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Tracy Roberts, who has experienced a supply issue with her medical cannabis, at her home on Nov. 9, 2018.

Kayle Neis

Part of cannabis laws and regulations

Patients are facing shortages of medical cannabis as some of Canada’s largest marijuana growers struggle to meet demand amid widespread shortages in the newly legal recreational marijuana market.

The shortages mean that some patients will not have timely access to their medically authorized marijuana. And the supply shortfall raises questions about the design of Canada’s two-track market for medical and recreational marijuana. Without a legal requirement to give preference to the medical market, producers are free to focus on fulfilling large contracts with the provinces for recreational marijuana.

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The rules for purchasing medical marijuana is making the problem worse. Medical users must register with producers before making a purchase, so they cannot simply take their business to another medical producer when there are supply shortages.

Patients could buy recreational marijuana instead, as most of those products are largely interchangeable with medical products, but there are widespread shortages in that newly launched market. In Ontario, for example, there are long delivery times resulting from product shortages.

The digital shelves in Tilray Inc.’s online medical shop are nearly bare. The Nanaimo, B.C.-based company has sold out of its strains of dried flower, according to its website. Tilray’s supply of cannabis oils have been sparse and inconsistent. When items are restocked, they are being snapped up fast, forcing patients to watch the site and race to place their online order before the latest batch of product sells out.

While Canopy Growth Corp., Aurora Cannabis Inc., Aphria Inc. and CannTrust Holdings Inc. have more selection, they are still sold out of some of their strains, oils and capsules aimed at medical patients, according to their websites as of Friday. In some cases, producers are waiting weeks for new cannabis plants to grow. In other cases, there are delays in getting products tested, packaged and shipped to clients.

“A lot of these big companies had tons of patients and then signed big deals with provinces, taking on more they could handle,” ​said Michael Verbora, the medical director of Canabo Medical Clinic, a chain of marijuana clinics owned by producer Aleafia Health Inc. “It’s putting a big burden on the medical [cannabis] system and it could have been prevented.”

Tilray, Canopy, Aurora, Aphria and CannTrust have amassed some of the largest patient bases in the nascent cannabis sector. Since Oct. 17, patients can request that their medical documents be returned or transferred to another provider. But most people don't know that, says Deepak Anand, vice-president of business development and government relations at Cannabis Compliance Inc.

Canadian patients aren’t the only buyers any more, either: Growers are shipping millions of units to provincial distributors across the country for recreational sales and are also exporting overseas. All this demand has put a strain on the supply of legal cannabis in the weeks before Oct. 17 and especially after.

There has been a spike in patients, with weekly referrals to the Canabo clinic chain up 30 per cent since legalization. Dr. Verbora says Ottawa needs to allow middlemen that connect patients who need a certain strain or type of oil with producers that have some, making the medical system less fragmented and more efficient.

He says it could be helpful if clinics such as Canabo could dispense cannabis on-site or if pharmacies were involved – both of which are prohibited under the Cannabis Act.

“Whoever has the product gets the patient,” he added. “It’s just growing pains for the industry, but patients should be protected."

Even though growers aren't required to earmark enough inventory for patients, Health Canada says it’s expected that producers would “prioritize” medical sales.

In e-mails to The Globe and Mail on Thursday and Friday, spokespeople for Health Canada said the government has observed some “localized shortages” of supply in some markets and in some product lines, but “remains confident that there is sufficient supply of cannabis overall to meet market demand now and into the future.”

At the end of September, two weeks before legalization, Health Canada says producers shipped more than 14,500 kilograms of dried cannabis and 370 litres of cannabis oil into the recreational market, according to data supplied to Ottawa by producers. Growers had more than 90,000 kg of flower and 41,000 litres of oils on hand, and Health Canada says initial recreational sales “represent only a small fraction of that available inventory.”

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That’s no comfort to Tracy Roberts, 40, of Saskatoon. She says she’s been a client of Tilray’s for years, using a mix of dried flower and oil to help cope with her bipolar anxiety disorder, degenerative disc disease and breast cancer. She’s been waiting three weeks for Tilray to restock its online shop. A new batch of the strain she smokes was restocked last week, but she says it sold out again mere hours after Tilray posted about it on social media.

“All Tilray keeps telling me is we’re trying our best, be patient and we’ll have product soon,” she said. “It’s been really tough on my mental health. It feels like we’ve been hung out to dry. There’s got to be some way to protect the medical patient.”

Ms. Roberts has been waiting three weeks for Tilray to restock its online shop.

Kayle Neis

Social media is littered with stories just like this: A cancer patient who has trouble sleeping. A mother of a boy with epilepsy who panicked because Tilray didn’t have any oil that her son uses to manage seizures. A man with chronic pain trying to stop using painkillers.​

Tilray spokeswoman Chrissy Roebuck said that the company saw a surge in registrations and orders from patients before Oct. 17 that “it didn’t expect.” It declined an interview request, saying that the state of its medical inventory will be discussed during its earnings call on Tuesday. (Other cannabis growers are also set to report this week, starting with Aurora on Monday.)

Some companies, including Tilray, say they could get product to patients faster if Ottawa licensed more production space and new equipment faster. (Canopy, Aphria and Aurora have all spoken publicly about waiting to get regulatory approval to expand their production.) Health Canada says it’s issued dozens of new licences and 191 expansion amendments since May, 2017, while licensed square footage has ballooned from two million square feet to 13 million sq. ft.

Ottawa also says it’s asking growers to tell their patients when they will be restocking their online shelves. Tilray, though, just displays the phrase: “Out of stock. Coming soon.” Ms. Roberts was tired of waiting and says last Friday she transferred her file to another cultivator: B.C.-based Canna Farms Ltd. She expects her order to arrive midweek.

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“For patients, legalization has been a disaster,” said James O’Hara, head of advocacy group Canadians for Fair Access to Medical Marijuana. “There’s no question that there’s a supply issue, but it’s more than that. What I hear most from patients is ‘I can’t find my strain,’ the one that works best for their condition. And that’s causing problems."

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