Health Committee on Sept. 12th, 2017

[Marc-Boris St-Maurice]

If I may add, concerning the situation in Canada regarding licensed producers and the price they sell at, these companies are funded and publicly traded. Many of them are currently operating at a loss in the hope that eventually they will regain that. There's a lot of speculation, and I'm quite certain a number of these companies are going to go belly up, and someone is just vying to become the Walmart of marijuana. One of them is going to make it, and nine others are going to lose it. I don't think that's a healthy way to go about it. There are companies that are publicly traded that have been traded in the millions, hundreds of millions, on the stock market and haven't even sold a single gram of product. That's not a way to run a business responsibly. That's setting yourself up for some major failures.

[Len Webber, Conservative, Calgary Confederation, AB]

That's interesting.

I want to get into the licensing requirements.

I'm looking at Mr. Garza's numbers and his information here. Of course, there is quite a requirement, with criminal history checks and FBI background checks for gaining your licence. What about after the licence is granted and the production of marijuana has started? Do you have inspectors coming on a regular basis checking to ensure that there's no overproduction, that somehow plants are not missing, and things like that?

Do you have a strong policing requirement as well?

[Rick Garza]

I would like it to be stronger for the producer-processor, just to be candid. Much of the effort initially was focused on the whole issue of youth access and making sure the compliance checks were being done often in order to make sure that youth did not have access through the marketplace. The traceability system in itself is that red flag, and we're tied into that system, but we want to make more visits out to our producer-processors to ensure there's not diversion.

You make a great point. You need to make sure that you give the resources to the regulator so that those inspections can occur often with respect to producers and processors.

[Michael Hartman]

If I may, I want to emphasize this point because it's incredibly important.

For us there are three legs to the stool. There's 24-hour surveillance, there is the seed-to-sale inventory tracking system that is incredibly important, and there is also the banking when they do have access to banking. For us to be able to see all three of those at the same time in the regulated space gives us a very good sense of what's going on, and the key there is the seed-to-sale metric inventory tracking system.

[The Chair, Liberal, Bill Casey]

Thanks very much.

Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you very much.

Thank you all for coming today.

A lot of my views on this come from the public safety perspective, and particularly medicine. I'm a recovering ER doctor. I did that for almost 20 years, and one of the things that I found in my medical practice—and we studied it in our toxicology as well—was the instances of adulterated product. I would see that. I never saw someone come in just because they had consumed cannabis on its own. It was because they had consumed what they thought was cannabis, and it turned out to be something else.

Thankfully, although we were worried so much about opioids, there has been almost no recorded opioid contamination or overdose from it.

There were other things, too, such as plant alkaloids that could make people so sick they ended up in the intensive care unit with intractable seizures and that sort of thing. Of course this is a function of an illegal, unregulated market where you don't have quality control.

Has this been tracked, the incidence of emergency room visits or medical calls due to adulteration of unregulated product, and has this changed since legalization?

[Michael Hartman]

I don't know that I can say it has been tracked to the level where we'd know whether it's adulterated product or not. We do track emergency department visits as well as hospitalizations very closely, which goes back to the reported versus occurred incidents commentary at the beginning of the testimony.

We have seen an uptick in the number of emergency department visits as well as hospitalizations. Interestingly, there has been a slight uptick in the zero to eight-year-old category, which would tell me that it's a result of accidental consumption, but the largest uptick has actually been in the 35-plus category, which tells me that it is having more of an effect on people who are maybe trying it for the first time.

We don't have data on it, but there is some level of disagreement as to whether there are more incidents occurring or whether, because it has been legalized, the doctors are now more willing to ask the question, and the patients are more willing to admit to the fact that marijuana was at play in the situation.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Mr. Garza, what's your experience in this?

[Rick Garza]

It's the same experience in Washington state. Early on we had discussions with the Washington Poison Center because they were seeing an uptick in calls and visits to hospitals with respect to panic attacks, normal things that, honestly, I wasn't even aware of at the time, but I think that's one of the....

I want to throw out another issue, that of potency. Whether or not there's an increase in use among young adults, what we're seeing is an increase in potency of what adults are using, and we're concerned about that.

Also with the lowering of the price, should we be looking at minimum pricing, as is used in Scandinavia for alcohol, for example? That's because, like Colorado, we're seeing the price of cannabis fall to levels that we didn't expect.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you. Here's another question. I don't know if either of you, from either Colorado or Washington, will be able to answer this. I don't know if there are any states where there is basically a government monopoly on liquor sales. We have this in some provinces. I'm from Manitoba, and we have that. It's relaxed for beer and wine but certainly applies to spirits. As opposed to getting it from a 7-Eleven or a free-standing store, they're all government stores.

Ontario has just announced it wants to do its marketing not in the liquor stores but through the same body as the liquor stores. Other provinces will decide whether they want to have this through private storefronts. From your experience, do you have recommendations as to what would work better? I'll start with Colorado, and then Washington.

[Dr. Sam Kamin]

As I mentioned in my brief, such a model is impossible in the United States for cannabis today, because it's prohibited at the federal level and you'd be putting the state employees in a position of being required to do something that's forbidden by federal law.

When I was on the task force to implement amendment 64, we had public health officials say, with regard to alcohol, that we get much better results in terms of public health from government-run distribution than from private distribution. You don't have to worry about targeting and marketing. You don't have to worry about sales to underage people. You can control all of that yourselves.

We can't say it works really well in the United States, because we haven't had an opportunity to try it. I hope at least one province tries it here, so we can see what its effects will be.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

You agree, then, that it's a better public health system, at least with liquor.

[Dr. Sam Kamin]

We took testimony from public health officials that it was. I can't say that I know that myself.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Okay. Mr. Garza.

[Rick Garza]

Without getting into too much detail, until 2011 we were the monopoly for spirits in Washington State but then Costco through an initiative of privatized spirit sales.... But that was typically the model: less access and no advertising. State employees ran the liquor stores with no incentive. Whether they sold 50 bottles that day or 500 bottles, there was no incentive to sell. That model has been there for 12 other states in the nation since 1934. We were the first state that was overturned.

However, there's no doubt that when you have a control model, where the government is involved, access and consumption are lower compared with the licensed states. Typically it's 18% to 20% lower, because you've limited the number of outlets, for one, and you've often limited the hours they can be open. Ironically, that's part of the reason the public said, no, they wanted to be able to buy spirits just like they buy beer and wine.

There's no question that the control model where the government is involved—whether it's in distribution or retail—has the result you want, which is minimizing the negative impacts.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

[The Chair, Liberal, Bill Casey]

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair. I want to thank the witnesses for being here. There may be some frustration in my voice, but I think, Mr. Garza, you said it with your opening statement. You said, “How do you tell a story like this in 10 minutes?” There's great frustration on the opposition side that the government wants us to jam this into one week. I take your advice quite seriously when you say to take your time.

Mr. Hartman, when you were doing it, you said it was like flying a plane while building it. We have the same scenario here, except I don't see anyone really piloting the plane.

If you take a step back and look at the status quo in Canada, I don't know if you gentlemen are aware of it, but we had a peak use for youth boys of 50% in 2002. Now it's gone down to 22%. The government says it wants to legalize in order to decrease youth use. I found it quite disturbing, Mr. Kamin, that you said we shouldn't expect that when we legalize it.

In the bill before us, the government will be allowing 12- to 17-year-olds up to five grams of marijuana for personal use. Just on the health implications of that, there are some really serious questions that need to be answered, and I really hope the government allows us to have further testimony from witnesses like you. I have over a page and a half of questions to ask you, and I only have a very short period of time, so I'm going to ask a couple right up front and let you answer them.

How is it different in your states with regard to the age of consent? Anyone under age 21, how are they treated? I also want to ask about enforcement, because one of the scenarios here in Canada is mandatory blood testing. I don't think there's a precedent for that, but I believe that in your states, officers at the scene can actually take blood tests. There have been real concerns among our police officers about how this is actually going to work, as we heard this morning.

Could you comment on how youth under the age of 21 are managed? Are there any legal limits they're allowed to have for personal use? Could you also touch on the enforcement and these blood tests?

[Michael Hartman]

Just briefly on the first question, in regard to usage by those under the age of 21, on the medicinal side in the regulated market we do permit individuals aged 18 and up to have access to the marketplace provided they have the right prescription from a doctor, and so on. On the other question, candidly I'm not familiar enough with the data to be able to speak to it, but I am hopeful Mr. Garza or Mr. Kamin can.

[Dr. Sam Kamin]

In terms of possession by those under the age of 21 who don't have a doctor's recommendation, we treat that similar to alcohol possession, so it's an infraction. Essentially, it's a low-level criminal offence.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Garza.

[Rick Garza]

Similar to Colorado, if you're a medical patient with an authorization, you can acquire medical marijuana if you're 18, 19, or 20 years of age, and with a provider if you're younger.

It's a felony in Washington, which is a lot more egregious than the other states I just heard from, for a minor to either possess or try to purchase cannabis. I'm actually surprised that hasn't been changed over the last few years, but it's pretty rough in this state in respect to that.

[Colin Carrie, Conservative, Oshawa, ON]

Could you touch on the blood tests? How is this done in your states?

[Rick Garza]

We have to take them in and have a blood test done. They're trying to work on some kind of technology that would allow a swab, for example, to be able to do it at the scene. However, at this point they're taking them in to draw blood.

[Colin Carrie, Conservative, Oshawa, ON]

Okay, so they have to bring them to a health facility to do that.