Absolutely, yes.
Evidence of meeting #112 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was evidence.
A recording is available from Parliament.
Evidence of meeting #112 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was evidence.
A recording is available from Parliament.
5:05 p.m.
Liberal
The Chair Liberal Neil Ellis
Also, if there is anything that we didn't have time to cover and that you want to offer in a brief, you could submit that to the clerk. He'll get it to us.
That ends today's testimony.
Mr. McColeman.
5:05 p.m.
Conservative
Phil McColeman Conservative Brantford—Brant, ON
Mr. Chair, we have time left, and there are some follow-up questions.
5:05 p.m.
Liberal
5:05 p.m.
Conservative
Phil McColeman Conservative Brantford—Brant, ON
I have just one thing on my mind that I'd like to ask while we have the witnesses.
5:05 p.m.
Liberal
The Chair Liberal Neil Ellis
Anybody else? Mr. Casey, okay.
I see unanimous consent on that, so that's fine.
We'll start with Mr. McColeman. We'll give you three minutes.
5:05 p.m.
Conservative
Phil McColeman Conservative Brantford—Brant, ON
I'm wondering if you could do one basic thing for us. You've obviously worked with a lot of veterans. You've seen some successes and you've seen sometimes things not working. Could you give us one of each in just a very brief case-study fashion, if it's possible to do that in the short period of time we have here? Or you can just choose to do one that you think was very interesting, which involved a veteran, and tell us what the result was.
Could I ask that of each of you? Dr. Shackelford, why don't you go first?
5:05 p.m.
Physician, As an Individual
Last week, I saw a young woman who has been a patient of mine for four years, I would say, a service veteran with severe PTSD. She was taking, I think, seven different prescription drugs at the beginning of the cannabis intervention. As of last week, she had not taken any prescription drugs for about three years and is happily employed, now married and with no symptoms of PTSD whatsoever.
A man with extremely grievous combat wounds and PTSD continued to have quite severe pain from the wounds. His PTSD symptoms improved, but I was not as successful at treating the pain with cannabis interventions alone, as I would have preferred. He's on a low dose of narcotics, which in combination with the cannabis is more effective than were the narcotics by themselves, but it was not a full success.
5:05 p.m.
Medical Director, Canadian Cannabis Clinics
I don't have on the tip of my tongue case studies that would be like a testimonial to say this one worked and this one didn't work. There was no consistency in my experience of seeing veterans or anyone else with PTSD in terms of the drugs that worked or didn't work. I'm referring to cannabis drugs. There are wonderful stories I could tell you, but I would have to prepare for them. I wasn't prepared to give you case studies. I'm not seeing patients anymore. My work involves domestic and international setting up of clinics to give access to people who want cannabis medicine and to show the models that we have that will work in their country—
5:10 p.m.
Conservative
Phil McColeman Conservative Brantford—Brant, ON
Can I cut you off there? I have only a couple of seconds.
5:10 p.m.
Conservative
Phil McColeman Conservative Brantford—Brant, ON
I have one last question, which is about the ratio of THC to CBD oil. Let's take an oil product. How high do you go with the THC component? Will you go as high as required, or are there limitations on the hallucinogenic component that you're prepared to go to? I know many oils are of various ratios and many people experiment with different ratios to find what works for them, particularly in the veterans community. Do you have any comments on the range of each of the two major elements that we discuss when we're discussing this topic?
5:10 p.m.
Liberal
5:10 p.m.
Physician, As an Individual
I have a child patient with a seizure disorder who takes 250 milligrams of THC a day with extraordinarily good results and no psycho-activity at all—I think “hallucinogenic” is probably an incorrect term—and others who are doing extremely well with two milligrams of THC and two milligrams of CBD. I think it depends on the individual patient: 250 milligrams of THC is a lot, but it works extremely well for this boy.
5:10 p.m.
Liberal
The Chair Liberal Neil Ellis
Mr. Waisglass, I can give you 10 to 20 seconds to answer that question.
5:10 p.m.
Medical Director, Canadian Cannabis Clinics
I just want to reiterate that THC is not a hallucinogenic, and there is no absolute formula. What is interesting about cannabis is that very small doses can work. We know that the average amount, in data from Israel, the Netherlands, and Canada, is about one milligram, 1.5 milligrams, or 0.67 milligrams in the Dutch study. That's the average amount of dried cannabis per person per day, and yet veterans will often use three milligrams. There are people who use five or 10 milligrams of cannabis.
The individual variance is a very difficult thing, and nobody has ever been able to explain why this is the case. Tolerance is a bit of it. You know the word “tolerance” and what it means: If you get used to something or your system gets used to it, you sometimes need to have more of it.
5:10 p.m.
Sean Casey Charlottetown, Lib.
Thank you, Mr. Chair.
I'm not a regular member of this committee. In fact, it's been about six years since I was a member. However, I'm quite interested in this discussion, particularly around how medical cannabis has succeeded in allowing patients to take themselves off some other drugs.
Dr. Waisglass, you started to answer a question and were cut off. I want to come back to it, because it's actually the exact opposite of the discussion we're having. It's on this whole idea of cannabis as a gateway drug. During debate in Parliament, we heard it described as such by no fewer than three members of Parliament—Mr. Gourde, Mr. Deltell and Mr. Dreeshen.
To Dr. Waisglass first, and then Dr. Shackelford, what does the literature say with respect to cannabis as a gateway drug? What has been your experience in that regard?
5:10 p.m.
Medical Director, Canadian Cannabis Clinics
Cannabis is not a gateway drug. Anyone who says that is spewing out a lot of nonsense. There isn't a shred of legitimate evidence on the planet to support that. It's just rhetoric left over from the old “drug war” time.
In fact, there is a good paper on that. It isn't at my fingertips right now—it's a pity I didn't have the questions in advance to prepare for that—but there is good evidence that it is not a gateway drug. We'll just leave it at that.
5:10 p.m.
Physician, As an Individual
That is absolutely the case. There is no scientific evidence whatsoever that it is a gateway. The gateway, actually, is the dealer who has something else in that armamentarium, that little bag he carries around, and who says, “By the way, why don't you try this?”
There is no scientific evidence whatsoever that cannabis use in any way induces a desire for, or a need for, advancing to any other drug.
5:15 p.m.
North Island—Powell River, NDP
Just quickly, I'm a member of Parliament who represents a more rural and remote community. One of the challenges for the many veterans who come to our region is being able to access cannabis in the way they're hoping to.
Dr. Waisglass, with your multiple clinics across the country in the four provinces you named earlier, are you in any rural and remote communities? Do you have any information about the challenges those particular veterans face?
5:15 p.m.
Medical Director, Canadian Cannabis Clinics
That's a really good question about a really important subject. As you know, access to cannabis is all that's been on my mind for the five years I've been in this. I continue to be asked by countries all over the world about this and about how we can solve this problem.
We can't put clinics everywhere. The remote areas can't have clinics, but that doesn't mean they can't have health care. All over the planet we're using the audiovisual equipment that's available to us and very successfully managing to deliver health care to our north, to our indigenous communities where doctors can't get in, and to where nurse practitioners are scarce. This is how we are reaching those patients who can't go to a medical cannabis doctor in their community.