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Oh, the irony. Thanks to the Harper government's devotion to free enterprise, Canadians are about to get what Justin Trudeau has only promised – legal, quality-controlled marijuana, produced on a large scale. All you'll need is a compliant doctor to certify that you have aches and pains.

Until now the supply of medical marijuana has been cruelly limited, but the Harperites have fixed that. All entrepreneurs are now invited to compete for your business. As a result, Health Canada predicts, the number of medical marijuana users will soar. Take that, Justin!

In the United States, medical marijuana (now available in 20 states) has been widely viewed as a back door to legalization – especially in California, where the term "medical marijuana" is an open joke. Despite a crackdown by the federal government, pot, in all its infinite variety, is as available as plastic surgery. "On Venice Beach in California, you have guys in medical scrubs and with stethoscopes walking around offering to give you a prescription," Mark Kleiman, a marijuana policy expert, told NPR. (For the record, Mr. Kleiman, an adviser to the state of Washington, is cautiously pro-legalization.)

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Among California's leading cannabis emporiums is the Harborside Health Center, based in Oakland and San Jose. Its airy, light-filled premises offer hundreds of marijuana products, including Sun Grown Blue Dream, Platinum Cookies and 3 X Crazy. It offers online shopping and free delivery.

In Canada, getting a licence to use medical marijuana is straightforward. All you need to qualify is a "debilitating symptom" for which conventional treatment has failed or been deemed "inappropriate." Need help finding a sympathetic doctor? No worries! For a fee of only a few hundred dollars (plus tax), a handy online referral service will find you one. One energetic doc signed 4,000 eligibility forms – at fees of up to $250 apiece – before the cops swooped in and arrested him on fraud charges. Presumably, most doctors will be more circumspect.

Personally, I think anyone suffering from the excruciating pain of terminal cancer or other serious illness should have access to any treatment she wants. But the truth is that the benefits of medical marijuana have been wildly overstated, and that much of what passes for "medical" use is a fraud. How much medical marijuana use is actually medical? The answer varies according to the jurisdiction, how tight the rules are and what you mean by "medical."

Medical marijuana is thought to ease the symptoms of serious illnesses such as multiple sclerosis, glaucoma, cancer and Parkinson's disease. But the evidence of its effectiveness is mixed and large-scale clinical trials have never been conducted. In any event, less than 5 per cent of people who seek medical marijuana in California have any of these illnesses, according to Marijuana Legalization: What Everyone Needs to Know, an authoritative study co-authored by Mr. Kleiman. Most of them have "nonspecific complaints of anxiety, pain or insomnia." And despite the reams of enthusiastic testimony from patients, there is only "the slightest medical evidence" that marijuana helps.

Even so, public support for medical marijuana is overwhelming. Nobody wants to see other people suffer. And if your ailing mom thinks a hit will ease her crippling arthritic pain, then what's the harm? It's probably no worse than gin. Medical marijuana may be a sham, but it's also relatively harmless. You can get the munchies just thinking about it.

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