A year after legalization, some Atlantic Canadians struggle for access to medical cannabis

POT FOR FUN? FINE.
FOR CANCER?
GET IN LINE.

When a Nova Scotia woman turned to cannabis to deal with the agony of cancer and all that went with it, she thought she'd be okay. Pot helped and let her steer clear of opioids. Then her legal cannabis oil supplier was suspended by Health Canada.


Lindsay, a Nova Scotia cancer patient, wants speedier and less restrictive access to medical cannabis products. She was left without a licensed provider when Health Canada suspended her supplier.

“I'm stuck and I know I'm just going to have to work through the pain.”
– Lindsay

Lindsay laid on the couch at her Nova Scotia home, hours after receiving her monthly cancer treatment, and waited for the side effects to kick in.
Aches, pains, upset stomach, nausea and cramps are just some of her symptoms from the hormone suppressant.
Normally Lindsay, who asked to be identified by only her first name for legal purposes, would place a drop of cannabis oil under her tongue and go about her day.
But Lindsay has been left to find her own supply or suffer through the pain after CannTrust, her medical cannabis provider, placed a voluntary hold on its products in early July while undergoing a review by Health Canada. On Sept. 17, Health Canada suspended CannTrust’s licence.
“I’m stuck and I know I’m just going to have to work through the pain,” Lindsay said.
“Everything is left up to my husband. He’s working 12-hour shifts and then he has to come home and then has to deal with the family on top of everything else and a wife that can’t really do anything.”
ONE HUNDRED
Number of milligrams of CBD oil Lindsay must take each day to deal with pain and side-effects of her cancer treatment.
In order to switch medical cannabis providers, Health Canada requires the patient to obtain a new medical document from a health-care practitioner. Lindsay’s prescription is up for renewal within the next month and she plans to talk to her doctor about switching providers.
In the meantime, other pain medication is an option, but it’s not an option Lindsay wants to try again.
Lindsay was prescribed morphine after she entered remission from Stage 3 breast cancer.
“They gave me pain medication, like morphine or hydromorphone or something along those lines, and then they told me, ‘You’re in pain? Take more. You’ll be fine,’ and that bothered me,” she said.
“I didn’t want to be so oblivious to daily activities by being on pills.”
In early 2018, Lindsay met with her oncologist to discuss alternative pain medications and was given a prescription for medical cannabis.
She ordered her products online through her medical cannabis provider for a while but was struggling to dish out $90 each prescription without her insurance chipping in, so she started going to an illegal dispensary.
“They were selling it at a price that’s affordable for someone that’s on disability, so I kept going to them,” Lindsay said.
That was until the police raided and shut down the dispensary, causing Lindsay to turn to the NSLC.



“When I go to the NSLC, it’s self-medication and I know I could be arrested because I have a prescription,” she said.
Lindsay said she knows other people who purchase cannabis for medical reasons from the NSLC or an illegal dispensary. And they’re not alone.
About 20 per cent of Canadian men aged 15 years or older that used cannabis said they used it for medical purposes, but not all had a prescription, according to a Statistics Canada data from the first half of 2019.
In a recent study, researchers at the University of California San Diego suggest recreational cannabis legalization may have reduced Schedule III opioid use. Schedule III is defined by the United States Drug Enforcement Administration as “drugs with a moderate to low potential for physical and psychological dependence.”
SIX
Number of months to wait for an appointment in Halifax to get a medical marijuana prescription.
Alaska, D.C. and Oregon implemented recreational cannabis legalization in 2015 and saw a reduction of roughly 30 per cent in the number of prescriptions, total doses and spending of Schedule III opioids by Medicaid enrollees, the study found.
“Schedule III opioids are often used to treat mild to moderate pain symptoms, for which marijuana is suggested to also be effective,” the study reads.
In a 2016 focus group, researchers with the Canadian Centre on Substance Abuse noted that teenagers with high stress and anxiety were self-medicating with cannabis.
While more people are self-medicating with cannabis, mental health and addictions clinicians with the Nova Scotia Health Authority said they haven’t seen an increase in cannabis users as most clients already use cannabis, a spokeswoman said.
Beverley Ware, NSLC spokeswoman, said customers seeking medical recommendations on products has been one of the biggest issues the Crown Corporation's had since rolling out cannabis in its stores.
The NSLC was appointed by the provincial government to be the province’s recreational cannabis retailer and its employees aren’t allowed to give medical advice on its products.
THREE
Number of authorized cannabis growers suspended by Health Canada. CannTrust’s suspension left Lindsay and hundreds of other patients without a supplier of medical marijuana.
“If you say, ‘I have a sore back,’ or something, we wouldn’t address issues like that, but we can talk about the types of products that would provide the experience that you’re looking for,” Ware said.
Ware said customers seeking medical cannabis should be going through Health Canada, as “it is the only body that can fill a prescription.”
But in Lindsay’s case, she’s not sure where else to turn.
“The recreational product from the NSLC isn’t the same, but I’m buying it so I can walk and function like a normal human being,” she said, admitting it’s not much cheaper than buying from her medical cannabis provider.
“Every time I go to the NSLC for medical reasons, it’s a risk, but it’s what I have to do. I’m not doing it so I can get high. I’m doing it so I can walk.”
RECREATIONAL ACCESS
In person:
• Go to authorized retailer.
• Show proof of age and buy.
Online:
• Go to authorized dealer's website.
• Order desired product(s).
• Show proof of age to delivery person.
MEDICINAL ACCESS
• See health-care practitioner.
• Get prescription for medical cannabis provider from health-care practitioner.
• Register with a licensed producer by filling out forms and providing medical document.
• Order from provider.

BY THE NUMBERS


232
Number of licensed cannabis producers in Canada.

20
Number of licensed producers in Atlantic Canada. The breakdown: N.S. 9, N.B. 6, P.E.I. 3, N.L. 2. Source: Health Canada

3
Number suspended by Health Canada for violating terms of license.



THE 4 KEY ISSUES


Dr. Chris Milburn

“There is now very good evidence that youth who smoke weed chronically end up with lower IQs as adults and are significantly more likely to develop psychotic disorders like schizophrenia”
– Dr. Chris Milburn

1 KEY ISSUE:
TOO YOUNG TO SMOKE? STRONGER WEED CAN HARM DEVELOPING BRAINS


Getting caught smoking weed might not be the end of the world for a teenager, but the medical profession and education system continue to warn of the dangerous effects cannabis can have on developing young minds.
Cape Breton emergency room physician Dr. Chris Milburn says there’s no shortage of studies that show today’s marijuana is stronger than it was in the emerging days of pot culture in the 1960s and 1970s. And he says the effects, though varying, can be damaging to the brain and can lead to developmental disorders and health issues.
“There is now very good evidence that youth who smoke weed chronically end up with lower IQs as adults and are significantly more likely to develop psychotic disorders like schizophrenia,” said Milburn, who served on a Canadian Medical Association-Health Canada joint committee on medical marijuana.
Mary Lou Andrea, an active healthy living consultant with the Cape Breton-Victoria Regional School Board, says there is more talk of cannabis since legalization and educators are helping get the health message out.
“Students buy in more when they know how exactly how it affects their bodies and their brains. The brain is not fully developed until the age of about 25, so early use of cannabis has a very negative effect,” she said.
However, she says educational system worry over cannabis now appears to be usurped by the rising concerns about vaping and its effects on the physical health of young users.
Three major risks associated with adolescent cannabis use (as identified by Dr. Christina Grant, Dept. of Pediatrics, McMaster University)
• Lower school performance – Studies show that memory is affected by cannabis use and can limit a student’s academic performance. Evidence suggests that regular and continued cannabis use can lead to lowering of inhibition, reasoning skills and memory.
• Psychosis – Cannabis use can lead to some youth to experience psychotic episodes in which they can lose touch with reality, although the episodes eventually resolve. When early cannabis use is combined with heavy and frequent continued use, there is a two-fold risk of developing a chronic psychotic disorder, especially when there is family history of schizophrenia.
• Cannabis Use Disorder (CUD) – One in six youth who experiment with cannabis will go on to develop CUD which can result in lower grades, increased domestic conflict and social changes. Research suggests three per cent of older male high school students have CUD.



123RF photo

2 KEY ISSUE:
TOO WASTED TO WORK?


Better safe than sorry.
That’s the approach some employers took after recreational cannabis-use became legal in Canada.
Most safety-sensitive workplaces—read police officers, pilots and construction workers—have banned employees from using cannabis recreationally for at least 28 days before their shift.
“Given the nature of our work and our obligation to serve the public in critical circumstances, we believe adopting anything less than this approach would have been too great a risk,” Const. John MacLeod said of Halifax Regional Police’s cannabis policy.
Rick Dunlop, a labour and employment lawyer at Stewart McKelvey, said employers have always had the right to prohibit off-duty conduct if it will affect the workplace.
“I recognize that employee rights advocates are concerned about an employer infringing upon an employee’s private lives,” Dunlop said.
Still, “employers have a legitimate concern and right to take steps to ensure that employees off-duty consumption do not put the employee’s safety or the safety of their fellow employees in jeopardy,” he said.
A precise timeline of residual impairment has yet to be established, leaving employers to err on the side of caution, Dunlop said.
Seventy-six per cent of employers across Canada adjusted their alcohol and drug policy after legalization, a recent Conference Board of Canada survey found.
Workplace safety was the top reason for adjusting drug policies, followed by impairment or intoxication at work, employee mental health, increase in workplace accidents or injuries and increase use of cannabis, the study reads.
“Understandably, organizations with a high proportion of safety-sensitive positions were far more likely to indicate that they were extremely concerned about the impacts on workplace safety than those with few safety-sensitive positions.”
A spokeswoman for the Nova Scotia Labour Department said it is unable to track cannabis-related incidents in the workplace.
“Anecdotally, it is our impression that we have received less than 10 cannabis related complaints since cannabis was legalized, which is comparable to the number of cannabis related complaints received before cannabis legalization,” the spokeswoman said.
Prince Edward Island and Newfoundland and Labrador labour departments said there have been no cannabis-related incidents reported since legalization.





3 KEY ISSUE:
POT MAY BE LEGAL BUT IT’S NOT CHEAP. THAT MEANS DEALERS STILL HAVE THEIR NICHE.


By his own admission, Charlie is not the most worldly of dudes.
But the irony of what’s going on in the cannabis trade is not lost on the street-level pot dealer who’s closing in on 50.
“I know guys that served time in jail for selling a bit of weed and now people like Brian Mulroney are making money off it,” he said, referring to the former prime minister’s 2018 appointment to the board of directors of U.S.-based Acreage Holdings.
More bitter for Charlie (not his real name) Mulroney’s Conservative government attempted to enact legislation back in the early 1990s that would have classified marijuana in the same category as heroin and acid (LSD).
“The suits are all making big money off of the legalization and guys like me are still running from the police,” he said.
The Cape Breton resident insists he serves a demographic that is being ignored. And a recent survey done for NSLC, the liquor and cannabis arm of the Nova Scotia government, shows three out of five cannabis consumers still get at least some of their weed illegally.
Robert Walsh
“My customers might only have five or 10 bucks and they can’t get nothing for that at the liquor store.”
Then there’s the difficulty getting to Cape Breton Island’s only cannabis store, located on the outskirts of Sydney.
Regardless, in the eyes of police Charlie’s a criminal.
“It’s still a crime,” said Cape Breton Regional Police Service deputy chief Robert Walsh
“Our drug section continues to enforce the law with people who are growing and distributing cannabis illegally.”
Walsh doesn’t reveal details of the service’s street level policing, but he readily admits that the department has not experienced a “significant spike” in cannabis-related calls.
Yet that’s little comfort for small-time dealers like Charlie who are long accustomed to keeping their business off the radar of law enforcement officers.
“The government’s not getting its tax from guys like me,” he said.
“So, they’ll always order the police to get us for that – it’s part of the business, always has been, always will be.”




Brendan Quinlan

“I know I’m not impaired but to go out and take a chance on getting pulled over and going to jail, I can’t take that risk.”
– Brendan Quinlan

4 KEY ISSUE:
TOO HIGH TO DRIVE? ROADSIDE TESTS CAN’T REALLY SAY.


“I just stopped driving completely.”
That was the answer Brendan Quinlan gave when asked how he feels about the new impaired driving laws for marijuana.
Quinlan is a medical marijuana patient and licensed producer who says the new regulations leave him no other option.
“I got no choice, I can’t take a chance on that,” Quinlan, who lives in Holyrood N.L., said. “I know I’m not impaired but to go out and take a chance on getting pulled over and going to jail, I can’t take that risk.”
Under the current laws, drivers with can be charged with drug-impaired driving if they have more than two nanograms (ng) of THC (the psychoactive ingredient in marijuana) in their blood. Between two and five nets a $1,000 fine and five or over can get you up to 10 years in jail.
The problem, says Quinlan and others, is that the roadside screening device they use doesn’t measure impairment, and even if a person is found not to be impaired they can have their license suspended and vehicle seized.
According to the Highway Traffic Act of Newfoundland and Labrador, a driver who provides a sample of a bodily substance that shows an amount of drugs exceeding the legal limit will have their license suspended for 90 days. Nova Scotia has the same penalty, with Prince Edward Island only giving a 24-hour suspension. New Brunswick doesn’t specifically address it in their legislation but a peace officer can suspend a drivers license for seven days based on a roadside screening.
Provincial legislation changed to reflect Bill C-46, the federal impaired driving legislation that passed along with Bill C-45, the Cannabis Act. It allowed the use of these roadside screening devices and the subsequent blood test used to measure impairment if one fails the roadside test. Failing the roadside test is not a criminal offense but the legislation in allows a vehicle to still be seized and license suspended.
Quinlan said with the amount of cannabis concentrates he consumes he would always fail the roadside screening device, even if he isn’t impaired.
“I take some of that oil in the nighttime, the next morning I’ll still fail that,” he said. “It’s silly, no one get in trouble for being drunk a day before.”
He’s concerned that marijuana is being lumped in with alcohol in terms of impaired driving, when the two are far different.
“You can’t even compare them,” he said. “Someone smokes a bunch of weed they know they’re too high to drive and they’ll wait until they sober up. Get someone with a dozen beer in him and he’s sure he can drive anywhere.”

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