Chapter 9 - Use of marijuana for therapeutic purposes 

Current therapeutic practices

The main reservations about therapeutic use relate to the lack of comprehensive knowledge based on controlled medical studies and also to the long-term impact on the respiratory system and carcinogenic potential. In some cases, reservations have been expressed regarding the psychoactive properties of marijuana. There is a growing consensus on the therapeutic potential of marijuana, particularly smoked marijuana. While marijuana cannot, strictly speaking, be considered a drug, at least for the time being, it still has therapeutic properties. How then do we classify and regulate it?

Canada, the United States and many other countries have developed a parallel practice of allowing people with certain conditions to use marijuana. The most familiar example in Canada is without question the Vancouver Compassion Club.

In its mission statement, the club advocates a holistic approach to health. It not only supplies marijuana, but also delivers other forms of natural medicine (herbal therapy, acupuncture, massage, etc.). The club is built on the values of compassion, emancipation and complementarity between approaches.

In the six years since the Compassion Club was founded, an intimate knowledge of the therapeutic effects of marijuana has been acquired. The club offers a daily menu comprising seven to ten varieties of marijuana, one or two varieties of hashish, cannabis tincture, and baked goods containing marijuana. It sells marijuana for $3 to $10 a gram, depending on the variety. It currently serves more than 2,000 members/clients.

Our members have a huge range of symptoms and conditions such as HIV and AIDS, cancer, multiple sclerosis, arthritis, chronic pain, fybromyalgia, seizure disorders, glaucoma, hepatitis C, anxiety, depression, insomnia, eating disorders and many others. […]

It is important that medicinal users have access to a variety of strains, as the effect of cannabis varies depending on which strain is being used and the method of ingestion. Our members are made aware of the differences and can then select the best strain of cannabis to most effectively treat their symptoms.

Indica and sativa are the two main varieties of the cannabis plant used as medicine. Many strains are crosses of those two varieties. Within each of those varieties and crosses there are a huge number of individual strains, each with a different cannabinoid profile and effect.

According to the anecdotal evidence, the indica strains are a relaxant, effective for anxiety, pain, nausea, appetite stimulation, sleep, muscle spasms and tremors, among other symptoms. The sativa strains are more of a stimulant, effective in appetite stimulation, relieving depression, migraines, pain and nausea. We are now aware of specific strains that are effective for specific conditions and symptoms. Members keep track of their use in order to find the most effective strain for themselves. We also keep close records monitoring members' purchases in order to assist members to track their own consumption and for us to prevent reselling and to encourage responsible use. [1][23]

Having read that testimony and the documents given to us by the club, visited the club’s premises and examined its records, and heard the testimony of other people who work for similar organizations in Montreal and Toronto, we can safely say that there are links between this therapeutic practice and the data produced by research on medical uses of marijuana.

We also observe that this organization, like others that provide a similar service in Canada, keeps detailed records of their clients and their marijuana use; these records allow treatment to be monitored, but could also be excellent material for empirical research. We can only lament the fact that Health Canada has not undertaken clinical research in cooperation with this organization. We share the reservations voiced by Hilary Black regarding the traditional protocols used in research on therapeutic use of marijuana:

We created a research proposal with a team of research scientists from Vancouver. However, we were turned down because we refuse to facilitate a study using a placebo or low-quality, low-potency cannabis imported from the US National Institute on Drug Abuse. Any study attempting to prove the efficacy of cannabis as a medicine using such a low-potency herb, or unknown strains such as those currently being grown in Canada by Plant Prairie Systems, is destined to fail. There is no need to import cannabis for research, considering the high quality and huge quantity of cannabis being produced in Canada. The information we could gather is being requested by doctors, patients, pharmaceutical companies, Plant Prairie Systems and Health Canada, yet we are not financially empowered to facilitate this research. [2][24]

No one will deny that research on therapeutic uses of marijuana, whether smoked or synthetic, must continue in an effort to further clarify the key elements of quality, effectiveness and safety. Everyone agrees that we should learn more about the strains and doses appropriate to various conditions. For all that, do we have to think of marijuana as a drug like the other drugs listed in the pharmacopoeia? Do we have to have the same requirements as those applicable to prescribed drugs, or should we relax the rules to view marijuana a natural health product? Were it not for the legal system and the international conventions governing marijuana, would the plant not be considered more a natural health product like other plants and herbs?

Casting the issue in those terms forces us to think differently about the therapeutic use of marijuana. If the aim is to make it a approved therapeutic product, the reservations of the medical profession, or at least of some representatives of the profession, are understandable: they cannot endorse the approach until the proper controlled studies are carried out so that physicians can prescribe marijuana as confidently as they prescribe other approved therapeutic products. If marijuana is recognized as having therapeutic uses in some cases – at least as proven as any other plant used in homeopathy or herbal therapy – the aim is instead to give it the same status as other natural health products.