there are limitations on the amount of the psychotropic chemical tetrahydrocannabinol (THC) present. (The amount of cannabidiol [CBD] is not legislated.) According to the regulations, the maximum allowed dose of THC is 10 mg per package item, which might be too low for some medical patientsand is not at all relevant for patients taking only CBD. The medical benefit from legalizing the sale of edibles might be the convenience for patients seeking THC, since liquid extracts (oil) are already available. Medical patients are likely going to choose an amount and a response time that is tailored to their health care needs. Allowing for a low dose of THC is understandable, given concern over the unintended consequences of the more potent and lasting effects of edibles (the duration of the effect can be 4 to 10 hours).
A potential medical entrant for the dispensing of medical cannabis is pharmacists. At present, they can offer advice and counselling for patients taking cannabis but cannot dispense it. The Canadian Pharmacists Association is askingthat pharmacist be permitted to dispense medical cannabis. There is a strong case to be made for medical cannabis prescribed by physicians to be dispensed from a medical facility by a person the patient already trusts, a pharmacist. As well, allowing pharmacists to prescribe could also improve access and coordinate the exchange of information with the family physician. This separate and monitored medical cannabis outlet might also be the mechanism through which to remove GST.
There has been no fundamental change in the health care profession on the merits of the wide-spread use of medical cannabis. The Government of Canada has a frighteningly long list of potential problems arising from the medical use of cannabis. The Canadian Medical Association has warned of the risk associated with it, but it does also recognize that some patients with “terminal illness or chronic disease may obtain relief with cannabis.” Many in the health care community have called for clinical studies of this drug, but conducting such worthwhile work is hampered because private laboratories are not able to get compensated for their findings (via patent protection) on a so readily available product. It is likely that only governments are capable of financing such research.
To obtain a prescription for medical cannabis a patient simply has to find a physician with a valid licence in Canada. The form asks for information about grams per day, but apparently Health Canada is not required to check that the dose is respected. There are no stipulations about the relative THC/CBD content. Physicians may give their own advice and follow up with their patients, but apart from signing-off, this is not required.
Around the country, some licensed producers have physicians connected to them or on staff who offer clinical advice on treatment paths and dosage. Some charge for this service.
No best practices are in place, because medical testing of cannabis is largely absent. From a patient’s perspective, it might be intimidating to venture into this kind of care, which seems so unfamiliar.
We are astounded that there has been no comprehensive study on the implementation effects of legalizing cannabis. Such a study would include everything from health and safety to employment and wages. Statistics Canada is the only agency with all the information to conduct such a review, and we would encourage it to do so and release as much of its data as possible. A question that should be asked is, have there been any cost savings from reduced policing or court cases? There is also likely value in having provincial entities conduct their own reviews, but we doubt there is much energy or the funds to do so.
Given that two staples in policy debates are reflection and prediction, moving on with the legal market for edibles without this review is problematic.
Allan W. Gregory is a professor of economics at Queen’s University. His main research interests have been in applied time series issues primarily in finance, international, and forecasting. He is also active in health economics.
Medical cannabis must find a home in the Canadian medical environment, and edible products have the potential to devalue its opportunity to do this. We think there must be ways for cannabis to enter into the conventional health care stream, where Canadians obtain their health advice and products.
A potential medical entrant for the dispensing of medical cannabis is pharmacists. At present, they can offer advice and counselling for patients taking cannabis but cannot dispense it. The Canadian Pharmacists Association is askingthat pharmacist be permitted to dispense medical cannabis. There is a strong case to be made for medical cannabis prescribed by physicians to be dispensed from a medical facility by a person the patient already trusts, a pharmacist. As well, allowing pharmacists to prescribe could also improve access and coordinate the exchange of information with the family physician. This separate and monitored medical cannabis outlet might also be the mechanism through which to remove GST.
There has been no fundamental change in the health care profession on the merits of the wide-spread use of medical cannabis. The Government of Canada has a frighteningly long list of potential problems arising from the medical use of cannabis. The Canadian Medical Association has warned of the risk associated with it, but it does also recognize that some patients with “terminal illness or chronic disease may obtain relief with cannabis.” Many in the health care community have called for clinical studies of this drug, but conducting such worthwhile work is hampered because private laboratories are not able to get compensated for their findings (via patent protection) on a so readily available product. It is likely that only governments are capable of financing such research.
To obtain a prescription for medical cannabis a patient simply has to find a physician with a valid licence in Canada. The form asks for information about grams per day, but apparently Health Canada is not required to check that the dose is respected. There are no stipulations about the relative THC/CBD content. Physicians may give their own advice and follow up with their patients, but apart from signing-off, this is not required.
Around the country, some licensed producers have physicians connected to them or on staff who offer clinical advice on treatment paths and dosage. Some charge for this service.
No best practices are in place, because medical testing of cannabis is largely absent. From a patient’s perspective, it might be intimidating to venture into this kind of care, which seems so unfamiliar.
We are astounded that there has been no comprehensive study on the implementation effects of legalizing cannabis. Such a study would include everything from health and safety to employment and wages. Statistics Canada is the only agency with all the information to conduct such a review, and we would encourage it to do so and release as much of its data as possible. A question that should be asked is, have there been any cost savings from reduced policing or court cases? There is also likely value in having provincial entities conduct their own reviews, but we doubt there is much energy or the funds to do so.
Given that two staples in policy debates are reflection and prediction, moving on with the legal market for edibles without this review is problematic.
Allan W. Gregory is a professor of economics at Queen’s University. His main research interests have been in applied time series issues primarily in finance, international, and forecasting. He is also active in health economics.
