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The MMPR Isn't Working For Patients Using Medical Marijuana

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While many federally authorized patients who are covered by the injunction can continue to grow their own cannabis until a decision is heard next year, many other patients have been thinking about joining or have had to join various licensed producers (LPs) for their supply of medical cannabis. Since the MMPR falls short in many important ways such as price concerns and patient supply, currently, there is serious resistance to this program among patients: a program that still does not really meet the needs of its patients.

Most media coverage currently seems to polarize the issue: the corporate, mainstreamed licensed producers and the "green rush" on the one side, and forgotten patients on the other -- particularly patients' rights to grow being stripped from them after more than a decade. What we've heard less about is the possibility that these two sides can actually coexist, and leave patients the choice to grow or access a commercial supply. We also should consider the possibility that its these Licensed Producers that will be at the forefront of a potential recreational market, so they likely aren't going anywhere.

Health Canada constantly reminds us that dried marijuana is not an approved drug or medicine in Canada. It is the court which requires reasonable access to a legal source of marijuana when authorized by a physician. Its ironic to hear Health Canada reiterate to us that Canadians should remember cannabis isn't really medicine -- they're only allowing this program because of a court order. But the real proof of Health Canada's feelings towards medical cannabis is manifested in poor legislation, as well as the lack of sustained funding over the last decade for research and development.

Health Canada has been saying for over a decade that there is a lack of clinical research to support the use of cannabis as medicine, but they have done precious little to facilitate meaningful research, education, and dissemination of information until very recently. They have also done little to maintain its previous program‏, the MMAR. For example, in the affidavit of Susan Boyd (taken from the recent injunction), a Professor at the University of Victoria and co-author of Killer Weed, she states that the "safety of personal legal cannabis production sites could be easily corrected by having better guidelines, education and monitoring of these outdoor and indoor gardens". This implies that the concerns pointed out by Health Canada in regards to the MMAR and personal growing licenses were more or less an outcome of poor legislation, implementation and follow through.

And now, patients outside the scope of the injunction are going to need to register with an LP of their choice if they want to continue purchasing and possessing cannabis legally. Many of these patients, I suspect, will continue to access through dispensaries if they are available in their area (and there's always mail order from many of them). But many dispensaries could be at risk of closing or being shut down because the new regulations, technically, leave less of a grey area for them to operate in. For example, the new program provides access to multiple strains, which wasn't available under the MMAR through Health Canada's legal supply channel: dispensaries typically filled this void. We also can't forget about the mandatory minimums for trafficking and possession with the intent of trafficking. Patients may also decide to purchase their cannabis and extracts through illegal channels, which comes along with a host of other problems I won't elaborate on here.

Aside from the fact that the new regulations are confusing at best, layered with multiple court cases across Canada, patients under the MMPR can't access their medication onsite, and may have to pay for shipping. I have trouble following when they claim the new program seeks to treat cannabis more like any other narcotic used for medical purposes -- for one thing, what other medication is delivered to patients solely through the mail, coupled with things like the continued resistance from the Canadian Medical Association and the lack of coverage under public and most private insurance plans? Health Canada could, at the very least, have more of a hand in implementing education and resources for these bodies, even if that means funding more scientific research and following through on that funding. Conversely, Health Canada finds themselves under-funded and understaffed to deal with a system they openly admit they want little to do with.

The point is that cannabis is not like other prescription drugs. It's a plant. Its benefits span across numerous ailments. And it involves a very individualized effect where each person has to navigate what works for him or her in terms of strains, dosage and administration. Many doctors are not comfortable with this.

While reading about the MMPR, its easy to group all licensed producers together and frame them in a negative light -- a faceless corporation -- but they are working within the constraints of regulations that take one step forward and two steps back. Many agree its heading in the right direction, but instead of condemning them all, I'd like to see more evaluation on both sides about who these producers are.

The Canadian Medical Cannabis Industry Association (CMCIA), for example, just recently launched, placing important concerns such as insurance and provincial drug benefit coverage as high priority issues. This past weekend, Mark Gobuty, the CEO of The Peace Naturals Project and secretary for the Canadian Medical Cannabis Industry Association spoke at the first NORML Canada conference, acknowledging the important role dispensaries play, particularly in terms of patient care. But we could also ask: do they support patients' rights to grow? Do they support legalization or do they contribute to prohibition efforts? What kind of experience do key people within these organizations have? Do they have comprehensive affordability programs?

We should resist blanketing hundreds of these companies under one label: the bad guys. The past has shown us in many ways that for real change, we have to find ways to work with the system, because it's a powerful one. We also need to think about how the values of a movement can remain intact even as entrepreneurs are, in some cases, displacing activists and the grassroots activism that provided access to many individuals across the country. This is also about choice. Patients deserve the choice to grow for themselves or access through a licensed producer.

I'm torn too, because I have been captivated both personally and in my studies while learning about the work of dispensaries all across Canada. I see the MMPR as the start of an intense law enforcement effort to close dispensaries (except, perhaps, in Vancouver) and arguably, the dispensary model provides the best access to one on one patient care and quality cannabis products. They've already been doing a fantastic job for so long and have helped thousands of Canadians access their medicine with safety, confidentiality and dignity.

The reality could be that LPs will, in a few years, begin pushing for on-site pickup and the authorization to sell a variety of cannabis products like food products, effectively trying to mirror the unique role of dispensaries, and replacing the grassroots activism and activists across Canada that started it. What happens when a movement of activists must give way to a market for entrepreneurs, and what will happen over the long term when we blend movement values with an emerging new market and the economic principles of for-profit businesses?

The blog previously appeared on Lift.

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