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Major Studies of Drugs and Drug Policy | ||||
Canadian Senate Special Committee on Illegal Drugs | ||||
Volume 2 - Policies and Practices In Canada |
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Chapter 13 - Regulating Therapeutic Use of CannabisMarihuana medical access regulations
As stated above, there
are two parts to the Marihuana Medical
Access Regulations (MMAR): part 1, authorization to possess, and part 2,
licence to produce. One of the objectives of the regulations is to provide a
compassionate framework to allow access
to marijuana for medical purposes. The regulations establish a compassionate framework to allow the use of
marijuana by people who are suffering from serious illnesses, where
conventional treatments are inappropriate or are not providing adequate relief
of the symptoms related to the medical condition or its treatment, and where
the use of marijuana is expected to have some medical benefit that outweighs
the risk of its use.[1][24] As will be reviewed in
detail, the MMAR are intended to provide access to marijuana in special
circumstances only: in the case of serious medical conditions where
conventional treatment may not provide adequate symptomatic relief. Health
Canada explains that this limitation is due to “the health risks associated with the smoked form in particular, and
due to the lack of evidence supporting the claimed health benefits.”[2][25] Significantly, the
application of the MMAR is limited to “Cannabis (marihuana)” as referred to in
sub-item 1(2) of Schedule II of the CDSA. Thus, the regulations do not provide
access to other cannabis-related products. The key provisions of
the MMAR are as follows. Authorization to possess
Three distinct
categories have been established in relation to authorization to possess dried
marijuana, each with its own application requirements. In each case, the
application is to be submitted by the patient, whose declaration must include
information identifying the applicant and indicating that:
Category 1
v Conditions: A medical practitioner must provide a
medical declaration indicating, among other things:
·
All conventional
treatments for the symptom have been tried or considered;
Category 2
Source: Application for
Authorization to Possess Dried Marihuana, Category 2 – Medical Specialist Form v Conditions: Applicants
must provide a declaration from a medical
specialist to support their application, indicating, among other things:
·
All conventional
treatments for the symptoms have been tried or considered and were found to be
medically inappropriate for reasons outlined in the Regulations;
·
The medical specialist
is aware that no notice of compliance has been issued under the Food and Drug Regulations concerning the
safety and effectiveness of marijuana as a drug; and
Category 3
Source: Application for Authorization to Possess Dried
Marihuana, Category 3 – First Medical Specialist Form v The second declaration must indicate that, among other thingss: the specialist has reviewed the applicant’s medical file and the reasons why the conventional treatments are considered to be medically inappropriate; the specialist has discussed the applicant’s case with the first specialist and agrees that the recommended use of marijuana would mitigate the symptom, and the benefits of the applicant’s recommended use of marijuana would outweigh any risks associated with that use, including the risks associated with long-term use of marijuana; and the second specialist is aware that no notice of compliance has been issued under the Food and Drug Regulations concerning the safety and effectiveness of marijuana as a drug.
Dosage The medical practitioner or
specialist sets the daily dosage. If the recommended daily dosage is more than 5
grams per day, the medical practitioner or specialist must indicate that he or
she has considered the risks associated with an elevated daily dosage of
marijuana, including risks with respect to the effect on the applicant’s
cardio-vascular, pulmonary and immune systems and psychomotor performance, as
well as the potential for drug dependency; and that in his or her medical
opinion, the benefits of the applicant’s use of marijuana according to the
recommended daily dosage would outweigh the risks associated with that dosage,
including risks associated with the long-term use of marijuana. Maximum
quantity possessed
The authorization to
possess specifies the amount that may be possessed at any given time is a
30-day treatment supply. As explained above, the medical practitioner or
specialist sets the daily dosage used to determine the 30-day treatment supply. Duration
Generally,
authorizations to possess are valid for one year and may be renewed. Licence to produce
There are currently two
possible legal sources for holders of an authorization to possess: they can
grow their own supply or they can designate someone else to grow it for them.
Health Canada has stated that, in the future, they should also be able to
obtain it from a licensed supplier. Only holders of an
authorization to possess (personal-use production licence) or someone who has
been designated as their representative (designated-person production licence)
are eligible to hold a licence to produce. A designated person cannot be remunerated
for their activities. Conditions for obtaining
a licence to produce include the following:
v A person is ineligible
for a designated-person production licence, who has been found guilty of a designated
drug offence in the previous 10 years. The licence specifies
the maximum number of plants that may be cultivated. The licence also deals
with the maximum quantity of dried marijuana that may be kept in storage and,
in the case of a designated representative, the transportation of marijuana.
The maximum amount of marijuana that may be cultivated and stored at any time
depends on the daily dosage that has been set by the medical practitioner or
specialist, and whether plants are grown indoors or outside. The regulations
also deal with inspection powers and record-keeping requirements. Other provisions
There are also
provisions dealing with matters such as: measures to ensure the security of the
marijuana in the possession of an authorized person; the revocation of
licences; the showing of documents to police officers; the referral to police
of complaints received by inspectors; and the disclosure of information about a
medical practitioner to provincial licensing authorities of medicine. Of note
is a transitional provision extending section 56 exemptions for an extra six
months after the date of their expiry. Health Canada has
established an ongoing review process to monitor the effectiveness and
application of the MMAR and provide advice on future measures related to the
manufacture, distribution and sale of marijuana for medical purposes. This
process involves a series of activities intended to collect information and
seek input on various aspects of the MMAR. A 15-member committee representing a
number of different stakeholder groups is currently being established, with a
its first meeting planned in October 2002. [1][24] Health Canada, Information, Medical Access to Marijuana – How the
Regulations Work, July 2001. [2][25] Regulatory Impact Analysis
Statement accompanying the Marihuana
Medical Access Regulations, page 8. [3][26] These symptoms are listed in a
Schedule to the MMAR and were selected based on the outcome or conclusions of
scientific and medical reports, although seizures associated with epilepsy were
added in view of the findings in the Parker
decision. This list is intended to be reviewed on a regular basis and is to be
amended as new information becomes available. |