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A large crowd filled Dundas Square in Toronto as pot smokers of every kind gathered on April 20, 2011 to celebrate, and make a political statement at 4:20pm on the twentieth day of the fourth month - the 4/20. This woman, Naomi, who is a medical marijuana user, who says she had to fight very hard for her prescription. (Peter Power/Peter Power/The Globe and Mail)
A large crowd filled Dundas Square in Toronto as pot smokers of every kind gathered on April 20, 2011 to celebrate, and make a political statement at 4:20pm on the twentieth day of the fourth month - the 4/20. This woman, Naomi, who is a medical marijuana user, who says she had to fight very hard for her prescription. (Peter Power/Peter Power/The Globe and Mail)

Globe editorial

Getting medical marijuana to the people who need it Add to ...

The federal government is promising to create a new and improved system of medical marijuana, but does it have the will to make that system work for patients?

The current system is broken. Patients from around the country - a Saskatchewanian with migraine, a Quebecker with degenerative disc disease, a Nova Scotian with glaucoma - testified in an Ontario court case that they had been trying in vain for years. The court said in April that the system is unconstitutional because patients can't get the medical marijuana that would give them pain relief. The government is appealing that ruling.

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Why doesn't the medical-marijuana system work? Partly because a doctor's note is needed, and doctors have largely boycotted the system. And partly because the patients who do obtain a doctor's note need further approval from Health Canada, which has behaved, according to Mr. Justice D.J. Taliano, with a "tight, almost miserly, control." Some applications sat for as long as nine months without approval or rejection. Health Canada says the program was meant for "a small number of persons," but the judge points out that it is a matter of constitutional rights, not a numbers game.

Health Minister Leona Aglukkaq's proposed new system contains at least one big improvement: Health Canada will take itself out of the game. A doctor's note will be enough for a patient to obtain the drug - this time from a licensed commercial grower. Also good: Doctors will be consulted on the wording of that note, or declaration.

Therein lie some potential problems. Will doctors accept a role as the system's gatekeeper? Or should that role be limited to merely writing a note confirming that patient x has a particular condition? Will the government be prepared to accept doctors' legitimate concerns, and will doctors go into consultations with an open mind?

The licensing and regulating of commercial growers may help win over doctors, and even help de-stigmatize marijuana, which would seem to run counter to the government's larger agenda on drugs. But is it necessary to bar patients (or their caregivers) from growing their own supply, if they have found the right strain of the plant for themselves?

When Ms. Aglukkaq announced public consultations on improvements to the medical marijuana system, she stressed the anti-crime agenda - the need to "reduce the risk of abuse and exploitation by criminal elements and keep our children and communities safe," rather than to help sick people. As Paul Lewin, who represented a patient in the court challenge, says, "I think there is a hostility to all things marijuana and they're proud of this hostility. It's a badge of honour they hold up." This anti-marijuana government will need to show resolve to fix the system so it works for patients.

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