He is 47 years old and, chances are, he lives somewhere on British Columbia’s Sunshine Coast.
Under Health Canada’s medical marijuana program, he is approved to legally consume up to five grams a day of the pot he grows himself at home. Most likely, his general practitioner signed the forms he needed to get the drug.
And on average, he is a “he” — men in the program outnumber women by a ratio of about three to one.
As with a great number of medical marijuana patients, he uses the drug to treat severe arthritis, although he may suffer from other conditions.
Data obtained by the Ottawa Citizen through the Access to Information Act put this face to the typical medical marijuana patient for the first time, 10 years after the federal government — under pressure from a series of legal rulings — was forced to start allowing seriously ill Canadians to apply to use the drug.
As Health Canada moves to overhaul the rules governing medical marijuana, its own numbers show sharp disparities in the accessibility and use of the drug across the country as patients scramble to find doctors willing to prescribe.
Although all Canadians are supposed to have equal access to medical marijuana, enrolment in the program varies greatly across the country. Where you live and your doctor’s attitude to marijuana will help determine whether you receive approval from Health Canada to use the drug to treat serious illnesses such as cancer, multiple sclerosis or AIDS.
The geographic patterns contained in Health Canada’s data show that people from British Columbia are far more likely to have a marijuana authorization — about 33 people out of every 100,000, compared to five per 100,000 in Manitoba.
Between 2001 and 2007, the V0N postal code zone, which spans British Columbia’s Sunshine Coast — a ferry ride away from Vancouver — Gulf Islands, part of Vancouver Island and the area around Whistler ski resort, generated more applications under the government’s Marihuana Medical Access Regulations (MMAR) program than any other.
By contrast, in some well-populated swaths of Manitoba such as Steinbach and parts of Brandon, not a single person has applied to the program.
Marijuana advocates say it is the approach of doctors in different parts of the country, not patient needs, that determines who is getting medical marijuana. They point to what they say are more permissive attitudes toward marijuana in B.C. and better outreach by cannabis advocates to the doctors who must ultimately decide whether to sign a patient’s application.
“British Columbia has a bit more laissez-faire attitude to marijuana and a very good activist network informing doctors,” says Matthew Mernagh, 37, a Toronto marijuana user who, this spring, won a court decision that effectively has toppled Canada’s marijuana prohibition.
After he was arrested for growing pot in his apartment in 2008, Mernagh launched a constitutional challenge of Canada’s drug laws. Mernagh’s case was based on a complaint common to many patients who seek marijuana: the difficulty he had finding a doctor to sign documents to let him legally use the drug — in his case, to treat chronic pain and seizures caused by fibromyalgia and other conditions.
At trial, evidence was produced that suggested that less than one-half of one per cent of Canadian doctors had signed the 33-page form for a patient to apply to Health Canada’s program.
“I find as a fact that the physicians of Canada have massively boycotted the MMAR and their overwhelming refusal to participate in the medicinal marijuana program completely undermines the effectiveness of the program,” wrote Justice Donald Taliano in his April decision quashing the marijuana law.
The court agreed that the systemic refusal of doctors to approve patients for marijuana was an infringement on their rights. Mernagh was allowed to grow his own pot without Health Canada’s approval, a decision that — should it stand — effectively overrides Canada’s marijuana laws.
The court will hear the government’s appeal of the decision in March.
Mernagh might have had better luck with his doctor had he suffered from cancer or even arthritis. Health Canada’s data show that severe arthritis is now the most common reason for applications to the medical marijuana program. This trend is a relatively new one, as Health Canada has been deluged over the past three years by applications claiming severe arthritis as the medical reason.
But in the first years of the program, it was HIV/AIDS patients who were at the vanguard. Cannabis is an effective appetite stimulant and can help curb neuropathic pain and control nausea caused by the illness and AIDS medications.
By the end of 2007, HIV/AIDS patients accounted for the largest share of applications for the MMAR, even though there were far fewer people living with the infection than with cancer.
Estimates put the number of HIV/AIDS patients in Canada at about 60,000. By contrast, there are more than 177,000 new cancer patients diagnosed in Canada every year.
With the high uptake among HIV/AIDS patients, medical marijuana use is higher in areas with large gay communities. Vancouver’s West End and Toronto’s Church-Wellesley area can both make credible claims to being the most predominantly gay neighbourhoods in Canada. They also boast some of the highest per-capita MMAR enrolment rates in the country.
Urban doctors who see a lot of HIV/AIDS patients are more likely to be informed about new therapies and open to trying new approaches, says Lynne Belle-Isle of the Canadian AIDS Society, who wrote a 2007 paper on access to the drug.
“Physicians that treat people with HIV are likely a little bit more informed and HIV advocates have been involved in the medical use of cannabis for a long time,” she said.
There is also more research on the use of the drug as a therapy for HIV, Belle-Isle said, and the Canadian AIDS Society is the only major disease organization that believes patients should have access to the drug if it helps them.
But outside the gay communities, the data suggest participation in the medical marijuana program is actually lower in urban areas than rural ones. It is a counter-intuitive trend that is likely due to the fact patients in many larger cities have been better served by so-called compassion clubs that dispense pot outside of Health Canada’s program.
Some doctors are willing to write referrals to a compassion club but won’t agree to sign the forms required for the Health Canada program. The clubs offer a wider variety of marijuana strains that, advocates say, give better treatment options, compared to the single strain sold for $5 a gram plus GST by Health Canada.
Had he convinced his doctor to sign his release, Mernagh, at age 37, would number among the youngest approved marijuana patients.
Indeed, the Health Canada data dispatch of the notion that young people are applying to the program to score the drug legally. People under age 40 accounted for fewer than 20 per cent of the approved patients. Those in their 40s made up 38 per cent.
About eight per cent were older than 60.
OTTAWA CITIZEN DECEMBER 9, 2011
Most medical marijuana users middle-aged men