Health Committee on Sept. 15th, 2017

[Hilary Black]

There is quite a lot of great research around medical cannabis. It's in large-scale human clinical trials that is really where the dearth of research is. We have to remember that we're talking about a plant that's been prohibited for almost 100 years, so for people who have been wanting to research it, it's been impossible to find a legal, consistent supply. Also, it's very onerous and takes an extremely long time to get licensing, even for laboratories.

One of the things this government can do, besides funding research, is to encourage, facilitate, and expedite it in any way that's in your power to do so.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

You say there's a lot of research out there, but unless someone starts a process for an application, it's not going to do anything to achieve a drug identification number.

[Hilary Black]

As Jonathan said, there are some complications around cannabis because isn't patentable. My understanding would be that if the government allocated some resources and, from your side, encouraged research into the medical applications of cannabis rather than holding it back, then we would be able to start seeing more progress.

[The Chair, Liberal, Bill Casey]

Ms. Bogden, do you have a comment?

[Jacqueline Bogden]

I perhaps should have said in my first answer to the committee member's question, Mr. Chair, that the proposed cannabis act would provide greater flexibility for the minister to authorize different types of cannabis research than we do now. What I mean by that is it would improve the current process that requires individuals to seek an exemption in order to be able to do this kind of research.

I think one of the virtues of the proposed legislation is that it will enable and facilitate research. I perhaps should have mentioned that from the outset.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Ms. Black, I believe you're asking for prescriptions to be issued instead of authorizations. You feel it would give better access to the product. Is that correct?

[Hilary Black]

Because of the current medical regulations at the ACMPR, we call the authorization to cannabis an authorization rather than calling it a prescription because it's like the chicken and the egg, back to the fact that it's not an approved medicine, so you can't technically call it a prescription because it isn't an approved medicine.

By calling it an authorization and not a prescription, that is the answer that many people come to on the dead end of trying to get insurance coverage, and that's the reason why the Tax Court said that GST is applicable to medical cannabis.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

My understanding, though, is the doctors are reluctant to issue prescriptions because they don't have the research to back them up. They don't know the specific medical consequences of particular potencies and so forth, so I would suspect they would be less likely to issue a prescription than they would to issue an authorization.

[Hilary Black]

I am not a physician, but I do communicate with many physicians regularly. I would suggest that the authorization form physicians currently have to fill out takes more time and is more onerous than filling out a prescription on a prescription pad.

I think whether we call it a prescription or an authorization, it's not going to address the issue of the research and education that is needed for physicians across the country.

[The Chair, Liberal, Bill Casey]

Time is up. Thanks very much.

We'll go to Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you to the panel for being here today. I also want to thank you, Ms. Black and Mr. Vandebeek, for the work you do and have done for the last 20 years. I am a strong advocate for medical marijuana.

My wife at 37 years old was diagnosed with stage 4 breast cancer and went through incredible chemotherapy and radiation. The nausea was intense. It was uncontrollable to the point where there was desperation. We had to go to the illicit market to get marijuana to try, and it worked. It worked for her nausea. Of course, back then we had no idea what was in it. Obviously, there was strong THC in it that caused a lot of bad experiences, but it took away her nausea. I think it is vital to Canadians to be able to go to an outlet where they can be prescribed the proper marijuana for patients who suffer like that. Again, I'm a strong advocate for that.

You talked about some of your young patients. Of course, Mr. Zaid, you're a young individual as well, requiring marijuana. I'm happy that you found something that helps your headaches, by the way.

I ask you both, are you not concerned about the strong scientific evidence of the correlation between use as a youth and mental issues because of the developing brain?

I'll start with Mr. Zaid.

[Jonathan Zaid]

First of all, yes, of course I'm concerned about that. I think it's a different context when we're speaking about medical use and other recreational use.

Again, I tried 40 prescription medications. Not one of those medications was ever studied in my condition, no research whatsoever. They had side effects that included death and cognitive impairment, and these were given to me without any of these types of questions.

I think it comes back to when you're suffering a medical condition, there are risks to alternative treatments and there are risks to not having effective treatments, and so for me, the risks really weren't comparable to the benefits that it could afford me. I think that's the issue with lots of patients.

The second aspect I would propose is also that we talk a lot about cannabis as a whole, but really there are hundreds of chemicals within the plant itself. There is some research that THC is concerning regarding adolescents' brain development, but lots of the pediatric patients are on pure CBD, and that research isn't correlated to brain development.

With those two aspects, the medical context as well as different cannabinoids that may be being used, I think there is definitely potential among young people.

[Len Webber, Conservative, Calgary Confederation, AB]

Is it the CBD that helps you in your headaches, or is it a mixture of both, or is it the THC? What has helped you?

[Jonathan Zaid]

It's a mixture. During the day I usually use mainly CBD. I'm on cannabis right now. I don't think anyone would think I'm impaired. Most people wouldn't think I have a very severe chronic illness either. I have effective symptom management. I'm not high. I use a bit of THC at night. It helps me sleep, and that's such an important thing to having a healthy lifestyle. Overall, it's really effective in improving my quality of life.

[Len Webber, Conservative, Calgary Confederation, AB]

Ms. Elisma, you mentioned that you're a cancer survivor, and in your presentation you said you continue to use CBD. I understand that marijuana is good for nausea and such, but why would you continue to take it after your treatments?

[Daphnée Elisma]

One thing I didn't mention earlier during my presentation is that, in addition to chronic pain, I developed very persistent migraines. My treatment consists of high doses of CBD mixed with THC. This allows me to have a better quality of life. I currently have no migraine problems. They have completely disappeared since I started treatment. I used several prescription drugs previously, including naproxen. These very powerful drugs caused health problems for me. When I turned to medicinal cannabis, my quality of life improved considerably. I want to continue this treatment for the rest of my life.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you for that.

Ms. Bogden, you described licensed producers and the strict requirements they have to adhere to. I had the opportunity to tour a licensed facility north of Calgary. You described it accurately. It was like entering a federal prison to get in there to begin with, but yes, there were sanitary requirements. You could eat off the floor, it was that clean. It was very impressive. I encourage all of our members, if they have the opportunity, to tour one of these licensed producers.

With respect to comments you made about strict clearance for licensed producers, we've had a number of presentations here where people have recommended that we allow individuals who have had past experience, perhaps even marijuana convictions, to apply for licences and be accepted for that. What are your thoughts on that?

[Jacqueline Bogden]

We have a process around the security clearances that is in place principally for two reasons: to protect the integrity of the legal system as it stands now and to protect it against diversion. Very consciously we have made decisions around the requirements for security clearances for all of the key individuals in the organizations. It's an important feature of the system, and it would continue to be going forward if we want to ensure that the system isn't infiltrated by organized crime.

While we are certainly aware of the positions that others have put forward, and those will be taken into consideration as the regulations are designed in the future, I think we also need to remember the objectives the government has in protecting the integrity of the system.

[Len Webber, Conservative, Calgary Confederation, AB]

Okay.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you to all of the witnesses for being here.

Mr. Zaid, in what form do you ingest your cannabis?

[Jonathan Zaid]

I mainly ingest via vaporization as well as some capsules. I find that's the most effective for me. But I definitely would like to try other product forms, including sublingual tinctures and creams for nerve pain. These products aren't available within the system.

There was a Supreme Court case which ruled that patients should have access to a diverse range of products. Health Canada responded to that by allowing the sale of oils and capsules, but there is limited potency in the capsules, which is a big problem, and there still are not basic products like creams available. We would like to see a wider range of products.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madame Elisma, how do you ingest your cannabis? Do you smoke it or do you take it in some other form?

[Daphnée Elisma]

Like Mr. Zaid, I use a vaporizer. I also use cannabis oil, which I buy from a licensed producer of course. It really helps me a lot in managing the symptoms of my pain. I sometimes use it dried, and sometimes I smoke it, depending on what I need during the day. That said, I mainly use it in a vaporizer and as an oil.

[Don Davies, NDP, Vancouver Kingsway, BC]

Merci.

Ms. Bogden, you testified about the licensed producer as a very...you called it a strict licensing regime. You test for pesticides and mould, CDB and THC levels, sanitation, and safety. There are inspections. None of that is being done for edible manufactures today, is it?