With respect to (a), Health Canada considers all forms of smoking harmful to health. Many of the potential long term health risks of cannabis use, such as respiratory damage and disease, are due to smoking as a means of ingestion. Heavy cannabis smoking during pregnancy has been associated with low birth weight babies. Smoking cannabis interferes with the ability to concentrate and impairs learning processes. Cannabis users can become dependent. Research indicates that cannabis smoking may trigger psychotic episodes among users who already have or are at high risk for schizophrenia or depression.
With respect to (b), Health Canada has not established estimates of public health impact of smoking marijuana. However, under the renewed drug strategy, research on this topic will be considered.
With respect to (c), there have been no specific Health Canada initiatives. However, under the renewed drug strategy, a public education program targeted at youth will be launched in the fall of 2003, on the health risks of smoking marijuana.
With respect to (d), no research has been conducted, but under the renewed drug strategy, research is underway and a survey is scheduled to start in November 2003. Thereafter, surveys on this subject will be conducted every four to five years.
With respect to (e), ( i) and ( ii) an medical marijuana, in 1999, Health Canada developed a strategy to determine the risks and benefits associated with the use of marijuana and cannabinoids for the treatment of the symptoms of targeted serious diseases in patients unresponsive to usual treatment modalities. This strategy now includes the medical marijuana research program MMRP, a partnership with the Canadian Institutes of Health Research, a contribution agreement with the Community Research Initiative of Toronto CRIT, a community based HIV-AIDS non-profit research organization, and the Marijuana Open Label Safety Initiative MOLSI, another partnership with the Canadian Institutes of Health Research. An undertaking with Public Works and Government Services Canada PWGSC to award contracts to the private sector to conduct clinical trials, is currently under consideration. These initiatives aim at developing new knowledge concerning the risks and benefits associated to the medical use of marijuana. This knowledge will allow Canadians suffering from some serious and chronic conditions and diseases and their physicians to make better informed choices of proven therapies and further inform Health Canada’s policy making capacity in formulating sound science based decisions regarding access and use of marijuana for medical purposes.
Health Canada is dedicating $7.5 million over five years to marijuana clinical research through its MMRP. The first study granted under this program will be conducted by the Pain Centre of McGill University. It is a short term study, involving 32 clinical subjects to evaluate the effects of smoked marijuana for chronic neuropathic pain. In addition, through a contribution, Health Canada is funding CRIT to conduct a pilot study on the efficacy of smoked marijuana on appetite stimulation in persons living with HIV-AIDS. In total, since 1999, not including in-house human resources and administrative costs, Health Canada has invested $1,292,385 in its marijuana clinical research strategy. This amount includes contribution and grant payments for the conduct of clinical studies, the holding of three workshops to assist the Canadian medical community in addressing specific issues related to conducting of clinical studies on marijuana for medical purposes, and contracts with consultants to develop two information documents for distribution to patients and clinicians. These documents describe the current scientific knowledge on marijuana and the risks and benefits associated with its use for medical purposes.
The Canadian Institutes of Health Research CIHR, has supported 13 projects related to marijuana use since 2000, with a total investment of approximately $2,832,902.
With respect to (iii), see (c) above. Final costs of the program have yet to be determined, as the scope of work is under development.
With respect to (iv), The salary and operating costs of the Office of Cannabis Medical Access, for fiscal year 2002-03, were approximately $3.5 million. These costs include the administration of the medical marijuana access regulations and related regulatory and policy work.
With respect to (f), see (c) above. The medical marijuana research program described in (e) (i) and ( ii) will continue. Costs for research will depend on projects approved for funding by CIHR.
With respect to (g), during the development of the proposed cannabis reform legislation, Health Canada provided the Department of Justice and the Department of the Solicitor General summary documents on the health effects of marijuana. These summaries were based on published literature.
On May 27, 2003 the Government of Canada announced the renewal of Canada’s drug strategy and the investment of $245 million over five years. The renewed strategy will take a balanced approach to reducing both the demand for, and the supply of drugs. Health Canada, in close collaboration with its partners, including the provinces, territories, communities and stakeholders, will take the lead on implementing and coordinating this renewed strategy by investing in: increased government and stakeholder coordination and funds to support community-based prevention, treatment and harm reduction initiatives; enhanced partnerships, education programs and interventions designed to discourage and treat substance abuse, particularly among youth; new research activities, including funding for statistical analysis of drug trends to enable more effective decision-making; new enforcement resources to address marijuana grow operations and clandestine chemical laboratories.
Health Canada has stressed that any move towards decriminalization must be done in tandem with a renewed and fully funded drug strategy in order to provide the necessary emphasis on public education, prevention programs, enforcement resources and new research activities.