MMPR replaces MMAR and takes away patients’ right to grow

 

For many, the MMAR as we know it will come to an end soon, as the federal government of Stephen Harper has decided to make some changes. The proposed date of Sept. 30, 2013 will be last time that they would like to be able to grant Canadians permission to request authorization to possess or grow cannabis. The date of Mar. 31, 2014 is the last day that ill Canadians will be able to grow their own medicine, and the date that potentially thousands of them will become criminals in the eyes of the law. If your license is still valid as on this date, you may use it to register with a commercial grower. When it expires, you will once again have to see your doctor to renew your registration.

What started all this? According to Health Canada, the changes are necessary because:

“Over the years, stakeholders have expressed various concerns about the Marihuana Medical Access Program (the Program or MMAP). Program participants generally dislike the application process, and the fact that only a single strain of marihuana is available for purchase from Health Canada. Other stakeholders have expressed health, safety, and security concerns relating to the production of marihuana by individuals in homes and communities. Their specific concerns relate to the potential for diversion of marihuana to the illicit market due to limited security requirements, the risk of violent home invasion by criminals attempting to steal marihuana, fire hazards due to faulty or overloaded electricity installation to accommodate high intensity lighting for its cultivation, and humidity and poor air quality. Individual producers who are ill may be more vulnerable to health risks associated with mould. As more individuals receive licences to produce marihuana for medical purposes, the overall risk to Canadians increases.”

With the proposed new Health Canada program, all medical patients who need cannabis will have to purchase it from a licensed commercial grower and will not be able to grow it for themselves. As you can read above, they list several reasons why patients shouldn’t grow their own medication. Those in authority believe this creates health and safety risks to the patients and the neighbourhoods they live in. They believe we supply the criminals in our community with cannabis to sell on the street. The accusations don’t stop there, as we are allegedly at risk of home invasions, fire hazards, and the risks of having high-intensity lights in our houses. Apparently, this danger will increase as more licenses are issued. This sounds like a lot of fear-mongering to me. Do the authorities have the same concerns for those who use high-intensity lights to grow vegetables in their homes? Do they have mold concerns about indoor vegetable gardens? Are they worried that these gardens could start a fire? Obviously not, as they never seem to raise the same concerns about them, even though we are using the same equipment and food products. One would think that if cannabis was taxed and regulated like alcohol, it would go a long way in reducing criminal elements and the threat of home invasions, but apparently not.

Background

 

Canadians have been able to access therapeutic cannabis since 1999, if they held a Section 56 exemption. In 2000, the Terry Parker court case opened the gates to allow all sick Canadians the right to use cannabis for medicine. In 2003, the government found themselves in the courts again during the Hitzig case. During this case, the courts shot down five provisions of the MMAR program and found that there were “constituted barriers to eligibility and supply”. The Hitzig case allowed for patients to get a supply of dried cannabis and cannabis seeds directly from the government.

In 2005, the government again made amendments to the program, as they reworked the paperwork required, to attempt to make things easier for those applying. They also added language that allowed pharmacists to distribute cannabis to patients if it was allowable under the laws in their province.

2008 brought the government again before the courts, with the Sfetkopoulos case. This case resulted in a 2009 ruling that allowed designated growers to grow for more than one ill person. Then in 2010, the government found itself back in the courts with the Beren Case, which struck down the one-producer-to-one-user ratio, as well as the limit of producers per location. The result was that patients could grow for other patients, and designated growers could grow for two ill people, while increasing their numbers per location to four.

In 2011, a British Columbia court ruled, in the Smith case, that by not allowing cannabis derivatives, the MMAR prevented patients from a choice of alternative methods of using cannabis. This decision found that it was wrong to prevent patients from being allowed to produce items such as baked goods, tinctures, and other alternatives. Unfortunately, the new program does not allow this to happen, and only allows for dried cannabis, which will land this new program back before the courts.

Health Canada also says, “The Court decisions leading to the 2009 and 2010 amendments support Health Canada’s position that dried marihuana for medical purposes should be produced and distributed as much as possible in the same manner as a medication”. This leads us to today’s MMPR.

According to Health Canada, part of the issue with the present program is that it is growing faster than expected, and it is costing Canadians money to supply cannabis to people in the program. Didn’t sick and dying Americans hear the same thing when George Bush Sr. shut down their cannabis program? In 2002, there were less than 500 people in the MMAR, with an estimate of that growing to around 50 thousand by the end of 2014. They say it costs Canadian taxpayers $27 million to purchase cannabis from Prairie Plant Systems, while they are only taking in $1.6 million on the sales of cannabis and seeds. With little  income, one has to ask why there is such a large contract from PPS.

How will this new proposed program work? With the elimination of growing licenses and the movement toward commercial suppliers, patients will have to take a prescription from their doctor to a commercial grower to register with them. They can also purchase their medication from a pharmacy or a hospital that acts as a distributor for a commercial grower. The authorization to carry the cannabis would be the label on the container, much like the way other prescriptions are done. There is some concern within the cannabis community that patients will be forced to go with less. The proposal states, “licensed producers would not be allowed to sell or provide more than 30 times the daily amount in any 30-day period, taking into consideration the expected length of time for the shipment to reach the registered client, nor would they be able to ship more than 150 g at a time.” While the shipments will be small, the proposal doesn’t prevent the patient from getting over 150 grams per month. It means the patient will have to place more than one order per month, thus driving up the cost.

Options

Health Canada says that they looked at three options. This would include the proposal that is now being looked at by Canadians, the status quo, or one that they feel combines the two. They didn’t like the combined option because it would still require them to keep records, administration duties, and costs. The status quo was rejected because they feel that we are not responsible growers and are a threat to the communities we live in.

Licensing

When it comes to the production of the cannabis, the proposed program will allow for large-scale producers that will be licensed through Health Canada. They say this will allow for the proper inspection of not only the production site, but also the product it produces. In order for a company to become a licensed producer, it must complete several things. These include:
a detailed description of the physical security measures that would be put in place at the site;
a detailed description of how the licensed producer would keep records of their activities with marihuana and cannabis other than marihuana;
a quality assurance report that shows that the buildings, equipment, and proposed sanitation program to be used meet the good production practices […] requirements;
a copy of the notices provided to the local police force, local fire authority, and local government;
the maximum quantity of dried marihuana to be produced and sold or provided under licence (if applicable); and
floor plans of the site.

The proposed program will allow the new producers to sell more than one strain, which is a little bit of good news. If a patient wants to keep the special strains that they are presently growing, they are allowed to pass these onto the new producers. The license holders can also obtain an import-export license, which will allow them to bring in seeds and cannabis from other legal sources.
When it comes to the police and the sharing of information, it appears the responsibility of sharing this goes from the government to the licensed producers. If the police are doing an investigation, the proposal states that “a licensed producer would be required to confirm as soon as practicable whether the individual is a registered client or an individual who is responsible for a registered client and the daily quantity of dried marihuana specified in the medical document.”

Product Safety

All producers must also follow strict production practices that would insure all of their equipment, tools, and other needed items are kept clean and not allowed to get contaminated. The producers would also have to hire a quality control person who has the proper training, experience, and knowledge to approve the quality of dried marihuana prior to making it available for sale. The proposal mentions that “licensed producers would have to test dried marihuana for microbial and chemical contaminants and ensure they are below generally accepted tolerance limits for herbal medicines for human consumption, as established in any publication referred to in Schedule B to the FDA”.

When it comes to the packaging and labelling of the patient’s cannabis, the commercial grower will have a “tamper-evident and child-resistant container”. When it comes to how much you can have in that container and how it would be identified, the new proposal recommends, “the maximum package size would be 15g. Each package would contain standard information about the product, including the weight in grams, the percentage by weight of delta-9-tetrahydrocannabinol (THC) and of cannabidiol, the packaging date, the expiry date if one has been established by stability testing, and a warning to ‘KEEP OUT OF REACH OF CHILDREN’.”

Distribution & Shipping

How will people receive the cannabis they require? According to the proposal, individuals will have several ways to obtain it from the licensed producer through “secure shipping only,” and no storefront businesses will be allowed. The proposal also mentioned that cannabis “could also be sold or provided by pharmacists, authorized health care practitioners and hospitals” that would purchase the cannabis from licensed producers. So if there are no storefronts allowed, how will people know if their pharmacy or hospital carries cannabis. The company selling the cannabis must ship it to the patient or the distributors in packaging that allows for tracking, and would have to be airtight to prevent any odour escaping so it couldn’t be identified.

All records and transactions of the cannabis must be kept for two years. This includes all the sales and cannabis returned by patients. They must also have an inventory of all their medication, including the seeds, freshly harvested, dried and packaged cannabis.

Security

Authority has always had a problem with the existing MMAR program. They feel it allows the criminal element to legalize their growing. They also believe that growing cannabis in your house leaves you open to home invasions.  This is why the new proposals will require that all commercial growers have surveillance cameras inside and outside the buildings. They also mention that some of the areas within the facilities will need cameras and motion detectors to ensure that no undesirables get in, and no employee carries any products out the back door. All video recordings will have to be stored for two years.

When it comes to employees, they to must also be security cleared, as their names must be included in the licensing, and will require a criminal record check before the license will be given. If an employee is found to have a criminal past or criminal connections, the license will be rejected.

Benefits and costs

 

What are the benefits of going to this new program? They feel that the benefits include preventing cannabis from being grown in a house, reduction of home invasions, and reduction of fire risks to the growers and the people around them. Other than using our safety as a concern, they didn’t list any benefits to the patient who is already growing. Their analysis even states this when it reports that they “made no attempt to measure real or perceived health costs or benefits in terms of therapeutic effects or improvements to quality of life. Instead, the study relied on estimating purely economic impacts…” Basically, money is the issue. To me, it’s obvious that they prefer it going to large businesses and corporations instead of having a patient produce an affordable medication that creates income and small businesses.

The estimated cost for a patient to purchase cannabis under this new program is to be $9 a gram to start. For some people already growing, this will be an increase that is five times the amount that it is already costing them. The only thing protecting the purchaser from outrageous costs is the market—sort of like how the oil companies work and how the market is supposed to keep prices low. It’s something we all know about, but something that we don’t see because it doesn’t happen. With no plan to have insurance coverage to help pay for this product, the cost to many patients, who are on a low fixed income, will be a problem. Many will not be able to afford their medication and will be forced onto unwanted prescriptions, as they, unlike cannabis, are covered under drug plans.

Can we find savings through claiming this on our income taxes, like other medication? Will we be taxed? With no savings, what is there for the patients? At one point, we were told that this program would be easy to access. While the paperwork is gone and no longer delayed by a department that is understaffed, this program will not be any easier to access. The proposal does nothing to make it easier for a doctor to fill out the prescription and paperwork for the patients. This isn’t just my concern, but is reflected in the estimates provided by Health Canada. They predict that the existing program would have over 50 thousand people in it by 2014, and reach about 435 thousand by 2024, whereas in the new proposed program, they estimate there will only be a total of 308 thousand by 2024. Does that sound like something that is easier to access?

What does it cost to run the program now, and what will it cost in the future? According to the proposal, “the administration cost of the current program would increase from $20.63 million in 2014 to over $120 million in 2024, in the absence of any changes. These costs include salary, employee benefits and accommodation costs associated with dedicated staff, operations and maintenance costs, training, supplies, and other corporate overhead costs”. With the reduction in work required, and the reduction of people in the program, the government feels that this new proposal will reduce administration costs by 90 percent (not including contract savings) and will save the taxpayers over $71 million per year.

Part of the report says that “Government, and ultimately, the Canadian taxpayer, are the main beneficiaries of regulatory change through the reduction in program administration costs. Business, especially medium-sized business, is also a beneficiary in terms of producer surplus benefits and the expansion of the legal marihuana supply industry that could grow to more than $1.3 billion per year in annual sales by the end of the forecast period”. But if the government and Canadian taxpayers are the biggest beneficiaries of this new program, one has to ask what benefit there is for the patient, or whether they are the forgotten piece of these new proposals. The government also recognizes that these new businesses will have some large setup costs, but goes on to say that the “returns supported by a growing industry could potentially compensate owners of capital in a relatively short time”.

In the end they also believe that this will have an impact on research and what they can learn as the “scientific information that could advance society’s knowledge about uses of the plant.” This was something that made cannabis researcher Dr. Mark Ware excited during his interview on CBC radio’s The Current. While this reads and sounds good, one only had to listen to the Health Minister tell Canadians on the same program that the collecting of this information was not going to happen.

Part of the rationale for this program as stated in the proposal is, “The proposed MMPR would provide a more efficient way of accessing marihuana for medical purposes, particularly by affording individuals with medical need increased choice in terms of authorized health care practitioners, marihuana strains, and suppliers.” It’s interesting that they state “affording individuals”. What about the patient who can’t afford this new program, but could afford the old one? What about the patient who will still have a problem getting a signature? Neither of these concerns is addressed in this new program. After speaking with my doctor about these proposals, I had to agree with him when he said, “the government didn’t think this through very well, for the patient or for the doctors”.
To read the whole proposal go to www.gazette.gc.ca/rp-pr/p1/2012/2012-12-15/html/reg4-eng.html

 

 

By Al Graham