Pubdate: Sat, 12 Jul 2014 Source: Ottawa Citizen (CN ON) Copyright: 2014 Postmedia Network Inc. Contact: http://www.canada.com/ottawacitizen/letters.html Website: http://www.ottawacitizen.com/ Details: http://www.mapinc.org/media/326 Author: Jordan Press Page: A8 VETERANS AFFAIRS MULLS CAPPING MARIJUANA PLAN Daily dosage, cost looked at as medicinal use jumps fourfold Veterans Affairs Canada is considering capping its medical marijuana program, limiting how many grams of pot former military personnel can receive, and how much the government will pay. Veterans Affairs wants to ensure costs for the burgeoning program don't spiral out of control. The cap, proposed last month, is also aimed at addressing medical concerns over the efficacy and safety of using marijuana for medicinal reasons. Federally, Veterans Affairs Canada is the only publicly funded payer for medical marijuana. Veterans who have a doctor's note for marijuana can receive regular benefits from the government to cover all, or most, of the costs. Between 2011 and 2013, the number of veterans in the program, as well as its cost, have increased about fourfold, according to an internal briefing note obtained by the Citizen. In 2013, 121 veterans received assistance for medical pot, at a cost of $353,000 to the department. Even more veterans use marijuana outside any formal pot program to treat physical pain and symptoms of post-traumatic stress disorder (PTSD), said Mike Blais, founder of Canadian Veterans Advocacy. "They're using marijuana rather than anti-psychotic drugs to find that peace," said Blais, who was recently prescribed marijuana for back pain stemming from an injury while he was a peacekeeper. More veterans want to be in the program and are asking for daily doses beyond what the department feels is safe. Without the cap, "uptake is expected to increase significantly," reads the June note to Veterans Affairs Minister Julian Fantino. Although most prescriptions were for five grams a day, between April and June the department received 22 requests for 10 grams a day or higher, according to the briefing note. "It appears that doses being prescribed may be beginning to climb," reads the note. In April, Health Canada changed the rules for the use of marijuana for medicinal purposes. Rather than the government approving requests for medical marijuana, it was left to doctors to prescribe it and patients to purchase it from licensed growers. Before the change, Veterans Affairs had no cap on its medical marijuana program because Health Canada gave eligible veterans marijuana at a fixed price of $5 per gram. But after April 1, private growers charged varying rates, a challenge for a program that as of early June had no cash cap or dosage limit. By putting limits on the program, the department believes it can strike the right balance and also give doctors some guidelines, as their regulatory bodies are skeptical about having their members prescribe marijuana. Quebec recommends its doctors don't prescribe, Fantino was told in the briefing note. The department recommended capping coverage to veterans at five grams per day, and a maximum cost of $9 per gram. Those veterans approved for funds could go beyond these limits, but would have to cover the difference themselves. The veterans currently in the program would be allowed to keep whatever benefit levels they receive, but would have their files sent to a review board to see if medical marijuana usage could be brought "to a safer level." "How can they say, we're only paying this much when you've been prescribed (marijuana) for this reason?" Blais said. An additional $2 to $3 a day might sound small, he argued, but adds up over time. "These are part of the benefits of that sacred obligation that we pay for prescriptions or services related to our service wounds." The Canadian Medical Association says even five grams is contentious. CMA president Dr. Hugo Francescutti argued there was little evidence to prove marijuana's efficacy as a painkiller, pointing to a recent McGill University study that found marijuana didn't help as expected with arthritis patients. "Are there other things that do what marijuana is supposed to do? Yes," Francescutti said in an interview. "Do Canadians have access to good pain control? No." - --- [sidebar] THE NUMBERS 90: Percentage of veterans receiving medical marijuana who use five grams or less a day 30 grams: The highest daily dosage for veterans in the program 1: Veterans in the program who receive 30 grams a day 5: Veterans in the program when it launched in 2008 $19,000: Cost to provide medical marijuana to those five veterans in 2008 64: Veterans in the program in 2012 $254,000: Program costs in 2012 121: Veterans in the program in 2013 $353,000: Program costs in 2013 $6 -$12: Cost per gram of medical marijuana from licensed producers - - with files from Lee Berthiaume - --- MAP posted-by: Jay Bergstrom