I read through the Government of Canada’s Proposed Approach to the Regulation of Cannabis.  I would encourage every person currently working with or are interested in working with cannabis to give it a read. 

My biggest concern was the Cannabis for Medical Purposes Section. Under this section, the current method of distributing medical cannabis by an authorization from a physician or nurse practitioner and shipped from a licensed producer stays intact when legalization of recreational cannabis occurs in July of this year. Although it is good news that medical cannabis is at least being discussed, I have several concerns with this decision.

1.    Recreational and Medical Users are Fundamentally Different

What bothers me the most about this document is the lumping of recreational and medical users as being the same. Their objectives from using cannabis are fundamentally different.  A recreational user tends to want a high THC and low CBD product to become altered (‘high’).  A medical user will commonly need a variable ratio of THC/CBD to manage the symptoms of their disease.

Saying that medical patients will have access through the recreational system is an issue.  First, they are lumped in with the recreational users. The options of cannabis products in the provincially authorized sellers have not been determined, but I would be surprised if it would be as extensive as what we have with the current medical system.

2.    Contrary to Popular Belief Cannabis is a Pharmaceutical Medication

When cannabis is ingested (either orally or through smoking/vaporization) it leads to pharmacological effects.  These can help to manage symptoms in a patient with chronic conditions but also help people without medical conditions to reduce stress, help them sleep or relax.

The use of cannabis in any patient with a medical condition can likely benefit with support and education from a healthcare professional with special training in cannabis.

3.    Some Medical Users Can’t Currently Access Cannabis

With the College of Family Physicians of Canada (CFPC) and different regulatory bodies coming out with strong positions against cannabis for medical purposes, many physicians will not authorize or refer patients for medical cannabis. When legalization of recreational cannabis occurs, many will wish to try cannabis but will not be provided any professional education on the cannabis strains that can best address their symptoms.

This could lead to patients with significant medical conditions accessing cannabis through recreational retailers.  I am worried that they will select cannabis types, administration methods that may not be the most appropriate.

4.    The Proposed Legislation Penalizes and Potentially Stigmatizes Medical Users

Under the proposed regulations, a recreational cannabis user can decide to purchase cannabis, walk into a government approved regulator and purchase the product the same day.  Under the medical system, a patient is authorized to receive cannabis, the authorization must be sent to a licensed producer, the form is verified, the patient orders cannabis and it is mailed to the patient.  This process can take at minimum days, and up to a couple of weeks.  This system and delay penalizes patients who need cannabis as a medical treatment.

If a medical cannabis user decides to buy his/her cannabis from an approved retailer.  They may first not carry the optimal strain for their medical condition or symptoms.  By purchasing cannabis at these retailers, they may also be stigmatized as just another recreational cannabis user.

Here is How I Feel Medical Cannabis Distribution can be Improved Starting in July:

1. Allow other healthcare professionals with sufficient cannabis competencies to be able to authorize medical cannabis. Recreational cannabis will be a legal product, there should not be more restrictions on medical cannabis
2. Acknowledge that medical cannabis users and recreational users are different and using cannabis for very different reasons
3. Allow medical cannabis to be distributed directly by a healthcare professional. With cannabis being considered a pharmaceutical, it should be distributed through pharmacies like every other medication.  This ensures that every medical patient gets some counselling education regarding the benefits and risks of cannabis use
4. Educate Canadians. Many seem to think that this drug is benign without any risk.  Medically complex patients should be provided education and support of a healthcare professional with cannabis training
5. Develop cannabis competencies for healthcare professionals. This develops a standard of a care for medical cannabis users.  It also differentiates healthcare professionals with specialized cannabis skills