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If pot is medicine, treat it that way Add to ...

It is estimated that there are now more than 200 marijuana dispensaries across Canada. They are most visible in Vancouver, Victoria and Toronto, but now they are springing up just about everywhere.

These dispensaries – which are illegal – are strange beasts: To purchase the products – dried, oil or edibles – you need a prescription for “medical” marijuana. Most dispensaries will refer you to a doctor who is happy to write a script for what ails you, such as pain (real or imagined).

In Canada, if you have a prescription, you can also purchase medical marijuana directly from state-sanctioned suppliers and they will courier it to your home.

But now some dispensaries are not bothering with the nudge-nudge-wink-wink of prescription and selling pot to anyone who will sign a waiver saying they need it for medical reasons.

These businesses are proliferating because there is a grey zone created by the new Liberal government’s promise to legalize marijuana possession, and its failure to provide concrete details on how it intends to do so.

There are two basic ways to control availability of drugs like marijuana: Criminal prohibition and administrative regulation.

Criminal prohibition has not worked: It has proved costly and ineffective. Pot is less harmful than tobacco or alcohol, but it is not benign. The best approach to reducing harm is to replace criminalization with health-focused regulation.

This point was made eloquently by the Centre for Addiction and Mental Health in a document entitled “Cannabis Policy Framework.” The report makes a number of sound recommendations, including:

– Set a minimum age for cannabis purchase and consumption

– Limit availability

– Curb demand through pricing and taxation

– Curtail higher-risk products and formulations

– Prohibit marketing advertising and sponsorship

– Clearly display product information, including labelling THC (tetrahydrocannabinol) and CBD (cannabidiol) content

– Address the risk of cannabis-impaired driving

– Enhance access to treatment

– Invest in education and prevention

CAMH researchers also recommend, first and foremost, a government monopoly on sales of cannabis products.

Before blithely accepting dispensaries as a normal part of the urban landscape we need to ask ourselves, 1) if marijuana is a legitimate prescription drug and, 2) if stand-alone private businesses are the appropriate method for distribution of marijuana, “medical” or otherwise.

There is a little bit of evidence (and, yes, plenty of anecdote) that marijuana is useful for treatment of some conditions, like nausea and pain.

But, if cannabis is a legitimate prescription medicine then shouldn’t it be subject to the same rules as other drugs, including being tested in clinical trials, packaged in measurable doses, and sold in pharmacies?

And why should we put conscientious physicians in the uncomfortable position of having to prescribe a sort-of-prescription drug that they know, in many cases, will actually be used for recreational purposes?

There are an estimated 500,000 users of medical marijuana in Canada over the age of 25: 24,000 of them purchase the drug from state-approved suppliers, roughly 200,000 buy from grey-market dispensaries and; almost 300,000 on the black market. Those numbers don’t even include “recreational” users.

Obviously, the time has come to fundamentally revamp our approach to pot. But public policy should be implemented deliberately and thoughtfully, not by pretending current regulations don’t exist and allowing dubious approaches to fill the void.

The move to legalization should be guided by public health officials, not potpreneurs. One of the key questions that flows from a promise of legalization of possession is: Where will marijuana be sold? There are many possible options:

– In state-controlled outlets, the way beer and liquor is sold in many provinces

– In corner stores, in the same way as cigarettes;

– In so-called coffee shops, as is done in the Netherlands;

– In stand-alone dispensaries – with or without prescription.

What we have now is none of the above, with marijuana sold in unregulated, glorified head shops, or by mail order.

These approaches are, medically and legally, as preposterous as they are ridiculous.

The sale of marijuana is going to be legalized in Canada. The priority should be reducing harm, and the best way of doing so is with a state-controlled monopoly or, at the very least, firm regulation of private sales.

We need to dispense with the Wild West of unregulated pot dispensaries.

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