Concerns Stemming From the February 18th Health Canada Consultation Re. Proposed Changes to the MMAR:
At the February 18th meeting of the OCMA, several changes to the MMAR were presented to invited stakeholders. These changes were meant to address court remedies to the constitutionality of the program. While some of the proposed changes appear to be going in the right direction, overall they do not meet the needs of Canada's critically and chronically ill whom medical cannabis could benefit. Medical cannabis users and compassion society representatives who were present at the meeting expressed some of their concerns about the proposed changes at that time.
We hope this input from the key stakeholders will be addressed in the drafting of a regulatory proposal. Any continued impediment to access will force thousands of critically or chronically citizens to continue to suffer unnecessarily or to risk arrest for accessing their medicine, neither of which are acceptable to the Canadian courts or public.
The following is a summary of those concerns and others that have surfaced upon further reflection.
Conditions and Symptoms included in Category 1 must be revised.
Removing the necessity for a second specialist for those in the former category 3, as specified by the Ontario Court of Appeals, is a definite improvement to the MMAR. The categories should further be revised in terms of which conditions and symptoms are part of category 1. For example, Hepatitis C is glaringly missing from category 1.
The specialist requirement for category 2 applicants remains arbitrary and unworkable.
The proposed changes to medical practitioner declarations and the elimination of the requirement to identify conventional treatments tried and the reason inappropriate or ineffectiveness, are a step in the right direction. However, there is no scientific or medical reason to require a specialist for category 2. Cannabis need not be subject to more restrictions than pharmaceuticals or over- the-counter drugs with similar, or worse, safety profiles.
Furthermore, with so many medical associations - including the CMA, Colleges of Physicians and Surgeons, and the Health Protection Association - advising physicians not to participate in the federal access program, this requirement makes the program unnecessarily onerous for some, and completely unworkable for many others.
As such, all applicants should be subject to the same requirement of support from one medical practitioner. In addition, medical practitioners eligible to verify conditions and symptoms must not be limited to physicians, but must include other primary health care practitioners such as Naturopaths and Doctors of TCM.
The disclosure of information of MMAR participants to police must remain voluntary.
Police must avoid the arbitrary arrest and enforcement of the CDSA against medicinal users legally permitted to possess and cultivate. However, the proposal for mandatory disclosure of information to police is a violation of privacy rights. There is no reason to discriminate against those who might benefit from the therapeutic use of cannabis by forcing them to disclose personal information at the request of police organizations. Health Canada has a poor record of confidentiality, having accidentally released a list of Section 56 exemptees to journalists during the early days of the program. For many potential and current participants in the MMAR program, this requirement is reason enough to avoid federal registration for therapeutic cannabis use. As a result, police and courts will continue to be the position of using their discretion in relation to legitimate medicinal users who chose not to participate in the MMAR because of forced disclosure.
Health Canada's plan to eventually "fade-out" PPL and DPL licenses ignores the needs of medical cannabis users.
Health Canada's plan to eventually fade out Personal Production and Designated Person Licenses is of no benefit to the most important stakeholders in this program: the patients. For many, growing their own source of medicine not only allows for control over the mode of production (organics vs. non-organics) and strain selection, but also minimizes some of the costs associated with cannabis therapeutics. Future plans for the MMAR must continue to allow personal production and designated person licenses and implement the courts' remedy of allowing Designated-person Production License holders to grow for more than one holder of an Authorization to Possess, and more than three holders of licenses to produce to cultivate together.
Supply issues have not been properly addressed, and a productive relationship with Compassion Societies has still not been established.
The cannabis grown by PPS, available through Health Canada, is inadequate to meet the needs of medical cannabis users. Plans for a second production contract will not address the need for a wide variety of strains, stronger product, and safer cultivation techniques. These goals would best be achieved through the contracting of a large number of small-scale producers who possess the expertise and experience necessary for this important undertaking.
Compassion Societies across Canada have garnered unique and invaluable experience supplying cannabis to over 7000 of Canada's critically and chronically ill, including most of the current MMAR license holders. Although Health Canada has recently acknowledged this fact in court to defend the lack of supply by its own program, the OCMA has yet to develop a cooperative relationship with these important organizations. Health Canada must act to legitimize compassion societies as soon as possible and recognize them as effective models for distribution.
Cost coverage is unresolved.
Health Canada must establish affordability and cost coverage for all use of cannabis for recognized medical conditions and symptoms. This must not be limited to Health Canada's product, which is below quality standards for potency, variety, and safety. Coverage must address all costs of medicine, including personal cultivation and purchases from compassion clubs. The failure to act on this important issue will continue to force many legitimate users of medicinal cannabis into poverty.
Until these pressing concerns are properly addressed, Health Canada cannot claim to be working with the best interest of Canada's critically and chronically ill in mind, and this program will remain an unworkable and unconstitutional failure.
Canadians expect and deserve better from Health Canada.
