Canadian Court rules Medical Marijuana includes brownies, cookies
June 11, 2015 10:21 PM   Subscribe

While whole States are legalizing marijuana, Canada is still struggling with the medical marijuana issue. Canadian Health Minister Rona Ambrose is outraged by the Supreme Court Ruling as, despite recent court rulings in favour of the use of marijuana, her government maintains that cannabis has never been proven safe and effective as a medicine. The head of British Columbia Doctors Association says doctors across Canada are being bombarded with information on medical marijuana by the same companies producing the drug, a clear conflict of interest. Supreme Court ruling here in case anyone missed the link in first URL
posted by smudgedlens (42 comments total) 8 users marked this as a favorite
 
A little counterpoint to the idea that the ''Pro" group are unfairly organized.

This is welcome, and local news - the defendant comes from Victoria.
posted by not_that_epiphanius at 10:28 PM on June 11, 2015


I like the title better punctuated like this:

Canadian Court rules! Medical Marijuana includes brownies, cookies.
posted by clockzero at 11:02 PM on June 11, 2015 [18 favorites]


What "conflict of interest" is this? It sounds like there are 2 bodies with 2 interests. Doctors are ostensibly interested in patients, and companies in selling their medicines. A "conflict of interest" is when one person has a responsibility between two interests and is torn between them. That's why the problem with aggressive sales tactics to doctors has been the gifts and quid pro quo. But now it seems we are at the point where "conflict of interest" just means "moral bad thing" and so giving information about pot now qualifies as creating one.
posted by cotterpin at 11:03 PM on June 11, 2015 [5 favorites]


I'm still trying to figure out why they don't just prescribe marijuana in pills you pick up at a pharmacy, like every other drug. This whole grow your own thing seems really convoluted and asking for abuse.
posted by Canageek at 11:06 PM on June 11, 2015


Not to split hairs, but can cannabis really be classified as "medicine"? I'm not saying it's safe, or that it shouldn't be sold, or even that I agree with the Conservatives' entire approach to drugs policy.

Anyway I live in Victoria and there is a medical marijuana club or whatever on Quadra Street with an actual pot vending machine.

Living in the future.
posted by Nevin at 11:17 PM on June 11, 2015


Nevin: Drug then. (Though I thought it was being investigated for medicinal properties in a couple of areas?)
posted by Canageek at 11:25 PM on June 11, 2015


Not to split hairs, but can cannabis really be classified as "medicine"?

There are cases where it treats otherwise intractable nausea and otherwise intractable epilepsy. cf. Epilepsy Foundation, Time magazine.

I'd be fine with legalizing it regardless; incarceration for marijuana possession destroys lives.
posted by sebastienbailard at 11:28 PM on June 11, 2015 [1 favorite]


Also, speaking as an teetotaler, I've seen some really specious arguments coming out of the criminalization camp. Most notably "Unlike conventional medicine, we have no way of moderating how much drug is delivered with pot! Oh dears!" when it seems to me that people are pretty good at figuring out how much of the stuff they need ingest.
posted by sebastienbailard at 11:32 PM on June 11, 2015 [2 favorites]


Is anyone preparing marijuana pharmaceutically, in pill form?
posted by fatbird at 11:32 PM on June 11, 2015


I don't really understand why it's marijuana that always seems to be the problem, when plenty of highly dangerous and potentially addictive drugs can be prescribed by a doctor with no fuss. I suppose it has to be because of a general aura of deviance around marijuana, but it's still really strange that in this one case so many people find the distinction between medical and recreational use impossible to draw.
posted by Segundus at 11:44 PM on June 11, 2015 [5 favorites]


“Here we have providers who have a vested interest in promoting the product being the ones to potentially train professionals in how to provide that product,” Dr. Cavers said.

Dr. Cavers then ripped the garment care tag off of his lab coat. "Nobody who makes a product should tell people how to use it," he explained. "And if you'll pardon me, I must now set fire to the operator's manual for my new MRI machine."
posted by compartment at 11:48 PM on June 11, 2015 [16 favorites]


The residual wariness around marijuana is substantially an echo of the racism that criminalized it in the first place.
posted by Small Dollar at 11:54 PM on June 11, 2015 [21 favorites]


It's all about race and class issues- marijuana is an icky, counterculture drug that bad people take. There's a bunch of people for whom "marijuana" signifies not cannabis but dirty hippies and black people stealing their money on welfare.
posted by Pope Guilty at 11:57 PM on June 11, 2015 [7 favorites]


Is anyone preparing marijuana pharmaceutically, in pill form?

Yup.

...
So it’s not like Marinol, the synthetic THC-only pill that many cancer and MS patients dislike because of extreme psychoactivity and difficulty in dosing (it’s hard to swallow a pill when you’re wretching from chemo and it takes 45 minutes of digestion before you know if you took the right amount.)

-Ten More European Countries Approve Pharmaceutical Weed - But What About the Real Thing?

posted by sebastienbailard at 1:02 AM on June 12, 2015


Whoa. I think concentrating it, and packaging it in a pill form would make it much easier to abuse.

Dabs are not pill-form, but they are highly concentrated and pretty much designed for "abuse" if that's what recreational use is being called.

I am dubious about the medical claims and the whole WEED IS MEDICINE justification for legalising reefer, but I will withhold judgement whilst the clinical trials are performed.... and I won't be holding my breath.

I do not want to see this taken over by goverment tax collectors and large corporations which seems already to be where this is going. Like alcohol, there will be severe restrictions on making your own and tax revenue will become the new causus belli to pursue growers and users.

Just legalize it. Don't tax it. Don't allow big corporations to control it.
posted by three blind mice at 1:56 AM on June 12, 2015 [1 favorite]


So it’s not like Marinol, the synthetic THC-only pill that many cancer and MS patients dislike because of extreme psychoactivity and difficulty in dosing (it’s hard to swallow a pill when you’re wretching from chemo and it takes 45 minutes of digestion before you know if you took the right amount.)

And yet I never hear any of these complaints leveled against edibles?

(Not that I'm against people having the choice -- I just find it odd.)
posted by PeterMcDermott at 3:20 AM on June 12, 2015


Dabs are not pill-form, but they are highly concentrated and pretty much designed for "abuse" if that's what recreational use is being called.

Coincidentally, I was reading something by the Guru of Ganga himself, Ed Rosenthal just last week that suggested the exact opposite. That dabs were designed to deliver high doses of THC for people who needed that kind of dosage for medical purposes.

Not sure I buy it. None of the people doing dabs on YouTube look very sick. But what do I know?
posted by PeterMcDermott at 3:23 AM on June 12, 2015 [1 favorite]


Both things can be true at once. Marijuana prohibition is absurd as policy in any country which vodka, supersize fries or BASE jumping gear can be legally sold.

And at the same time medical marijuana is mostly a farce and for every one actually sick person it helps there are probably many more sick people who should be receiving other or additional therapies for what ails them.
posted by MattD at 4:19 AM on June 12, 2015


This was a boring, but welcome decision. Back at the turn of the millenium is when Parker came out and first required the government to allow/regulate medical marihuana. Since then they've been fighting a rearguard action in the courts. And really, this case shouldn't be surprising: the difference between no-pot and pot is much, much bigger than the difference between pot (smokeable) and pot (edible/etc), and edibles/etc allow for medical marihuana to be used by people with a broader range of illnesses than purely smokeable.

I'd be very surprised if legalization came through the courts - they've rejected it a few times, and I think they're right to stay out of that argument. Maybe in October, with the fall of the government.

One amusing thing is that even with this new change, Mr. Smith (the defendant charged) would have been acting illegally - he doesn't have a condition requiring medical marihuana, and didn't have a producer's licence or whatever the term is. Meh, doesn't matter.
posted by Lemurrhea at 4:39 AM on June 12, 2015


Many people use opiates, or adderall, or Viagra, or any number of other drugs without a legitimate medical need. Are those a farce?

Many antidepressants perform barely above placebos, meaning that many people using them are probably getting no benefit. Are they a farce?

I could see an argument that the whole damn pharmaceutical industry is a farce, but I don't understand why marijuana, which at least doesn't kill people, is singled out.
posted by Turbo-B at 4:44 AM on June 12, 2015 [5 favorites]


The thing about legalization: the alcohol, tobacco and pharmaceutical lobbies alll know that there are already plenty of people growing their own. There are several hydroponic supply stores here in town that are thriving, and weed is not (yet) legal here. Thanks to aggressive policing a few decades back, domestic growers developed systems and strains which allow anyone with spare room and an outlet or two to grow really impressive weed. Make it legal and, guarannteed, a big chunk of the potential users wiill continue to produce their own. In the US Washington State has found numbers disappointing regarding tax revenue from the newly-legalized herb, no doubt becauuse many users found growing manageable.

Cannabis is used by millions of people globally, daily, and as such has an almost unbelievably safe track record when it comes to substances ingested by humans, recreationally and otherwise. It beggars belief that its "safety" continues to be a subject of discussion.

Don't know about Canada, but the biggest concern here in the US is who gets to make money and ganja, as something that can be grown simply with little technical expertise and requires no real processing, can be done by anyone. This is scary to those for whom money is the bottom line. Racist overtones (the name "marijuana" was affixed by the Feds who wanted to vilify weed by giving it a "foreign" name) are just a smokescreen.

My father always told me, "Look for the buck." Never has this been more clearly true than with regards to the legalization debate.
posted by kinnakeet at 5:16 AM on June 12, 2015 [5 favorites]


Canadian Health Minister Rona Ambrose is outraged by the Supreme Court Ruling as, despite recent court rulings in favour of the use of marijuana, her government maintains that cannabis has never been proven safe and effective as a medicine.

The current Health Minister has a BA in political science. It has yet to be shown that a BA in political science is either safe or effective and yet here we are.
posted by srboisvert at 5:56 AM on June 12, 2015 [7 favorites]


I am dubious about the medical claims and the whole WEED IS MEDICINE justification for legalising reefer

I used to feel this way. Then the group of friends I have who are dealing with muscular dystrophy, and who were generally anti drug themselves, started to get tracheotomies in order to allow them to breathe. They discovered that cannabis edibles has immense benefits for them, allowing them breathe easier.

Y'know what? They also enjoy it. What's up with that?
posted by not_that_epiphanius at 7:01 AM on June 12, 2015 [1 favorite]


I am dubious about the medical claims and the whole WEED IS MEDICINE justification for legalising reefer

It helps in seizures, and some people have them daily.
posted by Brian B. at 7:11 AM on June 12, 2015 [1 favorite]


I am dubious about the medical claims and the whole WEED IS MEDICINE justification for legalising reefer

I live in Iowa where we recently legalize cannabis oil for the treatment of seizures. Why? Because a bunch of moms stormed the statehouse and the news cameras followed and you had moms with their toddlers asking the politicians why they were being denied the treatments their kids needed.

It was a totally symbolic win, since you still can't legally produce said oil in Iowa, and we're landlocked by states were it is illegal, so you can't transport it back.

One of the families moved from Iowa to Colorado and they had the kid on the news a lot. He went from some ungodly number of seizures (in the hundreds) to like one a week and is now actually making developmental progress.

Personally I suffer from chronic pain. Pretty much nothing that is prescribable has helped (or had unacceptable side effects). Would marijuana help? No fucking idea, but it pisses me off I can't find out.

Take all that away. It's not as dangerous as cigarettes or alcohol, so why is it illegal? Why is it people say they wants fewer laws and regulations until it comes to what I want to put in my body?
posted by cjorgensen at 7:12 AM on June 12, 2015 [12 favorites]


I've always felt a little bit weird about arguing for medical marijuana. It can totally be used as medicine but it's not really medicine in the way that most medications are. I've always viewed MMJ as a stepping stone to full legalization so it feels a little bit like I'm arguing in bad faith.

What I really want to do it add all the medicinal benefits to the long list of reasons why it should be totally legalized.
posted by VTX at 7:36 AM on June 12, 2015 [1 favorite]


My line of work sees a lot of interaction with seniors, and there are many of them in assisted living or residential care facilities who have valid medical marijuana prescriptions but cannot use vaporizers due to health authority policies - which means they have to go outside in all weather with the tobacco smokers, regardless of mobility or respiratory issues. I think a lot of them will be happy to hear this.
posted by northernish at 7:37 AM on June 12, 2015 [1 favorite]


My ex boyfriend uses pot both medically and recreationally. He has ankylosing spondylitis, and pot is the only thing that touches the pain while leaving him relatively functional.

So, you can be dubious about the medical claims all you want. There are reams and reams and reams and reams of data supporting pot's use as a painkiller, appetite stimulant, and anti-seizure.

Honestly the only reason I'd be happy to see Trudeau win in October (apart from that meaning the PCs lose) is the likelihood of pot becoming legal. The thing about Canada as opposed to the USA is that apart from some beer and wine sales, all alcohol in Canada is sold under government monopoly, meaning we already have the infrastructure in place for controlled distribution. (Plus it's hilarious watching e-cigarette stores pop up like mushrooms in anticipation of pot becoming legal, hoping they can pivot their inventory to something much more lucrative.)

Just legalize it. Don't tax it.

I find this a fundamentally bizarre proposition. Yeah, I get not wanting big corporations to control pot; that's throwing the baby out with the bathwater. Look at the massive bump to state tax revenues that Colorado has gotten in the past year. This article discusses the potential financial benefits to Canada. $162MM (assuming similar numbers to Colorado) is nothing to be sneezed at. A right wing think tank estimates $2 billion in revenue and savings. That's about 8% of the total federal budget, and for sheer fiscal prudence it's a no-brainer.

I think what a lot of people might be missing w/r/t legalization and taxes is that it's not just the end product contributing tax to the government coffers, it's also the income taxes of everyone involved in the industry (don't forget contributions to the Canada Pension Plan and Employment Insurance). Not to mention the sudden drop in LEO expenditure, freeing up personnel and materiel to, oh I dunno, investigate the hundreds of missing and murdered indigenous women in Canada. You know, something that actually matters instead of busting someone for growing a basically harmless plant.

Treat it like alcohol--legalize it, sell it, tax it, reap the benefits. Rona Ambrose is a fucking idiot; the appropriate response from the Minister of Health would be to listen to what the fucking national experts on addiction have to say about pot. [PDF].
posted by feckless fecal fear mongering at 7:38 AM on June 12, 2015 [10 favorites]


cjorgenson, come to Toronto for a meetup. We'll assist in your experimentation.
posted by feckless fecal fear mongering at 7:39 AM on June 12, 2015 [4 favorites]


"Marijuana has never gone through the regulatory approval process at Health Canada, which requires rigorous safety reviews and clinical trials with scientific evidence,"

So whose fault is that?
posted by RobotVoodooPower at 8:14 AM on June 12, 2015 [4 favorites]


While there are certainly people who get a medical benefit from MJ, not all those folks going to the dispensaries are doing it for medicinal reasons. Considering if you've got $75, you can find a doctor to give you a MMJ recommendation. I'm sure you have stress or trouble sleeping, amirite?

So glad we in WA legalized and set up the recreational system, so this duplicity can be eliminated.
posted by Windopaene at 8:16 AM on June 12, 2015 [3 favorites]


I'm totally pro-legalization and I'm skeptical of some of the MMJ claims, but that's because some of the MMJ claims are patently hokum. Others, like the appetite stimulant and anti-convulsive effects, are known quantities - the science is there and the studies can be critiqued. What's the issue here?
posted by eclectist at 8:57 AM on June 12, 2015


Speaking of pill form, Sativex is a cannaboid mouth-spray approved for use in Canada for MS-related spasticity.

But it doesn't do much for pain, and MS sufferers are often prescribed something like Vicodin, which long-term does a number on your liver and/or kidneys and tears up your stomach. And then you develop a tolerance, but oops -- can't take too much acetaminophen, so then you're down the primrose path of tramadol, fentanyl patches, and other things with serious addictive properties.

So maybe the inevitable future where big corporations control weed is a good thing, as long as it isn't controlled by pharma companies with competing products.
posted by RobotVoodooPower at 9:05 AM on June 12, 2015 [1 favorite]


There are plenty of people who grow it just fine now so I highly doubt that corporations will "control" marijuana production in the future. It will probably be just like beer where there are big generic brands that are just okay, some smaller, more boutique more local companies that make a better crafted product, and some people that grow their own with varying levels of success.

I'm also fairly certain that dabs or some similar product will be like the Budweiser equivalent. Because of the way it's made, the THC concentration in each individual plant doesn't matter as much and it will make it easier to make a consistent product so the THC per acre balanced against whatever inputs are used will be the driving factor in industrialized MJ production. They could probably even test and mix different strains get the right mix of the other CBNs, CBLs and whatever else affects the effects.

I suppose that they'll be able to do the same thing with medicinal products to boost whatever compounds help with your specific condition while minimizing the ones that don't.
posted by VTX at 9:42 AM on June 12, 2015 [1 favorite]


We'll assist in your experimentation.

I've been thinking of making a trip to Colorado, but I am actually afraid it would be helpful. What then? Move to Colorado? Do it illegally in Iowa? Commute?

If it doesn't work that was a trip for nothing.

(For the record, the trip is on the books for 2016.)
posted by cjorgensen at 11:11 AM on June 12, 2015


Depending on your location, the advice that I've seen when the question gets asked on ask.me to post on craigslist's strictly platonic section works really well. A...uh...friend of mine did just that it turned out to be no big deal.
posted by VTX at 11:42 AM on June 12, 2015


I'm still trying to figure out why they don't just prescribe marijuana in pills you pick up at a pharmacy, like every other drug.

Marjiuana isn't just THC. It's a huge cocktail of interacting chemicals whose identity and quantity vary by species/cultivar/strain and growing conditions. When someone goes to a good dispensary, they choose from an enormous list of types and preparations with different effects. They're encouraged to record timing, dosage, and response for each type they try until they find what works best for their condition.

Maybe one day we'll have pills and inhalers and injectors and such that have different concentrations of different cannabinoids matched to different conditions, but we're really far away from that right now. I don't think most patients would object to research in that direction. In the meantime, the dispensary situation is pretty good for a lot of patients. It's not like there's a ton of risk with marijuana.

"We have this message that normalizes a drug where there is no clear clinical evidence that it is, quote-unquote, a medicine," she said, adding that never in Canada's history has a drug become a medicine "because judges deemed it so." [from the article]

I do understand why the doctors are upset. Marijuana is helping people and we have some studies about it, but due to all kinds of terrible legal shenanigans, there's actually very little research on it. Doctors in Canada are in a position where patients are asking for their support for accessing medical marijuana, but there may be no research for their particular condition, or it might not be very solid. They may not be able to make any recommendations about dose or strain or know what proportion of people with their patient's condition are helped and how much.

I don't think doctors are helping themselves by being reflexively anti-marijuana. So many people are obviously helped by it, and there is solid evidence showing that for several conditions and symptoms.
posted by congen at 1:54 PM on June 12, 2015


congen: Right, that is scary. I like drugs that I could pop in a GC and get a purity rating on. Before legalizing it they should do some nice large clinical studies (easy to get people to sign up!) and figure out what those ingredients are, and what they treat, so they can deliver analytically pure THC + X. Anything else is crazy and going to be imprecise and hard to dose properly.
posted by Canageek at 2:22 PM on June 12, 2015


But the dosing for marijuana seems pretty slack and easy, like if someone takes too much, not much bad happens to them. Then next time try taking less.

Its not like Tylenol where if you take a few too many pills and then your liver is permanently destroyed.
posted by Iax at 5:41 PM on June 12, 2015 [2 favorites]


I don't know if I should be posting here, but I'm super late to the game and nobody will probably read this anyway, right?

I am part of team that has just submitted an application to be a Licensed Producer (LP) under the MMPR to Health Canada.

Under the MMPR, only LPs can produce and sell medical cannabis. We cannot advertise our products and we cannot make any medical claims for our products 1. We can only currently provide medical cannabis in the dried flower form 2, and only by mail order. Patients require a prescription from a medical professional who may legally write prescriptions. Patients have a 30 day maximum amount that they can hold, and they can only purchase medical cannabis from one LP (at a time, they can switch but it's a pain in the neck).

Medical cannabis is treated schizophrenically by different aspects of the Canadian government. One one hand it's a schedule II drug, on the other hand, it must pass the same quality testing as other prescription pharmaceuticals (microbiological load, aflatoxins, heavy metals, a big list of pesticides, moisture content, the phytochemical profile [well, at a minimum THC and CBD], and potency).

An industry consultant told us that about a third of all lots that are tested, fail the tests and are destroyed. Or if they only fail the micro test, many companies will gamma irradiate the lot and submit for re-test. Even if they pass micro, there's all kind of microbial endotoxin in their dirty weed.

The grey-/illicit- market is even worse. A lot of cannabis in dispensaries are loaded with mold and pesticides. Granted, a lot of cannabis in dispensaries are just fine, from a quality standpoint.

We've written our LP application with a 1200 page Quality Management System that hashed out how we're going to follow Good Production Practices, and ISO production practices when possible, with all of the precautions and monitoring and remediation that we will do to make sure that the finished product is as safe as any other legal and regulated pharmaceutical that is prescribed. It's actually no small feat making a part of a plant conform to specifications required of single-agent pharmaceuticals like antibiotic pills.

These are some of, but not all, the reasons why medical cannabis from LPs can cost more than at the dispensary or from street level dealers.

That's only about a 2/5ths of the application. The other 2/5ths are security protocols; Health Canada is disproportionately worried about "diversion" (the same thing as "shrinkage" in retail). In any room where there is cannabis - from a bag of seeds or a flat of sproutlings to growing plants to big barrels of sub-packaged finished product ready to be packaged and shipped - a designated person (RPIC, A/RPIC) who has passed security clearance must be the first in and last out if there are any other staff in the room.

The quantity of cannabis is tightly tracked and all cannabis waste has to be destroyed before disposal. We have to know, at any given instant, how much cannabis seeds are in stock and where, how many mother plants we have and how much they all weigh, how many seedlings, how many mature plants, how much material is drying, how much waste material there is, and how much on hold inventory and how much active inventory, how many lot retention samples and where, how much returned product, &c.&c.&c.

We also have to keep track of how much of which lot was sold to which client - in case that we are made aware that a particular lot of "not safe" we can initiate a recall event and notify everyone who has been provided with material from that lot within a couple of minutes and start sending out return packages. Not all companies can do this, and I don't think anyone else is set up to do it as quickly and traceably as we will be able to. There have been a bunch of recalls and some failures.

All officers, directors, and the PICs all have to pass security clearance - which I kind of agree with; this is an attempt to explicitly bar gangsters and organized crime from entering the industry.

McGill university started a registry for medical trials involving cannabis, so that's a step in the right direction. This ruling is also another really good step in the right direction. One of the things that my company will aim to do is to produce genetically verified and highly tested/reported homogenous medical cannabis and make it available for academic/clinical research use. We're also thinking of blending different lots/strains (kind of like blending whiskey) to create medical cannabis with even greater phytochemical homogeneity.

It's not ironic that the government blames the lack of rational decision making is based on the lack of good research because it's the government itself who is making doing research difficult. Our company is really interested in facilitating well controlled and sufficiently statistically powered research to counter government prerogatives.

1 but there's nothing preventing us from offering "sampler packs" of medical cannabis with different ratios and concentrations of THC/THCA, CBD, CBN and let the patient decide which variety treats their symptoms most effectively. Our schtick is to make sure that the same strain has very similar phytochemical profiles from lot to lot, but all lots are assayed and each lot gets their potency and profile provided.

2 Yes, it was an unanimous ruling and the relevant sections are rendered "null and void." However, LPs are still restricted to what's in the MMPR. The MMPR will not change overnight. Aside from big government bureaucracy, there are some implications. How are LPs going to track how much cannabis has been provided to the patient? What other Food Inspection Agency regulations will be applied to edibles? It'll take time before LPs are allowed to provide edibles and concentrates 3.

3 Pills like marinol or even just THC don't really do much medically. It's odd, but different phytochemical profiles appear to be effective for different conditions. However, concentrates are easy to abuse. Why not cannabis in a pill? Just eating it raw isn't very effective because our digestive system isn't built to break down plant matter effectively. I guess you could eat kif or hash or concentrates, but it seems a waste since they're more expensive per unit of cannabinoids than dried flowers. Edibles can be made from lower quality dried flowers, but they must be cooked with edible oils to release the cannabinoids (and to decarboxylate any remaining THCA into THC and CBDA to CBD). There are tinctures that can be injested orally but they're typically really low concentration.

posted by porpoise at 4:37 PM on June 13, 2015 [6 favorites]


Fantastic, porpoise. I hope that my ex can take advantage of your products.
posted by feckless fecal fear mongering at 6:41 PM on June 13, 2015




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