GROWING UNCERTAINTY UNDER NEW RULES

Granting of Licences by Health Canada Just One Cause of Concern For
Medical Users

Eighteen-year-old Adam Greenblatt was lying in bed one morning when
his mother burst into his room and demanded to know if he had any drugs.

Greenblatt, who had been busted for possession while smoking up with
some friends outside his high school in suburban Toronto, thought his
mom was hassling him about pot again.

But this time was different.

Adam's father wanted to give marijuana a try, his mother said. Get out
your dope, she told him.

Michael Greenblatt, a dentist, had suffered from multiple sclerosis
since his late 30s. The neurological condition left him with a twisted
arm and unable to practise dentistry.

After 20 years of taking toxic pharmaceuticals that were getting less
effective at controlling his spasms and nausea, he was desperate for relief.

"I was in so much pain I had to try something else," he recalls.

He had never tried pot, even in high school or university in the
1960s, and didn't want to start by smoking. Adam sauteed some cannabis
in butter for him and smeared it on a sandwich.

Later that day, Adam's mom called him on his cellphone and told him to
come home. "Your father wants the joint," she told him.

Sitting around the kitchen table, Adam showed his father how to smoke
and inhale marijuana.

"It was remarkable," Adam says. "It was probably the first time ever
I'd seen my dad smile and be pain-free."

Today, Michael Greenblatt is one of more than 5,000 authorized
marijuana users in Canada. His son is his designated grower, providing
him with about 10 grams a day in edible form.

For Adam, the profound effect the cannabis had on his father's
symptoms was eye-opening. He went on to run as a candidate for the
Marijuana Party and work in a Montreal "compassion club," clinics that
operate in a legal grey zone by providing marijuana to sick people
outside the Health Canada program.

Greenblatt left the clinic shortly before it was raided by police.

He now runs his own medical marijuana dispensary in Montreal to help
other patients and advocates through the Canadian Association of
Medical Cannabis Dispensaries.

Greenblatt sells medical cannabis products to about 65 customers, both
by drop-in and mail order.

Today, with the Conservative government bringing in new regulations
governing the use of medical marijuana, the future of operations such
as Greenblatt's is uncertain.

Health Minister Leona Aglukkaq says the changes to the Marijuana
Medical Access Regulations (MMAR) are intended to balance the needs of
patients with concerns that home-grow operations are dangerous to
health and safety.

"We have heard complaints and concerns from many fire departments and
many mayors," she said.

Aglukkaq says she is also concerned about reports of criminal activity
within the medical marijuana program.

"There are people out there who are abusing this program,
unfortunately, for illegal activities," she said.

But Aglukkaq insists there is no link between changes to the medical
marijuana program and the Tories omnibus crime legislation, which was
passed this week in the House of Commons and also casts a shadow on
the program's future.

The toughening of drug trafficking laws means that anyone caught
sharing or selling marijuana will face mandatory jail sentences. No
longer will judges have the discretion to waive a sentence for pot
providers who offer the product to help the sick. If charged and
convicted of trafficking, they will do jail time - at least six months.

Health Canada is currently con-ducting consultations with
stake-holders on the proposed changes to the regulations.

If the new rules are adopted, no longer will patients be able to
legally grow pot at home or have someone grow it for them.

Under the current system, approved patients can produce their own
marijuana plants or designate a person they know to grow it for them.

Data obtained by the Ottawa Citizen through the Access to Information
Act shows that, between 2001 and 2007, about 55 per cent of approved
MMAR patients were licensed to grow and another nine per cent could
use designated growers.

For these patients, the incentive to grow is both one of cost - done
properly, it can be cheaper than the $5 plus taxes per gram for Health
Canada's pot - and of quality. Many complain that Health Canada's
contracted producer, Prairie Plant Systems in Manitoba, produces only
one strain of cannabis and it has a lower content of active ingredients.

Under the proposed regulations, Health Canada would license private
growers to provide marijuana products by mail order to approved patients.

But still unclear is who would qualify for growing licences or whether
there would be a variety of products available to patients. Many of
the so-called compassion clubs that provide marijuana to sick people
outside the Health Canada program would like to be approved. They are
encouraged that they were included in consultations on the new rules,
but worry the government will create regulatory blocks on security
grounds or make the cost of getting a licence unviable. That would
allow only a small number of big companies the right to grow and sell legally.

The prohibition on growing is just one in a basket of changes that
Health Canada has suggested making to the medical marijuana program as
it moves into its second decade.

The regulations would also relieve Health Canada bureaucrats of the
responsibility for approving applications that have already been
signed off by doctors.

The two-step process of asking a doctor before applying to the MMAR
program would end and doctors alone would decide whether to is-sue the licence.

Marijuana advocates are generally supportive of this change, but warn
it will do nothing to overcome the major obstacle for patients: few
doctors are agreeing to sign the papers because the Canadian Medical
Association (CMA) does not support the program. Patients still must
doctor-shop to find a marijuana-friendly physician, with some even
paying $400 or more to visit clinics specializing in medical marijuana
referrals. Others go to compassion clubs if there are any nearby or
in-stead buy marijuana illegally on the street.

Aglukkaq says solving this problem will require better research, and
more consultations with the CMA and provincial health ministries.

That's not good enough for Francois Arcand, an Ottawa medicinal
marijuana patient who is frustrated by the CMA's reticence to let
doctors prescribe the drug.

Arcand was studying civil law at the University of Ottawa in 1989 when
he was struck by a brain hem-orrhage. Doctors told him he had a
pear-sized arterial venous malformation in his head.

After surgery, he was left with little feeling on one side of his body
and suffered from near-constant seizures. Pharmaceutical drugs reduced
the number of seizures but sapped his appetite and left him in a mental fog.

Sick of watching him waste away, Arcand's brother bought some
marijuana for him. The drug was trans-formative.

It dramatically cut down on his seizures, restored his appetite, let
him sleep at night and helped him regain some movement in his right arm.

But Arcand couldn't get his doctor to agree to enrol him in the Health
Canada program.

Instead, he began buying it illegally. Having to resort to a criminal
activity did not sit well with someone who had once planned on
becoming a Crown prosecutor.

It took him seven years to find a vascular neurologist who would agree
to sign the Health Canada forms. Now he consumes his cannabis in the
form of a tincture, with the pot supplied by Greenblatt's girl-friend,
his designated grower.

"I blame the CMA. They're the ones who tell their doctors you don't
have a right to give a prescription," Arcand says.

By the numbers

4,884 - Number of Canadians authorized to possess marijuana (as of
January 2010)

10 - Age of the youngest patient, a boy with epilepsy, living in
Quebec's Beauce region, authorized for one gram a day, referred by a
pediatrician.

90 - Age of oldest patient, a man in downtown Vancouver with severe
arthritis, authorized to consume five grams daily, referred by a
general practitioner.

56 - Largest allowed dosage, in grams per day. It was approved for a
45-year-old man with spinal-cord in-jury and disease, living near
Kelowna, B.C.

Top medical reasons for marijuana applications, 2007-2011:

Severe arthritis 7,445

Other (Category 2)* 4,032

Chronic pain 2,194

Spinal-cord injury 2,130

Spinal-cord disease 1,583

Cancer 1,387

Multiple sclerosis 1,254

AIDS, HIV infection 1,130

Epilepsy 394

Hepatitis B or C 276

* Category 2 patients have debilitating symptoms of medical conditions
not covered by Category 1 for which conventional treatments are
considered ineffective. These applications require an assessment by a
specialist. Category 1 patients are authorized to possess marijuana to
treat symptoms of cancer, HIV/AIDS, epilepsy seizures, spinal-cord
injury or disease, and severe arthritis. They require approval by only
one doctor.

Top postal code zones for medical marijuana applications,
2007-2011:

V0N: 530. Includes B.C.'s Sunshine Coast, the Gulf Islands, part of
Vancouver Island and Whistler

V0R: 363. Central Vancouver Island, including Tofino

K0L: 341. Rural area outside of Peterborough, Ont.

V0E: 283. Rural parts of the Okanagan Valley

B0E: 279. Western Cape Breton, Nova Scotia

K0K: 263. Rural areas in Quinte and Prince Edward County,
Ont.

V9L: 219. Duncan, B.C., on Vancouver Island

V2R: 190. Chilliwack, B.C.

V0G: 189. West Kootenays, B.C.

V2V: 183. Mission, B.C.

Most populated areas without any applications for medical marijuana,
2007-2011. Based on 2006 census:

G0A: 89,695. Rural area outside of Quebec City

L4J: 68,897. Thornhill area of Toronto

L4C: 68,546. Richmond Hill area of Toronto

G0S: 64,237. Rural area that covers part of Quebec's Beauce
region

L6R: 56,600. Brampton, Ont.

Source: Ottawa Citizen analysis of Health Canada records released under the
Access to Information Act

Medical marijuana timeline

1990s: The seriously ill and dying begin fighting for a legal
exemption to the criminal law, demanding the right to obtain medicinal
pain relief though marijuana without fear of prosecution.

2000: Litigation continues. Numerous cases are before the courts as
patients seek easier access to medical marijuana.

July 2000: Medical marijuana hits the Canadian legal radar after
Ontario Court of Appeal issues the first ruling linking the
constitutional validity of the criminal law to the existence of a
medical exemption protecting patients' rights.

July 2001: Health Canada introduces Marijuana Medical Access
Regulations, and Canada became the second country in the world with a
government-run cannabis health program. Regulations create an
ex-emption to the criminal law allowing approved patients to possess
and grow their own cannabis, as well as gardeners to grow pot for
approved patients.

July 2001: Prairie Plant Systems of Saskatoon given a contract to grow
pot to sell to qualified patients.

May 2002-2004: Jean Chretien's Liberal government introduces a bill
that would have decriminalized the possession for personal use of
small amounts of cannabis. The bill looked likely to pass into law,
but it died when Parliament prorogued.

January 2008: In Sfetkopoulos v. Canada, the federal court strikes
down the regulation prohibiting a producer from growing for more than
one person. The government shuffled its feet.

August 2008: Federal Court of Appeal affirms Sfetkopoulos, but tight
growing regulations remain, with farms and large-scale production outlawed.

April 2011: Ontario Superior Court Justice Donald Taliano concludes
that legitimately sick people are not able to access medical marijuana
through appropriate means and must resort to compassion clubs or the
street corner, risking arrest and criminal charges. Warns that unless
the government addresses the legislative flaws within three months,
the criminal law would be struck down.

Ottawa appeals the ruling.

June 2011: Government of Canada announces it is considering
improvements to the Marijuana Medical Ac-cess Regulations program to
reduce the risk of abuse and exploitation by criminal elements.