Medical Marijuana, In Depth Review

Medical Marijuana, In Depth Review

The Cowichan Valley is no stranger to medical marijuana. With scores of legal and illegal indoor grow ops plus a couple of large scale commercial growers including federally licensed Broken Coast Cannabis, the Warmland appears to be an ideal region for growing cannabis.

 

Canada’s history with legal medical marijuana dates back to 1997 when The Ontario Court of Appeals decision in R. v. Parker (2000), found that the law prohibiting cannabis possession (s. 4 of the Controlled Drug and Substance Act, or CDSA) was unconstitutional based on the idea that it forced people to choose between their liberty and their health in cases where marijuana is used for medically-approved purposes.

 

Therapeutic Benefits

Much of what we know about cannabis’ therapeutic properties is anecdotal as there is a lack of clinical studies available. This presents a problem for physicians who are now the gatekeepers to legal access. For several decades, the marijuana prohibition has prevented funding for clinical trials, the very same trials that MDs rely on when prescribing medicine to their patients. Without peer-reviewed clinical studies, MDs have little solid information about efficacy and dosing to go on and the stigma surrounding cannabis is tough to beat.

 

The human body has something called an Endocannabinoid System. We have cannabinoid receptors throughout our bodies including the brain, the organs, connective tissue, immune cells and glands. This physiologic system is important for establishing and maintaining health and humans are not alone, we share this same system with all vertebrate species. The cannabinoid receptors are believed to be more numerous than any other receptor system in our body. Endocannabinoids are stimulating substances made naturally by our bodies, however what we are finding now is that Phytocannabinoids, the plant substances that make up Delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) are gaining interest from patients and researchers alike as the potential healing benefits are more closely examined.

 

Since 2001, Health Canada has granted access to marijuana for medical purposes to Canadians who have had the support of their physicians. This system was called the Marijuana Medical Access Regulations (MMAR).

 

Brief Overview of MMAR

Health Canada’s MMAR program was established in response to the Parker decision. Under the MMAR, patients could apply to grow their own cannabis at home or they could elect to designate someone to grow on their behalf, there was also a third option that allowed patients to buy from a single Health Canada medical marijuana producer, Prairie Plant Systems. Today Prairie Plant Systems is known as CanniMed Ltd. and is a Licensed Producer under the current regulations.

 

Of the roughly 40,000 Canadians licensed under the MMAR to grow marijuana approximately half resided in British Columbia. These were people either licensed to produce their own medicine at home or who had licenses to produce on behalf of an MMAR patient. Designated growers were able to take on multiple patients and supply them with a multitude of strains, often working closely with their patients to find strains that provided the greatest amount of relief from their symptoms. Cannabinoids are funny things, what works to relieve one person’s symptoms may not work as well for another person. In some cases, where designated growers were working together large-scale gardens were being built and run, some servicing upwards of 500 patients.

 

The MMAR was not without issues. During the trial proceedings in Allard et al. v. R.  the RCMP’s Shane Holmquist testified that police had trouble distinguishing legal grow ops from illegal ones and that “overgrowing” was problematic. Police had no way of knowing whether a license holder was growing the amount allowed according to their license or growing more and potentially trafficking. The potential for organized crime in the MMAR was also cited often as a negative to the program.

 

Health Canada has stated that the number of medical marijuana patients is expected to rise as high as 400,000 over the next decade and in April 2014, Health Canada officially changed the MMAR system to one that puts the onus of prescribing marijuana on physicians and the production of the plant on large-scale commercial growers. This new system is called the Marijuana for Medical Purposes Regulations (MMPR). The MMPR effectively put all of those smaller gardens out of business as they were ordered to destroy all plants by April 1, 2014.

 

However in March of 2014 a federal court judge issued an injunction allowing individuals with personal production licenses under the MMAR to continue growing their own cannabis while a constitutional challenge (Allard et al. v. R.) was heard, the trial came to a close in May, but at press time this case is still pending.

 

Brief Overview of MMPR

Starting in April 2014 the MMPR changed the way Canadians accessed medical marijuana. Now someone interested in trying cannabis as a treatment can discuss it with their physician or a nurse practitioner who then fills in a Medical Document (similar to a prescription but with some additional information as required by Health Canada) which goes to the Licensed Producer (LP) of the patient’s choosing. A list of LPs can be found online at http://www.hc-sc.gc.ca/dhp-mps/marihuana/info/list-eng.php and patients should look into each LP thoroughly as some have compassion pricing options while others have organic certification and each has its own library of varietals on offer.

Under the MMPR, a Licensed Producer must adhere to strict regulations that cover everything from security, use of pesticides (not allowed), odour control, quality assurance, procedures, record keeping and advertising. LPs are subject to monthly surprise inspections from Health Canada inspectors who look to ensure that the quality of the product is up to medicinal standards.

What really sets the MMPR cannabis apart from “traditionally grown” or black market cannabis are the growth conditions and rigorous testing involved. Clean room standards are put in place to prevent powdery mildew, mould, pathogens and particulates from getting on the medicine. These measures are necessary as most Canadians accessing medical marijuana have compromised immune systems already. A great many of these patients suffer from serious ailments such as epilepsy, cancer, Crohn’s, chronic pain, Lyme disease, Fibromyalgia, Multiple Sclerosis and PTSD to name just a few.

 

The requirements set out by Health Canada mandate that each and every batch of medical grade cannabis be tested by third party labs for cannabinoid content, particulates and harmful bacteria, once the lab verifies that the cannabis has met Health Canada standards the medicine is packaged in child and odour proof packaging and shipped via Canada Post or courier to the patient’s doorstep. Ordering is a simple process, it happens on the LPs website, much like ordering a book from Amazon. While the MMAR was regulated the MMPR is arguably much stricter but still manages to allow more Canadians access to safe, legal and medical grade marijuana.

 

Health Canada, MMPR supporters and the LPs contend that this system is the only way to ensure medical grade quality marijuana. Indeed, because LPs are currently unable to sell to compassion clubs or dispensaries the source of medical marijuana to these storefronts is very much illegal and the product is often times but not always untested. Having said that, some vLPs have weathered several recalls due to bacteria and improperly labeled cannabinoid content.

 

MMPR Restrictions

  • Patients are limited to no more than 150 grams per month and can only order up to 30 times the daily prescribed amount at one time.
  • Only the patient or a designated caregiver can order and possess marijuana and no more than 150 grams.
  • Only a small number LPs are licensed to produce and sell extracts, the rest are licensed only to produce and manufacture dried flowers or “buds”.
  • Prescriptions can only be written by a Health Care Practitioner (MD or Nurse Practitioner) licensed to practice in the province or territory that the consultation took place.
  • No LP is licensed to operate a storefront, all sales must be conducted online.
  • LPs are not legally able to sell to dispensaries or compassion clubs.
  • LPs face severe advertising restrictions; as cannabis is a narcotic and it is subject to the Narcotic Control Regulations. The only information that LPs can share with prospective patients is the name of an available strain, the cannabinoid content of that strain, the price per gram and information on how to contact the LP producing the strain.
  • Until early June, Canadians could only purchase dried marijuana from LPs. The sale of extracts was prohibited.

 

Recently, the Supreme Court of Canada ruled that the restriction to dried marijuana violates the right to liberty and security “in a manner that is arbitrary and hence is not in accord with the principles of fundamental justice.” This ruling allows patients more options when it comes to consuming medical marijuana. The door is now open to people who do not wish to smoke or vaporize the medicine and for whom cooking with or brewing the dried herbs into a tea left them vulnerable to possession and trafficking charges.

 

Several LPs have already applied for and secured licenses to produce and sell extracts. Before cannabis prohibition in 1937 the US Pharmacopoeia cited cannabis as a useful drug for the treatment of a number of ailments. Cannabis tinctures first began to make their appearance around 1840 and were soon very common. The SCC ruling gives patients more options, allowing, for example, the opportunity to take a drop of tincture under the tongue which is a much easier way to ingest the medicine.

 

Changing Societal Views

While pot is still in no way as widely accepted by society as alcohol consumption or cigarette smoking the general population of Canada is coming around to it. British Columbia’s provincial health officer, Dr. Perry Kendall has come out in defence of medical marijuana. In particular he criticized federal Health Minister Rona Ambrose’s suggestion that marijuana lacks the benefits of approved pharmaceuticals. “The U.S. states that have had medical cannabis access provisions actually have about a 20 percent lower overdose death rate from opioid prescriptions than states that don’t have access to medical cannabis,” he said. “It’s probably a lot less dangerous than opioids are – less than morphine would be or Oxycodone, which can be highly addictive and quite lethal.”

The Canadian Medical Association still believes there is insufficient scientific evidence available to support the use of marijuana for clinical purposes. It also believes there is insufficient evidence on clinical risks and benefits, including the proper dosage of marijuana to be used and on the potential interactions between this drug and other medications. However, the CMA has recommended that the advancement of scientific knowledge about medical marijuana must be encouraged.

 

A poll released last year by the Department of Justice illustrated that 70% of Canadians want marijuana laws to be relaxed while roughly 37% want to see full legalization.

Marijuana will play a pivotal role in the upcoming election. Two of the major political parties, the Conservatives and the Liberals, have made it a key election issue.

 

In Vancouver, a landmark decision to regulate medical marijuana dispensaries has caused an uproar with the Federal government. Despite urgings to the contrary from the Health Minister, Vancouver councilors voted 8-3 to impose new regulations. The new regulations include an annual licensing fee of $30,000 for commercial dispensaries and $1,000 for non-profit compassion clubs, and would outlaw Dispensaries within 300 metres of schools, community centres and each other. Vancouver has seen a jump from 20 dispensaries to roughly 100 over the past year.

 

Dispensaries are popping up in Victoria too and Victoria’s mayor says that the city will look to emulate Vancouver’s plan to regulate marijuana dispensaries despite warnings from the Conservative federal government that they are illegal. It is estimated that there are roughly 24 dispensaries located throughout the rest of Canada outside of BC.

 

In Duncan, we have several storefronts that deal with marijuana peripheral products but next week we will see the opening of a dispensary in Mill Bay. The Warmland Medicinal Cannabis Centre will open the doors at 850 Shawnigan-Mill Bay Rd. (Pioneer Square Mall) and in addition to the dispensary will also offer seeds, books, and vaporizers plus a dedicated space for workshops, the first of which is scheduled to take place on August 25th. Owen Smith, the cannabis baker at the centre of the Supreme Court extract trial and Kirk Tousaw, one of Canada’s top cannabis lawyers will be presenting. Learn more on Warmland’s Facebook page for more details.

 

Chris Clay, the owner of The Warmland Medicinal Cannabis Centre said that with just one exception “Everyone has been overwhelmingly positive” about the new shop.

Clay has been a medical marijuana advocate for more than 20 years, having opened Canada’s first hemp store in London, Ontario in 1993. “We’re hoping to put the Cowichan Valley on the map for medical marijuana,” he says. His store, while technically still illegal will provide the sort of hands-on advice and information that first-time medical marijuana users need. “Health Canada’s approach is not working” he says and indeed, many MMPR patients complain that buying medicine online makes purchasing decisions difficult and the advertising restrictions prevent LPs from being able to discuss efficacy and strain selection.  How the community reacts to Clay’s new venture remains to be seen but if the positivity he’s already experienced continues we will most likely see more services like Warmland in the Valley soon.

 

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