Philippe lucas 02 parallel session policy in medical cannabis and other psychoactive substances – the canadian experience

NORTHERN LIGHTS:Medical Cannabis Policy and Practice in Canada

PHILIPPE LUCASVICE PRESIDENT OF PATIENT RESEARCH & SERVICES, TILRAYCENTRE FOR ADDICTIONS RESEARCH OF BRITISH COLUMBIA

MARCH 2015

Universityof Victoria

Centre for AddictionsResearch of BC

MEDICAL CANNABIS IN CANADA

• R. v. Parker (2000) - constitutional right to choose cannabis as medicine without fear of criminal sanction

• In 2001, the Marihuana Medical Access Regulations (MMAR)

• 1 million Canadians used cannabis for self-defined medical conditions (Adlaf, Begin & Sawka, 2005; Belle-Isle & Hathaway, 2007)

• To date, approximately 50,000 Canadians have obtained an authorization to possess cannabis for medical purposes



CANADIAN MEDICAL MARIHUANA SYSTEM

MMAR

ENDEDMARCH 31, 2014

MMPR

STARTEDAPRIL 1, 2014



A STEP IN THE RIGHT DIRECTION

THE MARIHUANA FOR MEDICAL PURPOSES REGULATIONS (MMPR)

The most significant change in medical cannabis access since 2001, the MMPR were implemented by Health Canada in December 2012, and went into full effect on April 1st 2014

• Simplified/decentralized application process

• NPs can prescribe (maybe)

• Multiple Licensed Producers

• Increased quality control

• Increased strain/symptom awareness



CURRENT LICENSED PRODUCERS

Aphria

Bedrocan Canada Inc.

Broken Coast Cannabis Ltd.

Canna Farms Ltd.

CanniMed Ltd.

CannTrust Inc.

Delta 9 Bio-Tech Inc.

In The Zone Produce Ltd.

MariCann Inc.

MedReleaf Corp.

Mettrum Ltd.

OrganiGram Inc.

The Peace Naturals Project Inc

Tilray

Tweed Inc.

Whistler Medical Marijuana Corp.



TILRAY FACILITY LOCATION



FACILITY CONSTRUCTION







v1.0



GROW ROOM



GROW ROOM




v1.0




v1.0



TILRAY FACILITY



MMPR AUTHORIZED ACTIVITIES PERFORMED BY TILRAY

SEED1

PROCESSING5

SHIPPING / DISTRIBUTION8

GROWING / CULTIVATION3

STORING6

TECHNICAL SERVICES /FINANCIAL INSURANCE10

TE

ST

ING

/ R&

D

6

DISPOSAL / WASTE STREAMS9

HARVESTING4

PACKAGING / LABELLING7

PROPOGATION2



TILRAY SUMMARY

Scale

Investment

Location

Taxes

Product

Technology

Jobs

Nanaimo BC

65,000 SF facility with over 34,000 SF of production space

25+ million invested

over 120 direct jobs

Cutting edge technology & production practices

Dozens of strains, including many high CBD varieties

Significant contribution to local tax base



TILRAY RESEARCH STRATEGY

Phase 2 placebo-controlled clinical trial agreement with the University of British Columbia to examine the therapeutic potential of medical cannabis on the symptoms of PTSD

• 40 participants; military and police veterans and other survivors of physical violence.

• Study will compare vaporized cannabis of varying cannabinoid concentrations to placebo

• Health Canada and UBC review and approval process in Spring 2015

Pilot studies of cannabis-based preparations in the treatment of paediatric epilepsy

• New York State

• New South Wales, Australia

Patient patterns of use research

• University of Victoria



CANNABIS ACCESS FOR MEDICAL PURPOSES SURVEY (CAMPS)

The CAMPS questionnaire is a 414 question cross-sectional survey made available to Canadian medical cannabis patients online and by hard copy in 2011 & 2012.

With 628 responses so far, the Cannabis Access for Medical Purposes Survey (CAMPS) is the largest polling of Canadian medical cannabis patients to date.




DEMOGRAPHICS




Fig. 1. Primary medical conditions treated with cannabis by authorization. Note: Sleep Disorders, Attention Deficit Disorder, Fibromyalgia, Hepatitis C, Parkinson’s Disease, Wilson’s Disease, Scleroderma, Tourette’s Syndrome, and unspecified Psychotic Disorder Conditions each

comprised less than 2% of the sample and were aggregated into the category ‘Other’. The anxiety and mood disorders category included 35 participants who reported a primary illness/condition of anxiety, 34 who reported depression and 40 who reported both anxiety and depression. Comparisons

of these groups indicated equivalent profiles with regard to demographic characteristics, health, and use of CTP, and were therefore aggregated for statistical analyses; n = 502 * = difference between proportion Health Canada Authorized and Unauthorized p < 01.

25.00

PERC

ENT

REPO

RTIN

G

HIV / A

IDS

ARTH

RITIS

SPINA

L PAIN

AN

XIETY / DEPRESSIO

N*

CAN

CER

EPILEPSY

MU

LTIPLE SCLEROSIS

GA

STRO-IN

TESTINA

L*

CHRO

NIC PA

IN

OTH

ER

20.00

15.00

10.00

5.00

0.00

ALL

HEALTH CANADA AUTHORIZED

NOT HEALTH CANADA AUTHORIZED

PRIMARY MEDICAL CONDITIONS TREATED WITH CANNABIS




CHARACTERISTICS OF CANNABIS USE BY CONDITION



SUBSTITUTING CANNABIS FOR PRESCRIPTION DRUGS, ALCOHOL AND OTHER SUBSTANCES

V1.0

80%PRESCRIPTION DRUGS ALCOHOL

52%ILLICIT SUBSTANCES

32%87%

PERCENTAGE OF PATIENTS WHO USE CANNABIS INSTEAD OF OTHER SUBSTANCES

• Reasons cited: “better symptom management” and “less adverse side-effects”. • Patients who listed a greater number of symptoms were more likely to report cannabis substitution.• Younger patients (30 & younger) were far more likely to substitute cannabis for

prescription drugs, alcohol and illicit substances than older patients (50 & older).

MEDICAL CANNABIS PATIENTS’ SUBSTANCE SUBSTITUTION



DISCUSSION

V1.1V1.0

SUBSTITUTION FOR PRESCRIPTION OPIATES

With the recent rise in pharmaceutical opiate addiction (Dhalla et al, 2009; Fischer et al, 2008; SAMHSA 2007), and an associated increase in opiate-related morbidity and mortality (Moore et al 2007), cannabis may prove to be a safer substitute to address chronic pain issues in patient populations.



DISCUSSION

V1.1V1.0

SUBSTITUTION FOR ILLICIT SUBSTANCES

Evidence suggesting that cannabis might be an effective substitute for opiates, crack/cocaine, crystal meth and other illicit substances could be part of a public health-centered harm reduction strategy aimed at reducing disease transmission and overdoses stemming from injection drug use.

SUBSTITUTION FOR ALCOHOL

Public policies informed by evidence that cannabis might be a substitute or actual treatment for alcohol addiction (Lucas 2013; Reiman 2009, 2006; Mikuriya 2004) could have a significant impact on overall rates of alcoholism, as well as alcohol-related automobile accidents, violence and property crime.

THANK YOUQUESTIONS?

PHILIPPE LUCASVICE PRESIDENT OF PATIENT RESEARCH & SERVICES, TILRAYCENTRE FOR ADDICTIONS RESEARCH OF BRITISH COLUMBIA

[email protected]

Education

Philippe lucas 02 parallel session policy in medical cannabis and other psychoactive substances – the canadian experience