This month, the main issue in the Canadian cannabis movement is the publication of the finalized medical marihuana regulations. While the true effect of the new regulations will not be seen until patients begin transitioning to the new system, it seems the Marihuana for Medical Purposes Regulations (MMPR) will be far from a perfect solution for those who require medical cannabis in Canada.

Also, our Craig Jones, Executive Director of the John Howard Society, takes a look at the Canadian Drug Policy Alliance’s “Getting to Tomorrow” – an in-depth look at the troubled history of Canadian drug policy.

The MMPR: Beneficial to some, a nightmare for others

On June 19, 2013 the Conservative Government published the final version of the Marihuana for Medical Purposes Regulations (the “MMPR”). The MMPR is set to replace the Marihuana Medical Access Regulations (the “MMAR”). This will have the effect of drastically changing the way Canadians access medical cannabis.

For many, the MMPR will represent an improvement over the MMAR as high quality medical cannabis will be more readily available.

Under the MMAR, patients chose between producing their own medicine, designating another to grow for them and purchasing medicine directly from Health Canada.  Most patients chose to self produce or designate another to do so.

While this worked well for some, other patients were left without the resources, expertise or support needed to produce the medical cannabis they required. For those patients who struggled to secure a sufficient supply of medical quality cannabis, the MMPR may be an improvement.

Additionally, the MMPR may decrease the difficulties patients face in gaining sufficient medical approval to obtain medical cannabis legally. However, the medical profession still seems to question the validity of medical cannabis and the positions of doctors to prescribe an “untested” substance.

Unfortunately, for some patients the MMPR may have the effect of denying them reasonable access to the medicine they require. This is because the MMPR denies patients an ability to acquire medical cannabis other than by purchase from a new licensed producer. Although prices have not been set, it is almost certain the cost will be beyond the means of some patients.

Not only does the MMPR potentially make cannabis too expensive for some patients, the regulations also contain other flaws. First, the MMPR restricts patients to accessing only “dried marihuana” which denies access to medical preparations of cannabis based on extractions and was struck down for being unconstitutional by the British Columbia Superior Court in R v Smith in 2012. Second, the MMPR places arbitrary use restrictions on patients such as denying access to over 150 grams of “dried marihuana” at a time, regardless of the amount designated by the doctor, and requiring all medicine to be shipped via courier-type service. Unfortunately, these flaws may overshadow the benefits of the MMPR.

NORML Canada feels there is a clear and equitable middle ground: allow patients to choose between personal production and purchasing medicine from a licensed producer. We believe many patients will actually find improved access to medical cannabis under the MMPR, and for them this will be a welcomed change.

For the patients for whom the MMPR will not provide reasonable access to medical cannabis, retaining an ability to produce their own medicine would suffice – although this may require additional regulations as compared to the MMAR.

This solution would placate both sides: reducing the number of individual cannabis gardens, increase the quality control systems in place for medical cannabis and ensuring all individual who need medical marihuana are provided reasonable access.

Getting to Tomorrow: the CDPA gives Canada’s drug policy record an “F”

Getting to Tomorrow: A Report on Canadian Drug Policy – produced by the Canadian Drug Policy Coalition – sums up what’s known from the experience of 100 years of drug prohibition in Canada and around the world. This report card on Canada’s war on drugs gives governments an upper case F. Although overwritten in some parts, Getting To Tomorrow lays out the evidence and the experience of prohibition in such a way that an intelligent reader cannot fail to conclude that the status quo isn’t working – except for police agencies and organized crime groups – and that policy makers need to sober up and act accordingly. For students of drug policy, there is little new here. For newcomers, however, Getting to Tomorrow neatly organizes the legacy of unintended consequences of drug prohibition – and for them this 100-page report is highly recommended.

Right. So what is to be done? We need to be clear about what prohibition is in the context in which it debuted in Canada. It’s a matter of the historical record that the 19th Century produced three epic experiments in social engineering, i.e., laws and policies intended to perfect humanity and human communities. These were (a) National Socialism, which took its guiding spirit from the early science of genetics and its human analogue eugenics; (b) Soviet Communism, which drew on some of the same scientific principles; and (c) prohibition; the belief that human societies could be improved through defying the laws of supply and demand. More specifically, the operating assumption was that if supply could be choked off, demand would eventually diminish to zero. Supply was to be choked off through punishment and criminal stigmatization which was thought to be severe enough that no rational person would assume the risk.

Among the many curious features of this policy approach was that it was enthusiastically endorsed by people with deep familiarity with biblical scripture. Ironically, in the first chapter of the Old Testament – Genesis – we learn that prohibition doesn’t work. It didn’t prevent Eve from tasting of the fruit of the Tree of Knowledge and it didn’t prevent Adam from experimenting with God’s forbidden fruit. So exactly how prohibition came to exercise such an attraction for social and political elites of the late 19th Century is a mystery. But prohibition – as an article of faith – is deeply embedded in the successors of the 19th Century moral entrepreneurs. Since the passage of the Opium Act of 1908, this old testament morality has given rise to a complex architecture of institutions, laws, regulations and persons dedicated to succeeding where God failed.

Articles of faith are not easy to modify. The singular feature of prohibition is that, to its defenders, it has never been “done properly” — not that it has failed: i.e., penalties have never been severe enough, stigmatization has never been harsh enough. If we could only “get the prices right” – they claim – we could eliminate all illicit drug use, but we’re too humane, soft, liberal, lenient, tolerant, politically correct and squishy. The result, as we see with the Harper drug laws, is interminable tinkering as defenders fine tune the punishments so that we sinners will eventually ‘get it’ and do what their faith commands. The Harper government, following this script, has enacted increasingly severe penalties for growing and distributing cannabis on the un-evidenced belief that – contrary to experience across the rest of the world – Canadians can be persuaded to defy the laws of supply and demand by threat of criminal sanction. Of course there’s more to prohibition than simply defiance of established economic evidence: there is also the pleasure that arises from the exercise of moral authority and political power by one group over another. And the Harper Conservatives have been unusually fond of this preference in their approach to criminal justice and punishment. So these two forces, unshakable faith in the un-evidenced and satisfaction in the criminal stigmatization of wayward deviants, come together in a kind of perfect storm in the Conservative Party of Canada.

Getting to Tomorrow makes four broad recommendations that are 180 degrees from the Harper National Anti-Drug Strategy:

Missing from this list of recommendations – and only tangentially referenced in the report – is a discussion of the co-occurrence of mental illness and substance abuse. This issue is complex but it’s worth pointing out that mental illness – the chronic condition of the young – usually precedes the onset of substance abuse by as much as 10 years. It’s understood that psychoactive drugs – including alcohol – broadly conform to the 80/20 rule by which 80 per cent of the problems (social and personal) arise from a minority of users. Of this minority, a good majority suffer from complex traumas – sexual and physical abuse in childhood – and various other conditions including learning disabilities, anxiety, depression and personality disorders. Alcohol and drugs are fuel to the fire which is why they’re so difficult to treat and so urgently in need of treatment. So a framework for modernizing Canada’s drug policies ought to go deeper into the hidden burden of suffering that so often accompanies substance abuse. The authors are to be commended for giving voice to the interests of drug users – the majority whom are not problematic abusers – but could have devoted more attention to the shortfalls and deficits in Canada’s disjointed and out of sync mental health treatment system.

Finally, it’s not clear for whom Getting to Tomorrow is written. As a statement of principles and vision, it achieves its purpose. But it is not likely to persuade any but the already converted. Perhaps that’s too high a bar, too great a task. Policy makers on all sides actually do understand that drug prohibition doesn’t work – and will confess it in private – but they also understand that they are not up to the public education task and that they will pay an electoral price for ‘coming clean.’ As the former prime minister of Luxembourg mused, “We know what to do, we just don’t know how to get re-elected after we do it.” Political courage is always in short supply. Policy makers know that they will be excoriated by their opponents for speaking the truth about drug policy – that opportunism will trump decency and common sense when push comes to shove. Getting to Tomorrow could have addressed this deficit in our public discourse: how can Canadians get our policy makers to do what they know is right without cynically and opportunistically punishing their political rivals. Of course, nothing will happen under the Harper regime – unless Harper ‘goes to China’ – so perhaps Getting to Tomorrow is addressed to policy makers in that golden future when science, evidence and best practices matter again.