Article by Max Monahan-Ellison, Growth Op
Drugs for hemorrhoids — that’s where I started my career.
You might wonder what working on a clinical trial enrolment strategy for a rectal medication has to do with medical cannabis, however, it kicked off my passion for tackling misunderstood and stigmatized healthcare challenges that have guided me over the last decade.
As I charted a path in health care and consulting — supporting clients in public health, pharma and cannabis and working with patients and healthcare professionals across rare diseases, oncology, diabetes, arthritis, and more — I had no idea I would end up taking a leadership role in a national medical cannabis patient advocacy organization, or co-found a cannabis and emerging therapeutics consulting firm, but here I am. My passion for the sector started when I took the only cannabis policy course-work available while at the University of Toronto and I have also used cannabis for medical purposes, both for chronic and acute issues. I saw first-hand the challenges of navigating the treatment option and integrating it with traditional care, recognizing parallels with some of the experiences of patients living with rare-disease who require complex and new therapies, and those with stigmatized conditions. To this day I am incredibly grateful to have been able to dedicate most of my career and free time to working with patients, policymakers, and professionals at the intersection of cannabis and health.
In Health Canada’s 2020 Canadian Cannabis Survey (CCS), released last month, 14 per cent of Canadians aged 16 years and older indicated that they used cannabis for medical purposes, but medical cannabis is at a crossroads in Canada. After recreational legalization in 2018, many forgot about or deprioritized the needs of the patient community, the same community that paved the way for cannabis legalization as we see it today. And now, the dedicated legal medical access program is at risk.
I’ve seen commentary from the sector citing a recent surge in active client registrations reported in the federal medical system as a sign of growth of this market, but this followed a substantial drop from September 2019 to May 2020 and we are at similar levels to early 2019.
Recent survey research I led for Medical Cannabis Canada patients reported continued barriers to the legal medical regime, including high prices, stigma from medical professionals and more. It’s no wonder the 2020 CCS reports just over 20 per cent of medical cannabis patients in Canada access the treatment with a medical document from a healthcare practitioner.
As many advocacy groups and the industry gear up for the monumental review of the Cannabis Act this year, which regulates recreational and medical cannabis, there are murmurs among the industry that the entire medical program could be folded when it’s dedicated review comes up in a few years.
From my perspective, this is concerning. Many patients are navigating chronic and serious conditions, multiple comorbidities and other medications, and further pushing them to manage their treatment outside of medical channels could put them at risk.
To better understand what the future of medical cannabis should look like in Canada, we need to take a step back and get a holistic look at what it looks like now.
While many in the sector, including myself, often use “medical cannabis patients” as a catch-all term for the patient community, they are a heterogeneous group that span genders, age, socioeconomic status, race, sexuality, and ability, and navigate conditions ranging from anxiety and problems sleeping, to chronic pain, multiple sclerosis, epilepsy and so much more.
The treatment itself is also not homogeneous. With over a hundred cannabinoids in traditional cannabis, varied composition, dose formats and methods of administration, medical cannabis is not one treatment but a diverse class of therapies.
Despite this complexity and even though most patients are managing cannabis therapy alongside other medications and their outcomes are intertwined with other elements of care, the medical cannabis system in Canada in many ways operates in isolation of other traditional healthcare systems.