One year ago, UBC nursing professor Lynda Balneaves and PhD student Rielle Capler launched the Cannabis Access Regulations Study, (CANARY), to investigate how the end of homegrown medical marijuana would affect patients. One year later, with federal regulations on medical marijuana tied up in the courts, Capler discusses what they have learned about how patients are accessing cannabis.
What is the CANARY study?
It’s the largest study in Canada looking at the early impact of the new regulations on patient access to medical cannabis. There were about 450 patients nationwide that completed the survey, and a subset of about 30 that we interviewed to get a more nuanced understanding of the patient experience.
What are the current regulations in regards to medical marijuana?
Until last year, there was the Medical Marijuana Access Regulations (MMAR). Under that program, patients were able to grow cannabis for themselves or designate somebody to grow it for them, or they could purchase it from a sole supplier through Health Canada. That was the legal route.
The MMAR was supposed to be replaced last April with the Marijuana for Medical Purposes Regulations (MMPR), but a court injunction prolonged the MMAR for those already enrolled in it. The MMPR prevent people from being able to grow their own cannabis, or to have someone grow it for them. Instead there are a number of commercial licensed producers from whom they can purchase cannabis.
What have you heard in your survey and interviews?
We are at preliminary stage of analysis, but we’ve heard that patients really want the regulations to work, so they can use this medicine legally. At present there are some growing pains associated with these new regulations that are impacting patient access.
Under the old regulations, patients are saying they could grow it for $2 a gram, and get the amount that they need and the quality that they need in a timely fashion. The cost under the new regulations is prohibitive for many patients, and the availability of product from suppliers has been limited.
A lot of people who are using cannabis as a medicine are using it for critical and chronic illnesses. In some cases this is the medicine that works the best for them with the least side effects, and in some cases, it’s being used to address side effects or as a substitute for other medications, such as opiates.
How are patients consuming it?
Legally, they are only allowed to access it in a whole or ground bud form, which they can smoke or vaporize. They can’t legally purchase or produce extracts, baked goods or tinctures. But a lot of them prefer those routes. A court case is currently addressing this issue at the Supreme Court of Canada.
Many people may not realize dispensaries are actually illegal, given that they require a doctor’s note.
Dispensaries have created a grey zone, because they’re saying, “We’re not legal, but we’re doing it as legitimately as possible.” That’s what has allowed them to keep their doors open.
Some cities, like Vancouver, are tolerant because they recognize the need being filled and also that these dispensaries require a doctor’s confirmation.
The Canadian Association of Medical Cannabis Dispensaries has developed standards for dispensaries around all the aspects of providing cannabis to patients, including quality of supply, doctor’s notes and eligibility. The association has just started a certification program to support dispensaries with this.
What conditions are patients using it for?
They are using it for quite a variety of conditions. In our study, people were using medical cannabis to help cope with cancer, chronic pain, HIV/AIDS, arthritis, digestive disorders, Multiple Sclerosis, PTSD, anxiety and a large number of other conditions and symptoms.
For more info on the CANARY study, go to: www.canarystudy.ca