Honourable members of the House of Commons Standing Committee on Veterans Affairs, good afternoon and thank you for inviting me. It's a privilege to be invited to sit before you to share my knowledge and opinions about medical cannabis and the well-being of our veterans.
I'd like to apologize for not being there in person, which would have been better for all of us, but I had a conflict in schedules and I couldn't make it to Ottawa.
My name is Barry Waisglass. I am the medical director of Canadian Cannabis Clinics. I'll reference that as CCC, as we go forward in my introduction.
In the interest of full disclosure, I'd like the committee to know that I also serve as the medical director for Aurora Cannabis, one of Canada's largest licensed cannabis producers.
Prior to shifting my professional life to cannabis medicine five years ago, I worked for 40 years as a family doctor in a number of Ontario communities. Much of my career was focused on the successes my proffered treatments had on my patients, but the failures of conventional treatments and the harms caused by those treatments became increasingly apparent.
With my support, some patients began exploring complementary therapies, such as naturopathy and herbal medicine. For some, those included the use of cannabis to treat a variety of ailments, including chronic pain, asthma, skin conditions and insomnia. Frequently, they reported improvements in quality of life and restoration of function, with some able to reduce and even stop the use of the prescribed drugs, resulting in both cost savings and elimination of unpleasant side effects.
When Health Canada introduced a medical cannabis program, it legitimized the use of cannabis as medicine. CCC was created in 2014 to respond to the growing demand for access to medical cannabis by those with chronic health problems not responding to conventional treatments. We had two goals in mind: to provide improved access to both medical cannabis doctors and educators/counsellors, and to reduce harm from the growing use of opioids.
Prior to that time, medical cannabis doctors typically charged $300 to $500 and the patients who most needed the service could not afford it. Our clinic model offered all doctor and counselling services free to anyone with valid health insurance, but the demand for our services increased and development of new clinics was rapid. In only two years, by mid-2016, Canadian Cannabis Clinics had 17 clinics in Ontario. We now have 36 clinics operating in four provinces: British Columbia, Alberta, Ontario and Quebec. Since our inception four and a half years ago, we've treated over 65,000 patients, and we remain at this time the largest medical cannabis company in Canada.
The clinics are staffed primarily by family doctors, but also by emergency physicians, internists and psychiatrists, who work as independent health professionals responsible only to their patients and to their respective colleges. Most patients are referred by their doctor because of some form of chronic suffering that has not responded to conventional remedies. After a careful assessment, including review of medical records, medical cannabis may be prescribed if that patient has a condition likely to respond to medical cannabis and is without any contraindications. A cannabis counsellor is then assigned to provide the patient with the information needed to access the best available products for that person and to use them safely.
The term “medical cannabis”, as opposed to recreational cannabis, refers to a product recommended by a health care practitioner with expertise in this discipline. In Canada, that would be a doctor or a nurse practitioner. The expertise includes knowledge about jurisdictional laws and professional regulations, background science about cannabis as medicine, including benefits and risks, and the medical cannabis products available to the patient in his geographic area.
The medical cannabis patient then acquires the medicine exclusively from a Canadian licensed producer. In contrast, the recreational cannabis user receives neither prescription nor professional counselling and may acquire cannabis from any source, legal or otherwise, but, almost without exception, without the oversight of Health Canada regulating that growing operation. Experienced medical cannabis doctors will advise caution to cannabis-naive patients and will prescribe low-THC chemotypes. The recreational user is less informed and consequently at greater risk.
We have learned that response to medical cannabis treatment is variable, from little to no improvement at all to dramatic resolution of the presenting complaint. Those with a profound degree of suffering over prolonged duration often seem to respond best. I think that reflects many of our veterans. Science has helped us to understand why there is such a range of response to cannabis. All humans have a unique endocannabinoid system that is responsible for many of our body's complex regulatory functions. When the endocannabinoid receptors are exposed to the many different cannabis plant cannabinoids, it is understandable that there would be a different response in different individuals. It is important to consider that the top scientists in this field of study believe that many of our ailments are likely the result of endocannabinoid system dysfunction. It is particular to the many degenerative processes that affect us as we age.
We currently have, at CCC, 1,026 veterans on our roster and we average about 30 new vet patients each month. Almost all have chronic pain and/or PTSD. Their symptoms include anxiety, sleep impairment, depression, fatigue and headaches. Most also suffer from reductions in quality-of-life metrics, relationship dysfunction and anger issues. As a group, their positive response to medical cannabis has been significant, with reduction of symptoms, improvement in function and reduction in the use of their prescription medication. Further, many reported improvement with medical cannabis compared to illicit cannabis. Our experiential observations have been reinforced by the results of a number of papers: a study by S. Chan and her group, and a literature review by Yarnell.
This committee has already heard from some academics and clinicians—I'm specifically referring to the ones you heard from two days ago—who are entrenched in our health care institutions, most of whom have limited knowledge of cannabis. They have exaggerated to this panel the potential harms of this complex herb, while discounting its many benefits.
Anthropological and historical evidence illustrates the long history of this venerable plant as a medicine over centuries and across much of our planet. Today, although the evidence supporting the use of cannabis as medicine is primarily limited to observational studies and testimonials, the robust clinical research that some academics insist must precede our endorsement of medical cannabis is under way. Moreover, there is evidence from thousands of pre-clinical studies that prove we are on the right track.
We can, and we must, continue to cautiously recommend medical cannabis while awaiting more clinical studies, because of the significant benefits and relatively minimal risks compared to alternative treatment options.