Opening medical cannabis packaging is complicated and difficult for many patients, and this is intentional.The Cannabis Act was developed with the purpose of preventing youth access, protecting public health, curbing the illicit market and ensuring the medical stream is not misused. As a result, equity and accessibility often take a backseat.
“Packaging is a physical barrier to access,” says Ashleigh Brown, Founder and CEO of SheCann Cannabis, a community of over 5,000 patients. “We have had patients actually use hacksaws, pliers, or vice grips to get to their medication.”
When a patient is experiencing pain, tremor, swelling, or other problems with their hands, Brown points out, pinching, twisting and squeezing is not easy, preventing access to the very medication that may help alleviate those symptoms.
A 2019 survey from Health Canada estimates that around a third of patients use cannabis to manage arthritis symptoms and similar proportions for chronic and acute pain. For those surveyed and other patients managing conditions like epilepsy and multiple sclerosis, packaging can present a unique challenge.
“I can’t open my medication and it is a clear example of ableism in policy,” says Sarah Colero, a disability and medical cannabis advocate, who has been using cannabis to help manage ongoing complications like migraines and epileptic tendencies following multiple strokes.
Colero has been prescribed opioids at various periods of her life and the process of receiving accessible packaging is simple. “When I was prescribed hydromorphone and oxycodone (prescribed to combat pain), I couldn’t open childproof containers, so I submitted a request to my pharmacy for non-child proof packaging and was accommodated,” she added.
The Cannabis Act is structured so that the medical side mirrors the non-medical system, with the stated intention to reduce the incentive for people to access the medical stream for non-medical purposes.
In practice, “patients are being penalized for using cannabis over traditional pharmaceuticals,” says Trina Fraser, Cannabis Regulatory Expert, Partner at Brazeau Seller law and Board Member of Medical Cannabis Canada.
The solution is clear from existing pharmaceutical models, where patients in Canada can often request accessible packaging from their pharmacy, but it requires a fundamental shift in the way the Cannabis Act is structured.Currently, the Act limits the ability of producers to develop patient-centric solutions to issues like packaging. “
Producers have no flexibility in the current regulations,” says George Smitherman, President and CEO of the Cannabis Council of Canada (C3).
Consultations have already begun on the Cannabis Act, which is coming up for its statutory review, marking a key opportunity to create distinct regulatory requirements for the medical access framework that can address patient barriers like packaging.
“Good consultation and reform lead to better options for all Canadians,” says Brown.
Addressing areas like packaging, affordability, expanded access points in the medical framework, and dose-appropriate products start with having regulations that are tailored to the needs of patient communities.
“The government’s position is that it is better to over-regulate and then relax restrictions as warranted, as opposed to under-regulating and then trying to increase restrictions. With that in mind, a loosening of regulations over time is reasonable and expected,” Fraser added. “Feedback from stakeholders can guide Health Canada to the specific areas where adjustments can be made to enhance safe and equitable access for patients without risking public health and safety.”