Medical marijuana to sell for $5 per gram
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* Barbara Sibbald

There is no question physicians will play a crucial role in implementing Canada's new interim policy for providing medical marijuana, but many questions remain about how they will do it.

Under the interim policy, announced July 9, the 582 Canadian patients who have met requirements of the Marihuana Medical Access Regulations (MMAR) will be allowed to buy 30 marijuana seeds for $20, and then grow them for medical purposes. They will also be able to buy dried marijuana for $5 per gram, or about $140 an ounce. (Black-market marijuana costs $300 to $750 an ounce, according to the RCMP.) Health Canada currently has 370 kg of marijuana with a THC (tetrahydrocannabinol) content of 10% ready for distribution. Physician approval is required before patients can receive it.

The seeds and marijuana will be provided by Prairie Plant Systems Inc. in Flin Flon, Man., which is under contract with Health Canada to produce marijuana for clinical trials. The marijuana will be sent to participating physicians for distribution purposes; only doctors who have signed a patient's MMAR form will be asked to do this. Cindy Cripps-Prawak, director of the Office of Cannabis Medical Access, said MDs “are acting as an intermediary for Health Canada” in the distribution.

She said the amount provided “will be based on the dosage recommended by the physician,” and this could be as much as 4.2 g per day (about 6 cigarettes). There are no clinical guidelines. Setting the exact dosage is a “challenge Health Canada and doctors share,” Cripps-Prawak added. For health reasons, patients will be encouraged to use the drug as a tea or in baked goods instead of smoking it.

Ottawa was forced to put an interim policy in place after the Ontario Superior Court ruled that the federal regulations were unconstitutional because they did not provide a distribution method. The court gave the government 6 months to act. If it had not, the 582 exemptions allowing medicinal use of the drug would have become invalid.

Although Ottawa tried to put a positive spin on the policy, CMA President Dana Hanson was less than impressed. “Our unease over use of medical marijuana has been ignored in this new policy,” he said.

However, Hanson also acknowledged that despite physicians' displeasure over their unsought role in the medical marijuana debate, they must continue to participate in it. “The government needs to get it right, so we continue to be willing to work with them,” he said. — *Barbara Sibbald*, CMAJ