May 13th, 2015 – Canada’s medical marijuana marketplace is in upheaval. A recent UBC study found that one-third of medical marijuana patients were unable to access their medicine legally under the federal rules and as a consequence are turning to the black market for supply. Patient’s access challenges appear to stem from issues of product affordability, supply shortages by Licensed Producers and in obtaining a doctor’s approval.

The study, led by PhD Student Rielle Capler and UBC nursing professor Lynda Balneaves, looks at the impact of shifting federal regulations on patients. While the results are preliminary, Capler said many participants reported facing barriers including cost and supply.

“Patients really want to be able to use this medicine legally,” said PhD student Rielle Capler. “They’ve expressed patience and understanding that there are some growing pains (in the MMPR program), but in the meantime they’re also sharing that it’s really impacting … their health and well-being.”

The regulations were to be replaced in April 2014 by a new program, called the Marijuana for Medical Purposes Regulations (MMPR), which requires patients to buy cannabis from commercially licensed producers. But a court injunction has kept the old program alive for already-enrolled patients, until a constitutional challenge of the new rules could be heard.

Canada’s Medical Marijuana

Affordability:
With respect to affordability, under the old MMAR program patients were allowed to grow their own marijuana at a cost of about $2 a gram, compared to purchasing it at about $8 to $15 a gram from a producer licensed by Health Canada. This cost differential is likely due in part to too much demand for too little supply from licensed MMPR providers. Some also argue it represents the profit motive.

Supply Shortages:
Another challenge faced by patients is that there is inadequate supply from the current group of MMPR licensed producers to meet demand. There are currently only 17 Licensed Producers approved by Health Canada which has been moving very slowly to approve new producers. The result is a significant number of producer applicants stuck in the pipeline, high prices and regular product shortages.

Maybe an upcoming conference is an opportunity for the licensed producer sector to address product shortages. Aimed at educating current and prospective licensed producer applicants on compliance and other regulatory issues. The Canadian Medical Marijuana Conference happening in early June will be an opportunity for producers to convene, learn and air their concerns. Hopefully Health Canada will be listening.

Obtaining a Doctor’s Approval:
Finally, another issue faced by patients includes the difficulty of getting a doctor’s approval. Recently, The BC College of Physicians and Surgeons has instituted new rules that require doctors prescribing the drug must either be, or have the approval of, a patient’s primary physician. Unfortunately, not all doctors are educated on the benefits of medical marijuana and do not support its use.

However, a leading Toronto-based doctor Dr. Danial Schecter believes the market is moving in the right direction.

“I actually overall like the system because it allows physicians to assess patients from a medical perspective for their suitability for cannabis and cannabinoids and it also allows patients a secure and safe source for cannabis,” says Dr. Danial Schecter, founder and executive director of the Cannabinoid Medical Clinic.

What we need are more doctors who have educated themselves on the benefits of cannabinoids, along with increased supply from licensed producers (or people able to grow their own medicine) and lower costs for patients. Until this happens, patients will be in upheaval, reluctantly forced to seek their marijuana pain medications from illegal sources, and unfortunately carry legal and product quality risks in addition to their ailments.