EQUAL ACCESS ELUDES CANADIANS

Many Doctors Adverse to Prescribing Pot, but Those in B.C. Hold Fewer
Reservations

He is 47 years old and, chances are, he lives somewhere on British
Columbia's Sunshine Coast.

Under Health Canada's medical marijuana program, he is approved to
legally consume up to five grams a day of the pot he grows himself at
home. Most likely, his general practitioner signed the forms he needed
to get the drug.

And on average, he is a "he" - men in the program outnumber women by a
ratio of about three to one.

As with a great number of medical marijuana patients, he uses the drug
to treat severe arthritis, although he may suffer from other conditions.

Data obtained by the Ottawa Citizen through the Access to Information
Act put this face to the typical medical marijuana patient for the
first time, 10 years after the federal government - under pressure
from a series of legal rulings - was forced to start allowing
seriously ill Canadians to apply to use the drug.

As Health Canada moves to overhaul the rules governing medical
marijuana, its own numbers show sharp disparities in the accessibility
and use of the drug across the country as patients scramble to find
doctors willing to prescribe.

Although all Canadians are supposed to have equal access to medical
marijuana, enrolment in the program varies greatly across the country.
Where you live and your doctor's attitude to marijuana will help
determine whether you receive approval from Health Canada to use the
drug to treat serious illnesses such as cancer, multiple sclerosis or AIDS.

The geographic patterns contained in Health Canada's data show that
people from British Columbia are far more likely to have a marijuana
authorization - about 33 people out of every 100,000, compared with
five per 100,000 in Manitoba.

Between 2001 and 2007, the V0N postal code zone, which spans British
Columbia's Sunshine Coast - a ferry ride away from Vancouver - Gulf
Islands, part of Vancouver Island and the area around Whistler ski
resort, generated more applications under the government's Marihuana
Medical Access Regulations (MMAR) program than any other.

By contrast, in some wellpopulated swaths of Manitoba such as
Steinbach and parts of Brandon, not a single person has applied to the program.

Marijuana advocates say it is the approach of doctors in different
parts of the country, not patient needs, that determines who is
getting medical marijuana. They point to what they say are more
permissive attitudes toward marijuana in B.C. and better outreach by
cannabis advocates to the doctors who must ultimately decide whether
to sign a patient's application.

"British Columbia has a bit more laissez-faire attitude to marijuana
and a very good activist network informing doctors," says Matthew
Mernagh, 37, a Toronto marijuana user who, this spring, won a court
decision that effectively has toppled Canada's marijuana prohibition.

After he was arrested for growing pot in his apartment in 2008,
Mernagh launched a constitutional challenge of Canada's drug laws.
Mernagh's case was based on a complaint common to many patients who
seek marijuana: the difficulty he had finding a doctor to sign
documents to let him legally use the drug - in his case, to treat
chronic pain and seizures caused by fibromyalgia and other conditions.

At trial, evidence was produced that suggested that less than one-half
of one per cent of Canadian doctors had signed the 33-page form for a
patient to apply to Health Canada's program.

"I find as a fact that the physicians of Canada have massively
boycotted the MMAR and their overwhelming refusal to participate in
the medicinal marijuana program completely undermines the
effectiveness of the program," wrote Justice Donald Taliano in his
April decision quashing the marijuana law.

The court agreed that the systemic refusal of doctors to approve
patients for marijuana was an infringement on their rights. Mernagh
was allowed to grow his own pot without Health Canada's approval, a
decision that - should it stand - effectively overrides Canada's
marijuana laws.

The court will hear the government's appeal of the decision in March.

Mernagh might have had better luck with his doctor had he suffered
from cancer or even arthritis. Health Canada's data show that severe
arthritis is now the most common reason for applications to the
medical marijuana program. This trend is a relatively new one, as
Health Canada has been deluged over the past three years by
applications claiming severe arthritis as the medical reason. But in
the first years of the program, it was HIV/AIDS patients who were at
the vanguard. Cannabis is an effective appetite stimulant and can help
curb neuropathic pain and control nausea caused by the illness and
AIDS medications.

By the end of 2007, HIV/AIDS patients accounted for the largest share
of applications for the MMAR, even though there were far fewer people
living with the infection than with cancer.

Estimates put the number of HIV/AIDS patients in Canada at about
60,000. By contrast, there are more than 177,000 new cancer patients
diagnosed in Canada every year.

With the high uptake among HIV/AIDS patients, medical marijuana use is
higher in areas with large gay communities. Vancouver's West End and
Toronto's Church-Wellesley area can both make credible claims to being
the most predominantly gay neighbourhoods in Canada. They also boast
some of the highest percapita MMAR enrolment rates in the country.

But outside the gay communities, the data suggest participation in the
medical marijuana program is lower in urban areas than rural ones.

It is a counter-intuitive trend that is likely due to the fact
patients in many larger cities have been better served by socalled
compassion clubs that dispense pot outside of Health Canada's program.

Some doctors are willing to write referrals to a compassion club, but
won't agree to sign the forms required for the Health Canada program.
The clubs offer a wider variety of marijuana strains that, advocates
say, give better treatment options, compared with the single strain
sold for $5 a gram plus GST by Health Canada.

Had he convinced his doctor to sign his release, Mernagh, at age 37,
would number among the youngest approved marijuana patients.

Indeed, the Health Canada data dispatch the notion that young people
are applying to the program to score the drug legally. People under
age 40 accounted for fewer than 20 per cent of the approved patients.
Those in their 40s made up 38 per cent. About eight per cent were
older than 60.

[sidebar]

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 through 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 Medical Marihuana Access
Regulations, and Canada becomes the second country in the world with a
governmentrun cannabis health program. Regulations create an exemption
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 shuffles its feet.

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

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

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