May 24th 2018 - Social Affairs Committee with Various Witnesses
Senator Poirier: Thank you all for being here. I have so many questions that I think I’m just going to try to give bullet questions to see if can I get bullet answers and get as many as I can in.
Following Senator Manning’s questions, why is there such a difference in the cost of recreational marijuana and medical marijuana?
Mr. Jacob: As Philippe was saying, the costs do line up. But perhaps your question is why is there such a difference from top to low end. Is that more to the point?
Senator Poirier: Yes.
Mr. Jacob: It’s production style: larger-scale production, economies of scale, lower costs. Smaller, crafty, small-batch production that is more intensive and involves more hands-on treatment of plants means higher costs.
Senator Poirier: Someone who’s buying medical marijuana compared to recreational marijuana, they’re getting two different products, are they?
Mr. Jacob: No, both types of products exist in both worlds. It’s really the same products for both worlds.
Senator Poirier: If they can get it so much cheaper at the recreational side, why would they go to the medical place to get it, other than wanting the confidentiality and health monitoring by a doctor and pharmacists who know how to guide them through their medical process of needing the marijuana? Would that be the only advantage?
Mr. Jacob: This allows me to speak to your question, as well. A lot of consumers who come to cannabis through the recreational avenues that we have today are coming for medical reasons because of the difficulty of access.
We had an example of a person who came in with a shoulder injury and didn’t want to get on the opiates that were prescribed. She began taking a cannabis tincture that was a ratio between THC and CBD and realized that she was no longer taking her OCD medication. Her kids would always remind her when it was out because she started to be OCD. So she was on cannabis medication for pain and realized that her mental health issues were resolving themselves.
This is a patient now who, potentially, would realize that these benefits exist for them and will again seek access to the medical program through their physician.
Mr. Lucas: For clarity, maybe Jeremy and I weren’t clear. The range in cost for a gram of cannabis within the medical and the recreational systems is about the same. It’s $5 to about $15 a gram.
But that’s not a difference between medical and recreational. The $5 gram in the medical system would be the same cost in the recreational system. It’s just that that is typically the range in prices. That could be reflective of THC levels in a lot of cases where higher THC products can fetch a higher value, whether it be for medical or for recreational use. More and more CBD products are a little bit more expensive because you need more of those plants to produce a CBD extract than you do a higher THC extract. That can be more cost prohibitive to Canadians.
To be clear, there is no financial difference between the recreational cannabis and medical cannabis. We wouldn’t expect there to be some, but we do hope the taxation is removed on the medical so that it’s zero-rated.
Senator Poirier: I want to share that from what I’m hearing up in my end of the province, the people that need medical marijuana would prefer, because of confidentiality, to be able to go into a drugstore and get it rather than going to a storefront or have someone deliver it by mail. I’m hearing that that’s what the people would like to see.
I also understand, Mr. Lucas, that recently your company signed up with Shoppers Drug Mart to supply their brand of medical cannabis, conditional on approval of the pharmacy distribution being able to distribute the medical marijuana.
What is the key factor holding up the pharmaceutical distribution of the medical marijuana at this point? If you do have it, will you be able to offer it through a pharmacy at the same cost that a person would be getting it at now through another system?
Mr. Lucas: What a terrific set of questions, thank you.
Right now, the biggest obstacle is that there’s no explicit provision in Bill C-45 or in the current regulations to allow pharmacy-based access. We are extremely concerned by the suggestions of the government that they’re going to look at that as a next stage of changes in these regulations, maybe going as far out as 2020.
As we know, when Health Canada initiated the MMPR four or five years ago, they initially anticipated pharmacy-based distribution. The pharmacy system at the time wasn’t comfortable with that or with the level of consultation they had had, and they asked to be excluded from that option. Obviously there’s been a big turnaround, and now pharmacists feel that they want to be able to do this. Of course, they are well positioned to catch contraindications and interactions with other medications.
Shoppers Drug Mart is taking a unique path. They’re asking to be a licensed producer on par with Tilray or the other 100 licensed producers in Canada so that they can purchase from other licensed producers and distribute through their system.
What Shoppers Drug Mart will be able to do in the next few months is not going to be what other pharmacies are going to be able to do, because they’re going around the current regulations by making themselves a licensed producer. We think it’s great that cannabis will be available through Shoppers Drug Mart, but we would like to see all pharmacies in Canada being able to supply medical cannabis to patients.
I’ve been working on this for 20 years. Nothing is going to do more to help the normalization of medical cannabis than having it available through pharmacies. No matter what we do to educate patients — and we have a 24-7 helpline, et cetera — it still feels different than every other medication when patients have it delivered to their door.
Senator Poirier: Why can’t other pharmacies do the same as Shoppers Drug Mart?
Mr. Lucas: They could do the same, but it’s a time-consuming process to become a licensed producer.
Senator Poirier: Thank you all for your presentations. Greatly appreciated.
My first question is for Mr. Tousaw. We heard a lot of talk in committee about the risk associated with cannabis but not so much on not nearly enough education on the consequence of the law. When it comes to possession or home growth or age limit, in your opinion, are Canadians, young and old, well informed and aware enough about the consequences of Bill C-45? If they’re not fully aware of the consequences of Bill C-45, what could be the impact, in your opinion, on the juridical system?
Mr. Tousaw: That’s a very insightful question, and I would broaden it further. Not only are Canadians not aware of the impact of Bill C-45, but Canadians aren’t very well aware of the current laws surrounding cannabis. I cannot tell you how many people I talk to who think cannabis is legal right now. It’s absolutely stunning. I talk to people in the regulated industry who don’t know how the rule set works. The lack of knowledge.
Look, it’s complicated. You read legislation. You folks have all done it. It’s not easy to do. You have to slog through it. It’s referential. You have to think about it in a deep way. But there’s a tremendous amount of confusion out there. And the problem with that is that the legislation has so many sort of arbitrary limits that people are going to just, of necessity, run afoul of it.
For example, you’re going to be allowed to possess 30 grams of dried cannabis, and then there’s this equivalency ratio that applies to other cannabis products. So you’re going to have to do this math in your head when you leave the house, “I can bring two cookies with me and not four because four means I’m breaking the law and two doesn’t.” Or, “I have this jar of cannabis here. Do I have to weigh it before I leave the house?” It doesn’t make a lot of sense, and it’s completely arbitrary.
When you go to the alcohol store, you can go into the alcohol store and buy enough alcohol to kill a small town, put it in the trunk of your car and drive away. What we depend upon is Canadians exercising individual responsibility. We don’t depend on the government to say you can only buy six beers at a time each day, or you can buy six beers now, go home and drop it off, go back to the store, buy another six beers, go home and drop it off.
That’s the system we’re going to have for cannabis, and it doesn’t make a lot of sense. That’s why one of my recommendations to this committee is that all criminal penalties associated with personal — not commercial, personal — possession and production of cannabis should be eliminated from Bill C-45. Canadians deserve to stop being criminalized for their personal individual choices. They deserve that from this committee and this government. That’s the point of legalization.
There also has to be education. I think Health Canada is doing a very good job so far of educating people on each step along the way about what the changes look like and what the ramifications might be.
The best thing we can do for Canadians is make it simple. You’re allowed to possess cannabis. You’re not allowed to unlawfully sell it. You’re allowed to possess it. You’re allowed to grow cannabis. Just like you can’t make beer and sell it out of your garage, you’re not allowed to grow it and sell it out of your garage. But you shouldn’t risk going to jail for 14 years because you have five cannabis plants in your garden instead of four. That just doesn’t make much sense at all.
Senator Poirier: My next question is for Mr. O’Hara. I was wondering if you can do a comparison for us when it comes to access to medical marijuana for Canadians in need. What will the impact of C-45 be on access to medical marijuana? Will access be prevented? In your opinion, would it put medical patients in need of medical cannabis in harm’s way by turning to a different, less effective medication?
Mr. O’Hara: There’s a short answer to that, and that is that Bill C-45 doesn’t affect medical cannabis directly. This is more about the recreational side. Medical cannabis patients will still be able to access cannabis through the ACMPR system, which to this point remains unchanged. That’s one of the points we’re advocating strongly, that that continue on. There’s nothing in Bill C-45 for medical per se.
Senator Poirier: Mr. O’Hara, I understand that your organization has been working to get insurance companies to cover medical cannabis. Can you give us an update or an overview of the status of this project? How many companies provide some coverage today? Are you optimistic that others will be following suit?
Mr. O’Hara: That’s a great question. Really there are only a handful of companies that provide coverage today, and it’s important to note that they’re providing coverage that is optional for that policy to be taken up. Just because they’re enabling coverage doesn’t mean to say that it’s widely adopted. But there are some companies who have done that today. Sun Life is one, and there are a few others.
I fully expect that to continue. There’s a lot of interest and a lot of discussion around the topic within the industry.
Senator Poirier: Thank you.