Evidence of meeting #19 for Public Accounts in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was use.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Michael Ferguson  Auditor General of Canada, Office of the Auditor General of Canada
General  Retired) Walter Natynczyk (Deputy Minister, Department of Veterans Affairs
Cyd Courchesne  Director General, Health Professionals and Chief Medical Officer, Department of Veterans Affairs
Michel Doiron  Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

9:35 a.m.

Conservative

The Chair Conservative Kevin Sorenson

We'll now move to the opposition with Mr. Poilievre.

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

Paragraph 4.46 of the report indicates that shortly after the regulations were implemented the department once again identified the need to contain the rising costs of marijuana for medical purposes by imposing a dollar limit that would be paid per gram. It found that the per gram cost had increased.

What is the major driver for increased costs per gram of marijuana?

9:35 a.m.

Gen Walter Natynczyk

My understanding is that it's dependent on the strain of the marijuana.

I'm going to turn this over to my specialists, Dr. Courchesne and Michel Doiron.

9:35 a.m.

Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

Michel Doiron

A couple of factors have influenced the cost per gram. Initially, Health Canada controlled the cost and they had capped it. When the regulations changed in 2014, the cap was no longer there and it turned into a free market. The cost per gram varies according to the strain of marijuana based on the percentage of THC or other products in the marijuana. It goes anywhere from $7 or $8 per gram up to $20 per gram depending on the strain you buy. The Auditor General in his report highlighted that we had not capped the price per gram. That was correct. It's something that we've been asked to look at as part of the research by Minister Hare. We want to look at the best strains and whether there is any cost-effectiveness when it comes to these strains.

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

It says here that the cap on quantity was set at 10 grams per day.

Is that a lot?

9:35 a.m.

Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

Are a lot of veterans using that much?

9:35 a.m.

Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

Michel Doiron

A fair number of veterans are using up to 10 grams, but they're not necessarily using it all. In some cases, they're making sure they have it and use it when they need it.

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

On average, would they be using 10 grams per day?

9:35 a.m.

Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

Michel Doiron

They could be.

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

Has there been any consideration of the health impacts this might have?

9:35 a.m.

Assistant Deputy Minister, Service Delivery Branch, Department of Veterans Affairs

Michel Doiron

There has been a lot of discussion on the impacts this may have on the health of our veterans. Notwithstanding cost-effectiveness and other issues raised by the OAG, one of the goals of the review that we are presently doing with health experts at Health Canada and with our beneficiaries is to try to determine what is and would be the optimal amount and its benefits and where it become dangerous for the health of the veteran.

9:35 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

It seems to me that 10 grams of consumption in a single day, on average every day, probably causes more health problems than it solves.

I also note the explosion in the budget for marijuana. Here it show that costs between 2013-14 and the first nine months of 2015 rose by 25 times. That's twice the rate at which the number of veterans consuming marijuana increased. We've increased the number of recipients by 13 times and the cost by 25 times, and that's only in a two-year period. Then I see that the cost is expected to double again next year. This is a phenomenal growth industry within Veterans Affairs.

My question is, are we prescribing medical marijuana for PTSD?

9:40 a.m.

Gen Walter Natynczyk

Just to answer that, marijuana is not prescribed. It is being authorized for numerous medical issues.

9:40 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

Including PTSD?

9:40 a.m.

Gen Walter Natynczyk

Including mental health and PTSD. But the most prevalent is actually musculoskeletal issues, significantly more than for those veterans who have a mental health injury. Perhaps Dr. Courchesne could just mention a little bit more.

9:40 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

How many veterans are being authorized to have marijuana reimbursed for the purpose of operational stress injuries?

9:40 a.m.

Director General, Health Professionals and Chief Medical Officer, Department of Veterans Affairs

Dr. Cyd Courchesne

I want to just clarify that we don't prescribe.

9:40 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

No, of course not.

9:40 a.m.

Director General, Health Professionals and Chief Medical Officer, Department of Veterans Affairs

Dr. Cyd Courchesne

We don't prescribe for any issue. That would be their attending doctor.

9:40 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

How many veterans are being prescribed or authorized reimbursement for medical marijuana for mental health issues?

9:40 a.m.

Director General, Health Professionals and Chief Medical Officer, Department of Veterans Affairs

Dr. Cyd Courchesne

I think it's in the order of 900. As the deputy said, most people report that it's mainly for musculoskeletal related pain.

9:40 a.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

You say there are roughly 900 who are using medical marijuana for treatment of mental health issues. Has the department studied whether the use of marijuana helps or exacerbates those mental health problems?

9:40 a.m.

Director General, Health Professionals and Chief Medical Officer, Department of Veterans Affairs

Dr. Cyd Courchesne

I have to say that this is in the realm of clinical research, and we don't do clinical research. It's a very good question and it's a question that is being looked at.

9:40 a.m.

Conservative

The Chair Conservative Kevin Sorenson

We'll now move to Mr. Harvey, please, for five minutes.