Pubdate: Mon, 17 Aug 2015
Source: Duncan Journal (CN BC)
Contact:  2015 In Depth Media Ltd.
Website: http://www.duncanjournal.ca/
Details: http://www.mapinc.org/media/5535
Author: Gill Polard

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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MAP posted-by: Jay Bergstrom