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The future of legal pot

Roger Collier | CMAJ | May 17, 2017

Producers of medical marijuana want their products to be treated by insurers like any other medical product

Part II: The concerns of growers and advocates

 You might think that cannabis activists, who have been calling for marijuana to be legalized for years, would be ecstatic that the government has proposed legislation to do just that. Same goes for producers of medical marijuana, who could, if they expand to join the potentially lucrative recreational market, find a whole new set of customers.

Indeed, there has been optimism expressed from both advocates and growers. But the praise hasn’t been without reservations.

In part one of this article, CMAJ explored the concerns of physicians and health researchers about how the structure of the commercial market could affect public health. Here, in part two, marijuana producers and advocates offer their perspective.

In general, licensed producers of marijuana expressed praise for the federal government’s proposed legislation. Those who plan to expand into the recreational market have questions, though, about how it will be regulated. As for the medical stream, producers are advocating for their products to be treated the same as pharmaceutical products.

“We applaud this historic step the federal government has taken, which ensures patients have access to a secure and stable medical cannabis system,” said Brendan Kennedy, president of Tilray, a licensed medical marijuana producer in Nanaimo, British Columbia. “It is vital that public and private drug insurance providers work to provide coverage for medical cannabis in a manner consistent with other medical products.”

The government still has more work to do, however, said Kennedy. There are thousands of cannabis strains with varying effects, consumed in numerous ways and grown using a myriad of agricultural processes. To make educated choices, consumers need more information, he said, and the government should consider the necessity of branding and product diversification. “Allowing branding and different product formats — especially non-combustible forms of consumption — is crucial to give consumers options for medical consumption.”

How branding and advertising will be regulated in the recreational cannabis sector is also of great interest to Darren Karasiuk, vice-president of strategy for MedReleaf, a licensed producer in Markham, Ontario. Some legislators have looked to tobacco regulations for inspiration, noted Karasiuk, who suggested that, instead, current practices for selling and promoting alcohol would be a more appropriate framework.

Karasiuk, like others in his sector, was encouraged that the marijuana bill will not inhibit growth and innovation in the medical marijuana industry. MedReleaf has invested heavily in medical cannabis research, he said, and the company plans to continue that work, while also participating in the recreational market when it becomes legal.

“In broader terms, we think the legislation will provide a lot more scientific and economic opportunity for the industry,” said Karasiuk. “It will mean more opportunities for meaningful employment throughout the country and throughout the supply chain; from early-stage scientific pursuits to retail and all points in between. And we think it will contribute to a new wave of Canadian scientific breakthroughs and entrepreneurs, further helping our industry entrench its global leadership position.”

Greg Engel, CEO of the licensed producer OrganiGram in Moncton, New Brunswick, also lauded the federal marijuana bill. “As we have seen in other jurisdictions, a safe and secure adult recreational market begins with clear, strict and enforceable rules,” he said. Security and safety should be a priority, he said, offering particular praise for the government’s plans to protect the health and safety of Canadians, especially youth. “As a result, we look forward to greater detail related to issues such as child-resistant packaging.”

Cannabis companies that have positioned themselves to take advantage of both medical and recreation streams, such as Toronto-based Cronos Group, are excited about the new opportunities legalization will bring. “The legislation will help remove some of the negative perceptions previously associated with cannabis as it becomes more broadly accepted, and, as a result, we are hopeful that doctors will become more comfortable prescribing cannabis for medical applications,” said Eric Klein, who works in marketing and communications for Cronos.

Marijuana activists

Many long-time advocates for marijuana legalization are pleased the process is finally in motion. During April’s 420 rally on Parliament Hill, many expressed optimism about a future where marijuana users aren’t considered criminals. But not everyone in the cannabis community is happy with the proposed legislation.

One displeased advocate is Mark Stupak, owner of the Social Collective (SoCo) Medical Marijuana Dispensary in Toronto, who has been consuming 1000 mg of edible cannabis daily for 15 years, in addition to 40 mg of the antidepressant Paxil, with the knowledge of his doctor. He has been diagnosed with depression, anxiety, post-traumatic stress disorder and borderline personality disorder.

He’s particularly concerned about proposed new impaired-driving offences for having specified levels of tetrahydrocannabinol (THC), the primary psychoactive compound in cannabis, within two hours of driving. There would be a maximum fine of $1000 for having 2-5 nanograms (ng) of THC per millilitre (ml) of blood. Larger fines and escalating penalties for repeat offences, including imprisonment, would be handed out for having more than 5 ng of THC per ml of blood, or 2.5 ng in combination with 50 milligrams of alcohol per 100 ml of blood.

“The legislation, as it would be introduced by the Liberal government in regard to legalization of cannabis, would end my ability to drive,” Stupak said. “I’m not the only one in this predicament. As a collective of activists, we may end up launching a constitutional challenge right off the bat.”

Bob Davidson of Langley, British Columbia, who is a member of the Cannabis Coalition, is also concerned about the proposed changes to impaired driving laws. He said he has secondary progressive multiple sclerosis and has used cannabis daily for seven years. According to Davidson, people who use cannabis daily are not impaired by the drug in the same way as occasional users.

“Under this new law, I can medicate right now and days upon days from now will get arrested for impaired driving,” said Davidson. “If you asked thousands of medical cannabis users, they will say exactly the same thing: we don’t get the intense stoned effects with chronic daily use.”

Photo credit: Courtesy of the Hall family

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