Expand distribution of medical marijuana to pharmacies: health experts

Health professionals and patient groups argue for greater access through pharmacies

At an iPolitics Live event on Thursday morning, stakeholders discussed the future of the medical cannabis system in Canada as legalization of cannabis approaches. In particular, panellists were interested in a dual system that would place medical cannabis under the distribution of pharmacists around the country, separate from the recreational marijuana that will become available for purchase.

“We really think that cannabis is a legitimate medicine and should be treated that way,” said Jonathan Zaid, Founder and Executive Director of Canadians for Fair Access to Medical Marijuana. “That means ensuring that is in a distinct regulatory framework. We agree with the position that pharmacies are the best-suited system to allow for the accommodation of needs for medical cannabis.”

Zaid said that on top of maintaining the current mail-order system for medical cannabis and the allocation for personal production, that pharmacies would be best suited as a distribution point for patients. Zaid said that pharmacists have regulated oversight, and will lend additional educational and safety measures.

Zaid also said that he hopes that with the legitimacy that pharmacy distribution brings, that it will help the affordability of medical cannabis by ensuring that it becomes tax-free like other prescriptions, and that it becomes eligible for insurance plans.

“Canada’s 42,000 pharmacists are the medication experts on a patient’s healthcare team,” said Shelita Dattini, Director of Practice Development and Knowledge Transition at the Canadian Pharmacists Association. “We spend upwards of five years, some of us seven years, studying the pharmacology and therapeutics of all medications. We spend our careers every day learning about new medications and guiding patients through those.”

Dattaini notes that pharmacies are already set up to ensure the integrity, tracking and safety needed for distribution, and that they can do things like monitor drug interaction and side-effects.

“We are often the first to identify patients who might have risks for things like substance abuse, patients who might have contra-indications to medications, who may have addictive tendencies,” said Dattaini.

Dattaini added that it would be irresponsible not to have oversight for cannabis in therapeutic use, especially if it’s being used in combination with other medications.

New Brunswick has been looking to ensure that there is the research necessary to ensure that medical cannabis is building up the necessary scientific credentials be recognized as a legitimate medicine.

“We understood some time ago that basically more research needed to be done, and to that purpose, we created two health research chairs in New Brunswick at two universities,” said Bruno Battistini, President and CEO of the New Brunswick Health Research Foundation. “One to determine the social determinants of health as it relates to the use of cannabis, and the other one is more biomedical research.”

In particular, the research is done to ensure that patients are being given the right kind of medication when it comes to medical cannabis, what the doses should be, the by which route it’s being administered, whether the right documentation is present, that it’s being administered for the right reasons, and that that it’s getting the right responses.

“We need more research to define what is evidence-based, and best practices to give those to patients,” said Battistini.

With a deadline of July 1st looming, Dattaini believes there is enough time for pharmacies to set up a separate medical cannabis distribution stream, separate from the recreational one. What they need for that, however, are tracking identifiers.

“Pharmacy has shown up in the past that we can ramp up fairly quickly, and we’re poised to do that,” said Dattaini.

Zaid is concerned about the current state of the market, however.

“There is not enough supply in the medical market today,” said Zaid. While Health Canada has indicated that they are ramping up supply, Zaid notes that it’s important that supply is consistent for patients, and worries that medical strains will be pushed out as suppliers focus on the coming demand for recreational strains.

Currently, about 140,000 Canadians use medical cannabis, which works out to about 0.4 percent of the population.

“That will probably increase when we have more evidence-based by research and clinical trials that the use of these natural products, which would be cannabis in different formulations, would be efficient against different ailments,” noted Battistini.

It will be that research that ensure that medical cannabis gets a Drug Identifier Number, and constructs a drug master file, all of which will also help ensure that medical cannabis gets equal tax status and insurance coverage as other pharmaceuticals.