NORML Canada Reviews the Legislative Review

A comparison between the panel recommendations and what we recommend

When cannabis was legalized in Canada in 2018, we were promised a review of legislation within 3 years.  Due to the pandemic, finally after 5 years the review panel was appointed and stakeholders were contacted.

NORML Canada was a stakeholder in the legislative review.  Our Executive Director Jennawae Cavion and President Jack Lloyd participated in one of the panels regarding criminalization and how legalization has affected equity deserving people.  We are happy to say that our recommendations were considered and incorporated.  We wish we were consulted on other portions of the review but we appreciate the consideration we were given.  

Many believed this legislative review would result in dramatic, wide-spread changes–a silver bullet for improvement within the industry.  We are not optimistic in that sense because:

1)  The panel of experts are doctors appointed by the Minister of Health and the Minister of Mental Health and Addictions and Associate Minister of Health.  While they did engage with a fairly robust list of stakeholders (including us), they recognize our bias (as much as we recognize theirs).  Their goal is to support public health and addictions with a cautious measured approach.

2) Considering the LeDain Commission was appointed in 1969, with the final reports being published in 1973.  Cannabis wasn’t made legal for medical use until 27 years later with recreational use becoming legal 18 years after that.  Remember, these are all just recommendations.  Most of this will likely remain unactioned for a long time.

That said, some (actually most) recommendations are good, and we would even go so far as to say they support a robust cannabis industry. Some recommendations are problematic and still deeply stigmatized.  Below we have broken down our position on all aspects of the review.  

PANEL RECOMMENDATIONS

OUR RECOMMENDATIONS

Recommendation 1: The Government of Canada should allocate sufficient funding and resources to ensure the effective implementation of the cannabis framework, including the ability to address emerging public health and public safety issues.

Considering the review itself was 2 years late, it is obvious the cannabis file is lacking resources.  Our government needs to allocate appropriate funding to ensure the effective implementation of the cannabis framework to support a healthy industry and reduce stigmatization while still addressing legitimate public health and safety issues.  Education is key.

Recommendation 2: Health Canada should set and monitor targets for reducing youth and young adult cannabis use and cannabis-related harms.

The panel acknowledges most Canadian youth do not use cannabis, and outside of a slight increase in use for youth ages 16-19, youth use has otherwise remained stable and low.  Health Canada should be educating parents and guardians about safe cannabis use and storage.  It is our position that one of the most harmful aspects of underage cannabis use is that children (especially racialized children) can still be criminalized for it.  

Recommendation 3: Health Canada should redouble its efforts to inform Canadians about the potential risks to children that can arise from accidental exposure to cannabis products (irrespective of the product’s origin) and provide advice to consumers on where and how to store cannabis safely.

NORML Canada believes education is key to avoiding cannabis exposure to children or anyone who should not be accessing cannabis.  Adults are responsible for storing their cannabis (alcohol, Tylenol, cleaning products) out of reach of people who shouldn’t have it.

Recommendation 4: Health Canada should take a leadership role, working in collaboration with provinces and territories, to support the development and implementation of evidence-based school prevention programs and other interventions to reduce the prevalence of youth cannabis use. Federal, provincial and territorial governments should consider committing a portion of cannabis revenues to fund evidence-based public health interventions, including prevention programming for youth and young adults.

The DARE program was historically highly ineffective and we do not believe that format is the correct path.  We strongly support evidence-based policies for youth cannabis use, and dislike the use of “interventions”.   We support any It is likely that unbiased studies will show actually some policies need to be significantly relaxed, and intervention and prevention programs would be a waste of cannabis revenue.  Instead we support the creation of diversion programming and education for underage cannabis use.  Additionally, other parts of the law already exist to prevent access (especially at the retail level) and education and prevention of cannabis use should default to the parents and guardians.

Recommendation 5: Health Canada should establish a representative youth advisory board on cannabis to provide a mechanism to engage with youth and young adults on cannabis and related issues. This forum should allow young Canadians to share their knowledge, insights and feedback on cannabis policy, regulatory initiatives and non-regulatory programs that would affect them and their peers.

It is important to engage with youth on their level.  Young adults are adults and do not require the same type of oversight as an underage cannabis user.  It is important to increase education and gain insight and feedback on cannabis policy and regulatory initiatives.  

Recommendation 6: Health Canada should take steps to mitigate the risks associated with cannabis products that contain higher quantities or concentrations of delta-9-tetrahydrocannabinol (THC), including working to establish a definition of higher-potency cannabis products and applying additional health warnings that inform consumers about the elevated risks of these products. We offer a separate recommendation on the use of tax policy to disincentivize the consumption of higher-potency cannabis products. If the current trend towards consuming higher-potency cannabis cannot be halted or reversed, then Health Canada should be ready to implement additional product regulations. To be effective, such regulatory measures should be accompanied by strategies to prevent the illicit market from occupying this market segment.

This is a fear-based recommendation that feels knee-jerk. Increased taxation or outright prohibition won’t make high potency products (or the demand for them) magically disappear.  It will make legal sources disappear, with unregulated (untested) sources left to fill the gap.  Higher potency products could actually lead to lower and less frequent consumption (one small dab instead of a joint).  With alcohol the opposite is trend with beer facing a higher rate of duty than wine and spirits. Wine is the lowest by a long shot.  High THC products (like concentrates) are already taxed excessively based on the current excise regime.  Additional warnings or education and information is acceptable, and we encourage additional research.  High potency products existed long before legalization and will continue to exist regardless of regulated availability.  This gap absolutely will be filled by the unregulated market.  The panel suggests a “nudge” away from high potency products but that will only result in a nudge towards the unregulated market.  They also suggest that consumers need options with lower potency to make the switch but the reality is that they already have those options, and while fine for some but not for all.  We agree more research is needed but without that this recommendation is premature at best.

Recommendation 7: Health Canada should maintain key promotion and plain packaging and labelling requirements, including restrictions on characteristics that are appealing to youth, child-resistant packaging and limits on the use of logos, colours and branding, that are aimed at protecting children and youth, and prohibitions on promotions that imply wellness or lifestyle enhancement.

Cannabis should have the same considerations for labels and packaging that the alcohol industry gets.  Cannabis should not be marketed to children, that is fair.  The child-resistant packaging requirement for cannabis products is viewed as unduly burdensome by producers and consumers alike, and is something not imposed on tobacco and alcohol products. While we understand wanting to protect children from promotions it makes no sense to also protect adults from making adult purchasing decisions based on wellness or lifestyle enhancement.

Recommendation 8: Health Canada should ensure the cannabis industry is provided with clear guidance on the promotion restrictions and packaging and labelling requirements, including correcting misperceptions about what information is, and is not, allowed on product labels (or in cannabis promotions).

Health Canada should always be clear in all guidance but especially regarding promotion restrictions and packaging and labelling requirements so that rules are applied consistently (especially helping small operators remain compliant).  

Recommendation 9: Health Canada should regularly revise health warning messages to ensure they are appropriate to the product, reflect up-to-date evidence on the health risks associated with cannabis and are impactful in communicating these risks. Additionally, Health Canada should reinstate health warning messages that pertain to serious cannabis-related mental health risks, including psychosis and schizophrenia.

While we agree that Health Canada should be regularly revising messaging and updating information based on evidence, we disagree that health warnings pertaining to psychosis and schizophrenia need to be reinstated.  We do not deny that there are Canadians who may have extra mental health risks associated with cannabis use, psychosis and schizophrenia specifically affects a miniscule subset of the population (who is already predisposed to those conditions with or without cannabis).  Presence does not necessarily equal cause.  More research is needed to support the prevalence of cannabis psychosis, schizophrenia and other mental health issues. 

Recommendation 10: Health Canada should revise the packaging and labelling rules that apply to all cannabis products to more clearly convey information on delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) quantity or concentration to adult consumers, by simplifying product labels and allowing the display of only “total THC” and “total CBD” for each unit and for the package, and by requiring larger font sizes to display THC and CBD quantity (or concentration).

Simplification and continuity on labelling is welcomed.  Similar to nutritional labels, it is important for cannabis users to be fully informed on what they are using and that labels are easy to read.  Larger font sizes are also welcome but in some cases this may pose an increased burden to some producers.

Recommendation 11: Health Canada should consider allowing some portion of a cannabis package (for dried cannabis and fresh cannabis only) to be transparent, without undermining the intent of plain packaging requirements and other labelling rules to protect children.

This is a surprising recommendation. A clear viewing window on packaging would help inform consumers about what they are buying to avoid disappointment or potentially getting the wrong product.  Many retailers do not display cannabis in packages on shelves at all.  

Recommendation 12: Health Canada should revise the packaging and labeling rules to allow for the display of certain symbols that convey useful information to the consumer (for example, symbols related to organic certification or recycling), ensuring that permitted symbols do not serve as an inducement to youth or non-consumers.

We support any change that helps educate consumers.  Reduce, reuse, recycle!

That said, while additional bodies exist, the Canada Organic Certification is handled by the Canadian Food Inspection Agency.  Cannabis plants and their cultivation fall outside of the scope of the regime and as such cannot be certified organic or bear the Canada Organic Logo.  

Recommendation 13: Health Canada should revise packaging and labelling rules to allow the use of QR codes on product labels to convey factual information to consumers, within the constraints of what is currently permitted on labels or in cannabis promotions.

QR codes would be incredibly useful.  However, we don’t agree that the information in a QR code should be constrained by what is currently permitted on labels.  Perhaps it could link to certificates of analysis, information about the genetics or pictures of the grow.  We agree sticking to factual information is important.

Recommendation 14: Health Canada should develop a “standard dose” or “unit dose” (as appropriate for different classes of cannabis). The development of a standard dose should be prioritized and accompanied by regulatory amendments to require it as an element on cannabis product labels.

While we agree this might be helpful, especially for new users, we are pessimistic that it would be possible.  A standard dose varies from person to person based on a variety of factors (weight, age, tolerance, even what they had for lunch).  There is no standard dose because there is no standard user.

Recommendation 15: Health Canada should be vigilant with its regulatory enforcement efforts, with priority given to taking action against regulated parties who do not comply with rules that protect youth and to taking action when regulated parties repeatedly demonstrate non-compliance.

NORML Canada supports Health Canada’s efforts to pursue technical standardization.  This would bring in specific testing rules that labs would have to implement.  We would also support a requirement where producers would identify the lab who tested their products on the label as a stop gap measure to allow consumers to make informed decisions.  We especially want to see enforcement in THC shopping (for example in Michigan, if over 25% THC is claimed, 2 lab results are required).  However, we also acknowledge results are easily manipulated and that producers are incentivized to produce high THC because the provincial suppliers demand it.  We believe a THC calibration is necessary to ensure compliance among regulated parties.  To that end, if most parties are unable to demonstrate compliance (for whatever reason) the rule they are supposed to comply to should be reviewed/revised.  The reason producers are licensed in the first place is that they want to be regulated and operate in the legal system (otherwise they would just continue to operate in the unregulated market).  Health Canada should be supporting license holders. We do not agree with an arduous age verification, because the unregulated market requires no age gate or verification.  Ultimately retailers are responsible (and the panel agrees it has been well-handled by retailers so far) to ensure cannabis is not sold to youth with various in person age verifications.  

Recommendation 16: The Government of Canada, including Indigenous Services Canada, should continue to enhance and expand distinctions-based health, public health and mental health wellness supports, that are culturally appropriate, trauma-informed and in partnership with First Nations, Inuit and Métis communities.

The Government of Canada and Indigenous Services Canada should increase their support of Indigenous people working alongside them and following their lead and participating when asked.  We especially support additional access to culturally appropriate public health, mental health and wellness supports. 

Recommendation 17: We agree with the Standing Senate Committee on Indigenous Peoples that Health Canada and Indigenous Services Canada should work with Indigenous Peoples and communities to establish and fund a research strategy on cannabis and its effects on Indigenous Peoples and communities, recognizing that this research should be led, owned and used by First Nations, Inuit and Métis communities.

Health Canada and Indigenous Services Canada should make optional programming available to research cannabis and its effects on Indigenous people if the Indigenous community would like to participate and lead that research.  This research should not be mandatory and should not impose on Indigenous people in any way.

Recommendation 18: Health Canada should commit to co-developing culturally appropriate, evidence-based materials and programs to disseminate cannabis-related health information on a distinctions-basis with First Nations, Inuit and Métis.

Health Canada should commit to co-developing culturally appropriate, evidence-based materials and programs if Indigenous people want those materials.  Unwanted information and programming will fall on deaf ears.

Recommendation 19: The Government of Canada should take steps to amend the definition of intoxicant in the Indian Act to enable First Nations band councils to enact bylaws regarding cannabis.

Amending a small definition within a discriminatory act will not improve it.  The Government of Canada should work with First Nations to dismantle the Indian Act and replace it with an Indigenous Relations Act that retains protections for Indigenous peoples and lands (and whatever definition for intoxicants Indigenous people see fit).  We do believe that classifying cannabis as an intoxicant as a means of prohibition is harmful.  Cannabis is not alcohol and the prohibition of either makes both dangerous.  The Federal Government needs to remain accountable to our First Nations while following their lead on this.  Band Councils should be operating autonomously enacting bylaws as they see fit. 

Recommendation 20: We agree with the Standing Senate Committee on Indigenous Peoples that the Government of Canada, as it develops legislation in collaboration with the provinces and the territories, and First Nations governments, should establish legislative mechanisms for the enforcement of band bylaws and other laws related to cannabis by all police services, and to ensure that related offences can be investigated and prosecuted effectively.

We support Indigenous self-determination when it comes to their enforcement of laws.  While we do not support any approaches that further criminalize industry participants, we recognize that certain communities have passed regulatory framework and bylaws, and these should be enforced by the law enforcement agency they contract if the community sees fit.

Recommendation 21: We agree with the Standing Senate Committee on Indigenous Peoples that the Government of Canada should ensure adequate funding and training is available to First Nations communities for the policing and enforcement of band bylaws related to cannabis to better protect public health and public safety. We also encourage the Public Prosecution Service of Canada and other agencies at the provincial and territorial level to support training efforts for prosecutors on the laws of First Nations communities.

The Government of Canada should ensure adequate funding and training is available to First Nations communities to police themselves and enforce their own band bylaws related to cannabis.  Public Prosecution Service of Canada and other related agencies should make themselves available to support training efforts for Indigenous prosecutors from First Nations communities (but non-Indigenous people should not be imposing on Indigenous communities).

Recommendation 22: Health Canada should better advertise and evaluate existing supports for Indigenous licence applicants to determine if they are meeting needs in an effective way. Health Canada should also apply the recommendations we have made on broader measures to support equity-deserving groups and micro-licence applicants and holders to Indigenous applicants.

An equal but separate governing body lead by Indigenous people should be working with Health Canada to advertise and evaluate existing supports for Indigenous licence applicants to operate within the Canadian cannabis market.  Should Indigenous producers choose to operate on their own lands, the equal but separate Indigenous governing body would operate autonomously with the option for support or guidance from Health Canada as needed.  We find it interesting that the panel would recommend an application review prior to a facility build out and would like the same consideration for all licence holders.

Recommendation 23: Health Canada should take immediate steps to co-develop, with First Nations, Inuit and Métis, amendments to the Cannabis Act to better protect public health and public safety in Indigenous communities. These amendments should authorize the Minister to enter into nation-to-nation agreements with interested First Nations, Inuit and Métis to control commercial cannabis activities in their communities, when certain minimum standards are met. Over the longer-term, it is our hope that learnings and outcomes from these agreements and other processes could be used to inform the United Nations Declaration on the Rights of Indigenous Peoples implementation work for cannabis.

On an optional basis, and only as the First Nations communities see fit, Health Canada should begin consultation with First Nations to develop amendments to the Cannabis Act that better protect public health and safety in Indigenous communities.  There should be an Indigenous governing body supported by the Minister so Indigenous people can control their own cannabis on their land.  Unless directed by Indigenous stakeholders, the Minister should not attempt to exert any sort of control or influence over Indigenous people on their land.  The Minister should be supporting autonomy and centering First Nations rights to self-governance.  

Recommendation 24: We agree with the Standing Senate Committee on Indigenous Peoples that Finance Canada should work with First Nations to identify options for the development of an excise tax-sharing framework as part of its discussions on fuel, alcohol, cannabis and tobacco taxes.

Should Indigenous people want assistance, Finance Canada should find ways to support a First Nations lead taxation framework for their own products sold to their own people to improve their own lands that is separate from and has no bearing on Canadian taxation.

Recommendation 25: Health Canada should prioritize and accelerate its work on regulatory streamlining to reduce the administrative burden on federal licence holders, while ensuring that the public health and public safety objectives of the Cannabis Act are not compromised.

Health Canada should prioritize and accelerate its work on regulatory streamlining to reduce the excessive administrative burden on federal licence holders.  Public health and safety objectives should be reevaluated on a regular basis to ensure there isn’t additional undue burden placed on licence holders as a result of these objectives.  We also agree that current personnel security requirements might not be needed for some types of employees, some controls related to physical security may not be essential (such as visual monitoring of areas not in use), and some record-keeping and reporting requirements could be streamlined (such as harmonizing reporting between Health Canada and the Canada Revenue Agency to avoid duplication, reducing the reporting burden for some lower-risk activities such as waste and destruction, and reducing the length of time required to store certain records, especially visual records).

Recommendation 26: Health Canada should amend the regulations to allow cultivators, including micro-cultivators, to sell packaged and labelled dried or fresh cannabis directly to distributors. Cultivators should be required to follow the same quality assurance and testing requirements for dried cannabis that apply to processors.

In spirit this is a nice recommendation but it is impractical because cultivators would still have to meet all the burdensome regulatory requirements of a processor.  Additionally even if they meet those standards a provincial wholesaler still has final say on what they will and will not carry.

Recommendation 27: Finance Canada should consider a review of the excise tax model, recognizing that it was originally designed when the average price of dried cannabis was significantly higher than it is today. Further, Finance Canada should consider making reforms to the excise tax regime that would discourage the consumption of higher-risk cannabis products, for example, by applying progressively larger duties on cannabis products with higher quantities or concentrations of delta-9-tetrahydrocannabinol (THC) (or other intoxicating cannabinoids).

Perhaps the most important and impactful recommendation the panel made, Finance Canada should review the excise tax model to reflect the current market price of cannabis.  We support the recommendation of 10% ad valorem rate already suggested.  However, we do not support increased taxation on higher THC products.  The rate of taxation, especially for higher THC products is already creating a barrier of survival in the regulated market.  The consumer price is too high as it is which allows the unregulated market to flourish.  The demand is there and the demand will be filled, whether with regulated or unregulated products.  Higher taxation on any cannabis products but especially these products is unsustainable and will just result in a smaller product offering and potentially will force some producers to close their doors.

Recommendation 28: Health Canada should be more transparent with the data it holds on the state of the cannabis market and ensure that prospective licence applicants are provided with this information, in sufficient detail, to allow them to assess the feasibility of their business plans based on current market conditions.

 

Health Canada should be not only transparent but forthcoming with data it holds on the cannabis market sharing openly with prospective applicants to help them make appropriate business decisions and properly assess the risk of entering the market.  Market data should be accessible public information.

Recommendation 29: Health Canada, in consultation with Agriculture and Agri-Food Canada, should establish and support an expert advisory body to conduct a timely review of the regulation of industrial hemp and make recommendations about the most appropriate regulatory framework.

The current regulation of hemp absolutely needs review immediately.  Hemp should fall fully under the purview of the department of agriculture instead of Health Canada.  Grouping industrial hemp with cannabis is resulting in less hemp production since 2017.  Farmers should not require a licence to grow hemp, especially considering they must use genetics from approved cultivars with no THC.   

Recommendation 30: Health Canada should carefully examine, and where appropriate revise, its approach to regulatory fees for equity-deserving groups and micro-licence holders. This examination should include an assessment of how regulatory fees could be modified to promote greater diversity among participants in the legal cannabis market.

Regulatory fees (and other barriers to entering the regulated market) need to be re-examined to promote diversity in the cannabis space, especially for equity-deserving people and small operators like micros.  

Recommendation 31: Health Canada should work with relevant departments to ensure that federal licence holders and applicants, particularly small and equity-deserving businesses, are informed of existing programs (such as for grants and loans), incentives and supports that may assist them in establishing and running their businesses. Health Canada should offer post-licensing supports to help these companies navigate regulatory compliance and other business-related responsibilities.

Cannabis businesses deserve the same respect as any other business that benefits Canadian citizens through taxation.  The industry should not be left to sink or swim.  Health Canada should be forthcoming, encouraging and helpful to any licence holders to ensure they have the resources they need to succeed.  Equity-deserving groups experience challenges when attempting to secure loans, given their lack of existing networks and relationships with banks, lenders and investors. Health Canada could do more to make these applicants aware of business supports (for example, grants or loans) that may be available to them from other government departments and agencies (for example, the Black Entrepreneurship Loan Fund).  Health Canada should default towards mentorship and away from policing.  Their goal should be to get and maintain licensing and help companies navigate regulatory compliance and other business-related responsibilities.

Recommendation 32: The Government of Canada should consider whether offences under the Cannabis Act should be considered under the automatic record sequestration process that will come into force in November 2024.

We agree with the panel (and pleased to see urgency) when they say disadvantaged and marginalized groups, especially racialized groups, continue to be disproportionately impacted by over-policing and interactions with the criminal justice system because of disparities in cannabis enforcement. There are gaps in knowledge about the impact of cannabis on specific groups, and the extent of ongoing racial discrimination in law enforcement, particularly with youth. It is well understood that charges or convictions related to cannabis offences cause enduring adverse social outcomes, such as stigmatization, negative impacts on family structures, job losses, difficulties in securing employment and restrictions on travel and housing access.  We agree that sequestration needs to be updated to include the Cannabis Act.  

Recommendation 33: Health Canada should enhance and expand informational materials and educational programs related to cannabis for equity-deserving groups and subpopulations, in partnership with these communities, to ensure they are non-stigmatizing and culturally appropriate.

We agree with the panel when they say Health Canada should ensure that it follows an evidence-based approach when disseminating information on cannabis use and the associated risks and harms to consumers, or the public at large. As equity-deserving communities have their own interests and needs, informational materials should be co-designed with the intended audiences. Informational and educational programs need to be fact-based, non-stigmatizing, culturally appropriate, regularly evaluated and adjusted accordingly.

Recommendation 34: Health Canada should regularly collect and analyze demographic data from licence holders to assess diversity in the industry (including ownership, leadership and the workforce). Health Canada should publish this information in a timely manner to allow the public to monitor the diversity of representation in the industry.

We agree there is a lack of data available to assess diversity in the industry, but we don’t believe that should fall to Health Canada to collect and evaluate.  This may be a job for Statistics Canada, the Canada Revenue Agency or perhaps Innovation, Science and Economic Development Canada instead.  We would also want to see controls in place to avoid tokenism.

Recommendation 35: The Government of Canada should make substantial improvements in the systematic collection and publication of data related to cannabis that is disaggregated by relevant demographic indicators, such as race. Appropriate data safeguards must be in place to protect privacy and prevent further stigmatization.

We agree that the Government of Canada needs to make substantial improvements in the collection and publication of data related to cannabis that is disaggregated by relevant demographic indicators, such as race.  We agree that we need to find ways to protect the privacy of respondents and prevent further stigmatization of those groups.

Recommendation 36: The Government of Canada should establish indicators related to the environmental impacts of the cannabis industry, collect baseline data and continue to monitor these indicators and their trends. The Government of Canada should publish this information in a timely manner to allow the public to monitor progress.

The environmental impacts of the Cannabis Act has made industrial hemp (one of the most sustainable and environmentally conscious materials) less available.  We would like to see industrial hemp all fully under the purview of the Department of Agriculture.  Additionally, packaging for cannabis in Canada is excessive, and there are components that are either difficult to recycle or completely unrecyclable (510s and disposables).  Another example would be We would like to see recyclable components and a more robust recycling program.  We would also like to see increased use of programs like TerraCycle–where bins are left with retailers for people to dispose of their packaging.  Finally, we would like to address that the 10mg edible limit is also contributing to this issue.  If we were to move to 100mg limits (as we have put forward) we would see a 10x decrease in packaging.  We don’t need to waste time studying the impact, by then it will be too late. 

Recommendation 37: Health Canada should maintain the current limit of 10 milligrams of delta-9-tetrahydrocannabinol (THC) per package in edible cannabis products and continue to develop the research in this area to determine whether there are conditions under which the limit could be raised without unduly impacting public health.

Our petition had 3203 signatures from Canadians who want increased edible limits.  The panel heard this frequently during their deliberations and acknowledged said this was hard to find consensus on.  They understand that 10mg per edible per package is a tiny fraction of what other regulated market (and most importantly the unregulated market) has.  Considering the panel also wants dosing it makes more sense to consider 10mg a single dose, with multiple doses in one bag.  Consumers should not have to go to oil or capsules if they want a higher amount.  Based on the carry limit they can usually leave a store with 150mg in edibles at a time if they want.  If we want the regulated market to compete with the unregulated market we need to see the gaps.  This is a huge gap, and closing it would lead to significant displacement of illicit sales.  Public health stakeholders are concerned about exposure in small children but we would argue that if adults are responsible and storing their cannabis away from small hands, this wouldn’t be a concern.  Children accessing cannabis falls squarely on the shoulders of the adults in the house whether it’s one package or a dozen.  Studies from those same public health authorities show the worst that happened to these children was they slept.  There was no death, no allergic reactions, they just were a bit disoriented and sleepy.  The sky has not fallen.  Also, the panel acknowledges that there is no way to show whether the edibles the children had ingested were regulated or unregulated.  This is the perfect example of the unregulated market filling a gap in the market–they are regularly making products that look like real candy brands which can lead to easy confusion.  We understand the reason we need plain packaging and specific shapes and sizes for edibles.  Regulated products adhere to those standards while unregulated edibles do not, at all.  We do believe we need increased education around proper storage of cannabis products, as well as the difference between regulated and unregulated.  We would also like to see the responsibility of child cannabis exposure fall on the people responsible–the adults in the house who did not secure it properly.  There is no uncertainty for demand in the market as the panel suggests–if there was there wouldn’t be a robust market of illicit sellers filling the gap.

Recommendation 38: Health Canada should provide Canadians who choose to grow cannabis at home with information on the potential risks associated with home cultivation, as well as practical advice on how to grow and store cannabis safely.

Growing 4 cannabis plants is not unlike growing 4 of any houseplant inside.  Air quality is the same as any plant you water.  Electrical and fire hazards are easily mitigated with the use of LED lights (which draw less power than a chandelier and are about the same in warmth if you touch them).  Clandestine growing made growing dangerous in years past.  We also encourage growing outside.  Gardening is a wholesome, enriching, engaging activity.  The federal laws on this, however should apply in all provinces (including Manitoba and Quebec where it is not permitted).  We do understand that more information needs to be made available and again encourage increased education around cultivation.  

Recommendation 39: The Government of Canada should work with provincial and territorial governments to help consumers identify legal retailers and products, especially online, and prioritize public communication on the health risks associated with illicit products.

We believe the best way to divert from the unregulated market is to make a sustainable, robust and inclusive regulated market filled with products consumers want and reasonable barriers of entry that encourage everyone to participate and get licensed.  The unregulated market exists because the regime is burdensome and oppressive. Regulation has taken a significant bite out of the illicit pie, but as the panel noted there are still gaps.  The unregulated market will exist as long as there is a demand for unregulated products and innovation in the regulated market is unable to keep pace.  We do not believe anyone should be criminalized for cannabis, ever.  We need to make a compelling reason for someone to choose the regulated market.  Provincial and territorial governments should be doing more to promote regulated retailers (SEO, targeted local advertisements in local cities, social media promotion).  Additionally, provincial suppliers should not compete with regulated retailers in areas where retail is accessible.   

Recommendation 40: The Government of Canada should consider creating authorities to compel Internet service providers to block illicit cannabis websites and to compel financial service operators to provide financial information that helps identify illicit online operators.

This recommendation sounds nice but is completely unrealistic.  Even if authorities are able to shut down one site, another could be back up in 10 minutes.  It is very easy to infinitely copy and paste a website with slightly modified domain.  Servers are also international and none are compelled to comply with those requests from Canadians.  Most banks don’t do business with retailers as it is, and when they do the paperwork and verification is burdensome.  Adding an extra layer of verification will likely only result in the burden of this policy shifting to retailers and licence holders because unregulated sellers are using personal accounts or untraceable cryptocurrency.  

Recommendation 41: In order to provide access and continued support to patients who rely on the medical access program, Health Canada should maintain the program under the Cannabis Regulations, with the improvements set out in this report.

There are over 203,000 Canadians still attempting to access medical cannabis.  Patient access must be maintained and the number of healthcare practitioners providing medical cannabis based treatment increased.  Excise duty and sales tax should be removed from all medical cannabis purchases and the system overhaled to meet the accessibility needs of patients.  Practitioners have refused to sign MMAR/MMPR/ACMPR paperwork for legitimate needs (with doctors who do sign being subject to investigation or arrested).  Doctors never wanted to be the gatekeepers of cannabis.  Even now patients are directed by doctors to go to recreational stores instead of receiving medical care from medical professionals.  On a daily basis recreational retailers are bombarded with patients accessing recreational cannabis (paying recreational tax).  Patients are purchasing blindly because recreational retailers are not permitted to discuss medical use (as they shouldn’t).  In the interim if doctors insist on having recreational retailers be the point of access there needs to be a rebate program available to patients so they can be exempted from excise tax.  The program does not need to be maintained it needs to be overhauled.  

Recommendation 42: To improve patient access to cannabis for medical purposes, Health Canada should permit pharmacies to distribute cannabis products to individuals holding a medical authorization from a health care professional. Provinces and territories and the regulatory authorities for pharmacists should consider supporting this new access channel for patients once federal changes are made.

Medical cannabis needs a DIN assigned to it so it can be covered by benefits programs.  Many patients are on a fixed income, unable to work.  They cannot afford to pay for medical cannabis (especially through recreational channels) and need coverage for their cannabis.   Pharmacy access needs to be in person (not mail order pick up).

Recommendation 43: Health Canada should encourage additional research on the therapeutic use of cannabis in Canada, without compromising the frameworks established for the review and authorization of clinical trials and health products. Health Canada should support a transparent process to identify the specific potential therapeutic applications of cannabis that would benefit most from additional study.

We agree that more research needs to be done on the therapeutic use of cannabis in Canada.  Health Canada must support a transparent process to identify the specific potential therapeutic applications of cannabis that would benefit most from additional study including minor cannabinoids, terpenes, methods of ingestion, and cross-referencing efficacy against a variety of ailments.  These studies need to be funded by the Federal Government.  

Recommendation 44: Health Canada should establish and maintain a knowledge hub that provides up-to-date evidence and information on the use of cannabis for medical purposes for health care professionals and the public.

Health Canada should establish and maintain an unbiased knowledge hub with current evidence and information.  Health care practitioners should be encouraged to update their knowledge base with cannabis information on a bi-annual basis to ensure they are fully aware of any new developments.  This training should be mandatory requirement for all doctors and nurses.  At this time medical practitioners have created a vaccuum of information around medical cannabis.  The knowledge gap is being filled by budtenders and the Internet.  The reality is the medical patients who exist need guidance to treat their illnesses effectively.  Cannabis should not be trial and error.  

Recommendation 45: Health Canada, in partnership with provinces, territories, patients and health care professionals, should support the development and dissemination of national clinical guidance documents related to cannabis for medical purposes to increase the knowledge and understanding of health care professionals. These documents should cover issues such as: indications for which there is a sufficient evidence base of effectiveness, how to monitor patients, and how to track and report adverse reactions.

We agree health care professionals should be developing clinical guidance documents related to cannabis for medical purposes as a part of their regular care.  Current information that exists still stigmatizes cannabis use and leads health care professionals with the understanding that cannabis is dangerous substance.  Instead we would like to see information disseminated about cannabis as harm reduction and a focus on smokeless ingestion methods (like edibles, oils, extracts and vaporizing).  We also agree the documents should include indications for which there is a sufficient evidence base of effectiveness, how to monitor patients, and how to track and report adverse reactions.

Recommendation 46: Health Canada should prioritize efforts to move beyond a distinct medical access program so that cannabis is considered within standard drug approval pathways and part of conventional medical care. This should start with the rapid advancement of a pathway for cannabis health products containing cannabidiol (CBD). The department should also establish a science advisory committee to review the evidence related to delta-9-tetrahydrocannabinol (THC).

As the panel mentions, we appreciate that the increased availability of cannabis-based health products that have been reviewed and authorized under the existing framework for non-prescription or natural health products would mark an important advancement, because it would provide Canadians with access to legal products that have been reviewed for safety, quality and efficacy.  We agree that a science advisory committee needs to regularly review evidence related to both THC and CBD.  

Recommendation 47: To support patient care, Health Canada should amend the regulatory requirements related to the medical document to allow health care professionals to include specific information about the product format and dose of cannabis for the patient, similar to prescriptions for other substances.

We agree in spirit with this recommendation but again, there is a gap in information available to doctors to be able to prescribe specific doses.  Patients require a variety of formats for different occasions (for example, some may find oils are better for sleeping while inhaled cannabis is ideal for more instant dosing).  We don’t want patients to be burdened by unnecessary boundaries on ingesting their medication.  This would be difficult to pinpoint especially with dried cannabis (which may vary from harvest to harvest).  It is important to understand that sometimes more or less cannabis is required to achieve the same result.

Recommendation 48: To address public safety concerns, Health Canada should limit the number of registrations for personal or designated production of cannabis for medical purposes at a single site (where 4 are currently allowed, decrease to 1 registrant per site).

This is a terrible recommendation that will limit access and harm patients.  This would displace 75% of patients with designated growers and would be a literal death sentence for some of them.  There are only so many designated growers who have the space and capacity and are able to produce quality medicine, which they do for little to no pay.  Growing is a labour of love and growing for patients is a labour of compassion.  While it is true there is some cannabis diverted to the unregulated market, there are 203,000 Canadians who struggle with access and finding a designated grower as it is.  We would like to see Health Canada create a patient matching system and incentivize designated growers to donate their cannabis through a subsidy program.

Recommendation 49: Health Canada should build on its recent efforts to seek additional clinical justifications from health care professionals authorizing high daily amounts and consider whether and how additional scrutiny could be applied. Health Canada should use its regulatory authorities to refuse and revoke applications that are deemed to pose a risk to public health or public safety.

Barriers should not be created for patient access.  We acknowledge while there is some diversion happening with medical (and recreational) cannabis, patients do not need additional scrutiny in what is already a borderline inhumane process.  Many patients choose not to ingest cannabis by smoking it.  They make extracts, creams, edibles and other products that require more cannabis to get the same result.  For example, when it comes to extracts most are getting a 10-15% return on input (if they are lucky) meaning if they have 100 grams of input they are lucky to get 10-15 grams of output in ideal circumstances.  We need to stop finding new and cruel ways to punish vulnerable patients.  We need to increase access and remove barriers so these Canadians can live and medicate in peace.

Recommendation 50: Finance Canada should review whether the excise tax should be applied to cannabis for medical purposes products.

We support patient rights and access to medical cannabis.  Medication should not be taxed and it especially should not be taxed at the rate recreational cannabis is taxed at currently. Patients want cannabis for medical purposes to be treated like prescription drugs, which are generally covered by insurance or benefit programs and are exempt from excise and sales taxes. Finance Canada should examine the excise tax as it relates to cannabis for medical purposes, especially if pharmacy access is permitted as recommended.

Recommendation 51: Health Canada, Public Safety Canada, Statistics Canada, the Canadian Institutes of Health Research and other partners should work with stakeholders, including those with lived and living experience and from marginalized communities, to identify key research priorities. This prioritization effort should guide ongoing investment in cannabis-related research.

Considering the lack of available statistical information available and the noted knowledge gaps, we agree that Health Canada, Public Safety Canada, Statistics Canada, the Canadian Institutes of Health Research and other partners should work with stakeholders, including those with lived and living experience and from marginalized communities, to identify key research priorities. We especially support the prioritization effort should guide ongoing investment in cannabis-related research.  In fact, this report is evidence of how desperately we need ongoing investment in cannabis-related research.

Recommendation 52: Health Canada, Public Safety Canada, Statistics Canada and other partners should support ongoing surveillance and monitoring activities for cannabis that are responsive to the variety of potential impacts of cannabis and cannabis legalization, including monitoring the state of the cannabis market, social equity impacts and environmental consequences of cannabis legalization.

There is a wide gap and a lot of missing information in forming even these recommendations in this review.  We do believe that there should be ongoing monitoring of the state of the cannabis market, social equity impacts and environmental consequences of cannabis legalization.

Recommendation 53: Health Canada should take steps to develop an amendment to the Cannabis Act to mandate periodic independent reviews of the legislation to regularly monitor its impacts. Consideration of the social equity impacts of the legislation should be mandated as an element of future reviews.

We agree that periodic independent reviews of the legislation should occur, but we believe it should be more frequent than 5 years, it should be reviewed every 3 years.  A lot can change in the landscape in as little as 1 year.

Recommendation 54: In addition to regular independent reviews of the Cannabis Act, Health Canada should conduct ongoing evaluation of the cannabis program, and implement any necessary changes.

We support the regular evaluation and changes are important to ensure the successful implementation of any initiative. In some instances, it may be appropriate for the monitoring and evaluating to be performed by an independent body. Regardless of the nature of the evaluation, reviews should adequately assess the effectiveness of a given program or initiative to determine if its intended objectives are being met. These evaluations should be made public to ensure transparency and accountability.  We would go one step further to say that evaluation must occur every 3 years to ensure assessment is current.

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