Health Committee on May 13th, 2014

[Yvonne Jones, Liberal, Labrador, NL]

Have you done any research around whether it decreases the use of prescription painkillers? I've dealt with a lot of cancer patients, in particular, and I know that people in the health care system offered it as a form of treatment for patients, depending on what they were going through at the time. I'm just wondering if there's any evidence that it can reduce the use of painkillers, for example, for people who are suffering in that way.

[Philippe Lucas]

My primary area of research is called the cannabis substitution effect. That's a phenomenon where people either consciously or unconsciously use cannabis instead of using prescription drugs, alcohol, or illicit substances. The evidence suggests that approximately 80% of medical cannabis patients use cannabis instead of prescriptions drugs. About 50% use it instead of alcohol and about 35% use it instead of illicit substances. So, the retrospective studies certainly suggest that many, in fact the overwhelming majority, of medical cannabis patients reduce the use of pharmaceutical drugs by using cannabis.

[Yvonne Jones, Liberal, Labrador, NL]

Okay.

In the note I was looking at here, it talked about community-based medical cannabis dispensaries in Canada. How many of those actually exist in the country, and where are they? How do they work? What is it that they do, in terms of providing a service for patients or the public?

[Philippe Lucas]

There are about 75 medical cannabis dispensaries. It's a shifting number because they tend to open up and close down on a pretty regular basis in Canada. They tend to be concentrated in major urban areas. They have been shown, through research and otherwise, to provide a safe source of cannabis to Canadian patients who might need it.

They've been the primary provider of medical cannabis research in Canada thus far, because unfortunately the Canadian government hasn't been very forthcoming in providing funding for research into the medical efficacy of cannabis. Despite the switch over to the new MMPR program, they continue to exist and provide medical cannabis to patients.

[The Vice-Chair, NDP, Libby Davies]

Okay. I think we'll halt it there.

Thank you very much, Ms. Jones.

We'll now return to Dr. Morin.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you very much, Madam Chair.

My colleague, Dr. Lunney, mentioned the study conducted by scientist Andra Smith, to whom I referred a bit earlier. As far as I understand, you were not familiar with that longitudinal and perinatal study.

I will give you some information related to my question. The study consisted of a 10-person subject group and a 14-person control group. I thought it was peculiar that three young individuals from the control group said they had consumed marijuana one to four times in the previous year.

I think discussions on marijuana do not make enough of a distinction between

heavy users, light users, and occasional users.

Mr. Lucas, you said in your presentation that about 40% of Canadians have consumed marijuana in the past. That's a fairly high percentage.

Can you tell us what portion of those people have consumed marijuana a few times in their life? What percentage of people consume it regularly, a few times a month? What percentage do heavy users account for?

I don't know what the criteria or categories are, or where the limit is. I would like to hear what you have to say about this, since 40% represents a lot of people.

[Philippe Lucas]

The statistical information I remember is that 44% of Canadians admit to consuming marijuana at least once in their life.

As a researcher on drugs, I can tell you that the figure is probably a bit higher than that. Usually, when people call in and ask questions about drug use, not everyone gives an honest answer. So the percentage may be a bit higher than that.

In drug research, we call that.... We acknowledge that there's probably under-reporting going on with regard to substance use.

The other statistic that I recall is that around 10% of Canadians have used in the last month.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

So about 40% of people have smoked marijuana at least once in their life, and 10% of Canadians have smoked it the last month. Is any information available on those people's health status or the consequences of their marijuana use?

I don't want to accuse my colleagues across the way of fear mongering, but we can see where the conversation is headed. They seem to be insinuating that even the slightest marijuana use can cause irreparable long-term damage when, ultimately, I feel that the reality is much more nuanced.

Do you have any information on the health status of the 10% of Canadians who consume marijuana every month and of the 40% who have consumed the drug at least once? What are the long, medium and short-term effects on those people?

[Dr. Zach Walsh]

I can speak specifically to university students who we do research with at UBC. This is generally a high-performing group. Of those students, the rates of cannabis use are similar to what we see in the general Canadian population. We have about 35% to 40% who have used in the past year and maybe 5% to 10% who are fairly frequent users. We're embarking on a study to follow their university careers to see if there are differences in how these people go through their undergraduate education.

In looking at our cross-sectional data, we find that even the frequent cannabis users, on measures of mental health and well-being, are equivalent to and in some cases less anxious than are the non-users and even the infrequent users. We don't see any functional deficits on our measures according to the cannabis use, at least amongst the UBC undergraduates, who are admittedly overall a fairly high-functioning bunch.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you, Dr. Walsh.

You mentioned earlier in your presentation that after 28 days there were no differences in conditions between heavy users, light users, and non-users. Can you expand a little more on what other data you were able to collect, beyond cognitive differences, after those 28 days? Have you been able to evaluate whether there were other differences after 28 days of non-use of marijuana?

[The Vice-Chair, NDP, Libby Davies]

A very brief response, please. You're well over time.

[Dr. Zach Walsh]

That study was conducted at Harvard a number of years ago. Based on their sort of comprehensive neuropsych IQ tests, they didn't see any differences between the heavy users, the recently abstinent, and those who were never users.

[Philippe Lucas]

I just wanted to add regarding your first question that for the health care costs of Canadian users, according to 2002 data, the average cannabis user costs the health care system about $20 a year, the average tobacco user $822 a year, and the average alcohol user $165 a year.

[The Vice-Chair, NDP, Libby Davies]

Thank you very much.

[Philippe Lucas]

That's according to recent research.

[The Vice-Chair, NDP, Libby Davies]

We'll now go to Mr. Lizon.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much, Madam Chair.

Thank you, witnesses, for coming here this morning.

The first question I have is for both gentlemen.

This study has been going on for a few weeks. Are you familiar with the presentations that previous witnesses have made to the committee?

[Philippe Lucas]

I'm not, but I'm familiar with Dr. Sabet and some of his past statements on the use of cannabis.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

There were many witnesses here. The reason I'm asking this is that some of your views presented here are contradicting not their views, but their studies and their expertise. You can comment on this. We had people here who are professionals in the medical field and the pharmaceutical field. Therefore, I'm just curious as to what you base your findings on.

[Dr. Zach Walsh]

My findings are based on a comprehensive review of the empirical literature, on my expertise as a professor at UBC, where I teach the course on drugs and behaviour, and on my considerable experience in treating mental health and addiction.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Dr. Walsh, as you stated before, you are not a medical doctor or a pharmacist.

[Dr. Zach Walsh]

That's correct.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thanks.

[Philippe Lucas]

I'm a medical cannabis researcher and an addictions researcher, so my responses are based on scientific literature and experiences with medical cannabis patients as well, but frankly, I wouldn't cite anything that I didn't think could be backed up by peer-reviewed literature. That's why I've provided this committee seven or eight papers that support some of the findings I've stated here today.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Okay.

Going back to the discussion about prescription drugs versus cannabis, this committee completed a study on abuse and misuse of prescription drugs. We concluded it just a couple of months ago. All the prescription drugs, before they enter the market, have to go through the process of approval.

Contrary to that, cannabis has not gone through that process of approval. Therefore, we talked about and you talked about monitoring the patients. People who take prescription drugs.... We know there are side effects. We know that some people experience adverse effects, and those have to be reported. Sometimes, based on those adverse effects, the drug can be pulled from the market. This is not the case with medical marijuana. Can you comment on this?