Veterans Affairs Committee on Nov. 20th, 2018

[Dr. Cyd Courchesne]

We decided on a cap of three, because that's all the science and the information we could get from users, but everything above is on a case-by-case basis.

[The Chair, Liberal, Neil Ellis]

Ms. Wagantall.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you very much.

I would just mention that the research is absolutely critical, and we do need to collaborate with other places. Israel would be a good place to collaborate with, I would say, if you're interested in that. They've done a great deal of research specifically on the medical cannabis.

[Dr. Cyd Courchesne]

Their average usage is 1.5 grams a day.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Yes.

As an anecdotal example, I have a close friend whose husband has been bedridden for eight years on 1,000 pharmaceutical pills a month. His life is being fed, turned over and surviving a great deal of physical and digestive pain due to the pharmaceuticals he's taking, including three stronger than the opioids that people are struggling with right now. He's very much reliant and bedridden.

Someone said to his wife that she had to at least try. She did have the opportunity to get 10 grams in suppository form, which is why she needed the 10 grams. So it's definitely not doing it for pleasure or fun. After his first receiving it, she had her first real conversation with him within half an hour of his receiving the suppository. From there he wanted to go forward with gradually reducing the pharmaceutical load that he was being given. She could not find a doctor who was willing to work with her on that, so she did it on her own, which is very dangerous. To make a long story short, eventually, a year ago, and a year into the process, he walked into my office. He walked into his doctor's office and the doctor's jaw hit the floor, and he said, “What's going on here?”

There are a great number of veterans, I believe, who are discovering there are options to pharmaceuticals, and that the side effects are significantly less damaging to their lives than the effects of multiple pharmaceuticals. So the research really does need to be done. I'm wondering, with the decision of the Auditor General seeing the spike in use, and the spike in expense to the government and to VAC, when you went to research this did you look at what it costs annually to the department for pharmaceutical medications that are used by our veterans? Do you have a number on that?

[Dr. Cyd Courchesne]

We do.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Can you quickly tell me what it is?

[Dr. Cyd Courchesne]

I can't right now.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Is it comparable?

[Dr. Cyd Courchesne]

Well, it's more, because people take way more medication than they use cannabis.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

As people were starting to use cannabis, was there a decrease or did it stay the same? Was there an increase in the use of pharmaceuticals at the same time?

[Dr. Cyd Courchesne]

As I mentioned to your colleague here, we did look at that. We did not see a decrease.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

You looked at exactly how much was being spent within the department on pharmaceuticals versus how much—

[Dr. Cyd Courchesne]

Yes, but all pharmaceuticals are not all for mental health problems, so we—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

No, I understand that. I'm talking about PTSD, I would suggest, or depression or those types of issues.

[Dr. Cyd Courchesne]

We didn't see a concomitant decrease with—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Okay, but do you know how much money was spent on comparable prescriptions for pharmaceuticals?

[Dr. Cyd Courchesne]

Well, we looked at the total of what we spent on medications per year.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Are you not able to determine how much is due to the same types of conditions that you would treat with cannabis? We really don't have numbers on that.

[Dr. Cyd Courchesne]

Well, it's difficult because, again, we're not a health care system. These are not patients we follow, who we have any—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

We're talking about money being spent, and that was the flag.

[Dr. Cyd Courchesne]

Yes.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Okay, so now we're spending far less on cannabis, because we've controlled the amount being given to them. I'm not suggesting that there are issues there, because they can get more if they need it. I guess my concern is that, if we're going to look at this, we need to look at it holistically with what we are prescribing to our veterans to deal with those specific issues. There is a great deal of anecdotal evidence in other countries doing research. I think it's important that we do due diligence to find out these decisions.

Do you have a list of the doctors, how many across Canada are involved in authorizing?

[Dr. Cyd Courchesne]

Well, we could get that information from Blue Cross, because they're the ones who collect all the.... There are more than a handful. We have 8,000 people who are receiving authorizations from their physicians.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

I'm aware of one in my province who can give authorization.