabis legalization. While recreational users are new to this forum (and welcome – the more the better!) – medical cannabis patients have been treading these muddy waters in Canada since 1990’s.

Tough Start

1900 – 2000

We could go through Canada’s entire history on marijuana prohibition to present day but there are plenty of resources available online. It’s an interesting history, one that all Canadians should know, as it was regularly used to exploit biased immigration policy and widespread racism. Maybe start with Emily Murphy and her book The Black Candle published in 1922. Unsurprisingly, Cannabis was criminalized in Canada in 1923 when it was added to the Schedule of Opium and Narcotic Act.

Fast forward a bit as Marijuana gained popularity in the 1960’s and 70’s and resulted in some excessively high conviction rates and in response, the Le Dain Commission recommended removing some criminal components. Although no legislation was actually changed, there was an environment of tolerance through the later 70’s under Prime Minister Pierre Trudeau. There’s a lengthy gap in Canada’s movement on the topic of legalization but in 1999 the first patients requesting medical cannabis qualified and approved under unique section 56 exemptions.

Please welcome the MMAR

2000 – 2014

In 2001 The Marihuana Medical Access Regulations (MMAR) was implemented. The MMAR was the first real step taken so individuals with a medical need could access medical marijuana. Additionally, authorized patients could grow their own medical cannabis, obtain it from authorized producers or Health Canada. It’s important to note that in 2001 there were fewer than 100 registered medical cannabis patients. While there were small adjustments to MMAR over the years – no substantial advances are realized until much later.

In the early 2000’s there were a few failed decriminalization attempts under then Prime Minister Jean Chretien. Unfortunately, further progress was quickly halted in 2007 when Stephen Harper announced his Anti-Drug Plan.

In 2013 the Canadian Government instituted the Marihuana for Medical Purposes Regulations (MMPR) to create a protocol for a commercial industry aimed at production and distribution of medical marijuana. This meant that patients could access quality-controlled dried medical marijuana produced under sanitary and secure conditions. Remember that in 2001 there were fewer than 100 registered medical marijuana users. In 2013 that number skyrocketed to over 37,800 individuals.

Spoonful of Sugar

2015 – 2017

A pivotal moment that broadened access to medical marijuana occurred in 2015 when the Supreme Court of Canada decided that restricting access to only dried marijuana was unconstitutional in R. v. Smith.. How a patient chooses to take their medicine should never be made inaccessible, restricted or criminalized. This decision is important because it shifted the mentality of skepticism towards legitimacy. Individuals with the medical right to use cannabis should be able to create products that are more accessible and/or palpable – especially if the government has not regulated producers to meet dosage demands. A spoonful of sugar helps the medicine go down. As the saying goes.

On August 24, 2016, the Access to Cannabis for Medical Purposes (ACMPR) replaced the MMPR. It is Canada’s solution to the issue that medical marijuana patients were required to go to a licensed producer only and that it violated section 7 security rights of the Canadian Charter of Rights and Freedoms. Reasonable access now meant that Health Canada would work alongside the Canadian Government’s pledge to legalize marijuana for all users to find a solution to how medical cannabis access functions within or alongside the more comprehensive plan.

History Made

2017 – today

The ACMPR can be summed up in 4 major strategies that regulate the legalization of medical cannabis production, distribution and use.

1) Regulations for commercial production by licensed producers that outlines quality controls and secure and sanitary conditions.

2) Allowances for individuals to produce cannabis for their own medical purposes or designating someone to produce for them.

3) Continuation of MMPR oversight of licensed producers while transferring influence to ACMPR.

4) Amending regulations under MMPR regime and updating definitions of and expanding the scope of products other than dried marijuana.

When the clock struck midnight across the nation – recreational users were relieved to finally spark their government approved and purchased marijuana joint with their fellow Canadians. Recreational marijuana use has endured its own legalization struggles and on October 17th – their hard work paid off. But it’s not a free-for-all. There are some details around the subject that could still land you in jail or paying large fines. Another question that was raised that day was why would anyone pursue medical cannabis status if use is legalized entirely? We explored the cost-benefit analysis in our article on Medical Cannabis or Recreational Marijuana – Which one is right for you? but perhaps there are other issues that arise.

Since legalization, The Canadian Medical Association has shockingly asked that the medical cannabis system be phased out – citing that without access barriers, there’s no need for a medical system.  This request carries so many potential problems. While their argument was supported by a general lack of scientific research on the health benefits and dosing of medical cannabis that’s like saying if people like vanilla ice cream why should there be other flavors? Just because you don’t understand the benefits of a potential treatment or how much to give does not mean you ignore the prospect of a new medicine entirely. Fortunately, Health Canada responded to the request with a statement outlining that the Cannabis Act will “aim to facilitate research with the goal of improving our knowledge of the risks and benefits of cannabis.” By operating the medical cannabis system within the legalized structure will allow for more funding for research into:

Recommended dosage – Imagine: What exact amount of CBD oil to be pain-free?

Possible interactions with other medications – Can it replace some pharmaceuticals? (Is this an option?)

New cannabis-based drug submissions – Think edibles!

Impact of cannabis on healthcare – Think healthcare coverage for medicinal cannabis!

Best known practice – Everyone needs this!

Health Canada has committed to reviewing the medical marijuana system within 5 years after legalization “to determine whether the system is meeting its objectives”.

This garners support from researchers and patient advocacy groups as well as the Canadian Nurses Association. The nurses have pointed out 2 legitimate arguments that:

Relying on recreational legalization will urge licensed producers to focus on recreational use products leaving medical cannabis patients without choices for consumption. It disregards the medical cannabis patients who are underage but who undeniably qualify for medical cannabis therapy.

So what does this mean for the future of medical cannabis?

Does recreational legalization ultimately hurt or benefit the medicinal applications of cannabis?

Is there an opportunity for a tiered system of delivery?

What we really should be asking is – why is there such apprehension towards medical cannabis?  Who does that benefit? Time will tell, unfortunately, or fortunately, what the outcomes are for medical cannabis as it operates within recreational use legalization in Canada.

Our history is strong and the research that is available is undeniably in favor of maintaining a medical cannabis system. We’ve explored the differences between the two structures medical cannabis or recreational marijuana. Let’s make sure that we all understand that legalization is still a step in the right direction for everyone. If nothing else, the stigma long-time associated with “pot smokers” being lazy, criminal or any one of the many scapegoat’s policy makers have used throughout the years can now be put to rest.

Medical cannabis is a viable treatment option for many Canadians and it’s about time that they weren’t judged for it.