All eyes this month have been on Ontario as it unveiled its framework to govern the use and retail sale of recreational cannabis. The Neighbourhood Pharmacy Association of Canada (Neighbourhood Pharmacies) and its members want to ensure that the legislative and regulatory environment now being developed in Ontario is one that results in a safe and reliable distribution system to prevent youth from accessing cannabis. Unfortunately, the small number of retail store locations proposed by the province may in fact overly restrict access and introduce the unintended consequence of increasing “black market” demand.
More importantly, the Ontario government was unable to deal with the pressing health policy issue of cannabis for medicinal purposes. As our country begins work to legalize and safely regulate cannabis, we all share a common goal – ensuring that our system is safe and reliable for Canadians, while keeping cannabis out of the hands of children. Reaching this goal will not necessarily be easy. Carefully structuring the regulations for both medical and recreational cannabis (yes, there is a difference) will be vital. Thankfully, we have a ready-made solution: Canadian neighbourhood pharmacies.
In Canada, medical cannabis users (and soon-to-be users of recreational cannabis) do not receive clinical advice before accessing the drug; yet these same users could also be taking other prescription medications. Without the appropriate clinical oversight the current medical cannabis regime poses a risk to patient safety.
Take just one example. The consumption of cannabis in combination with blood thinners or benzodiazepines can lead to dangerously low blood pressure, increased risk of bleeding, and disruptions in blood sugar levels. The result could be poor health outcomes for Canadians who expect medical cannabis to help, not hurt them. We can do better than this. We must do better than this.
Canada’s neighbourhood pharmacies are calling for a dual system: a medical cannabis system where there is evidence of therapeutic benefit, alongside a recreational system, with strictly controlled and restricted access. Pharmacies are highly accessible healthcare destinations and including pharmacies in the distribution and dispensing of medical cannabis ensures patients receive optimal care and minimizes the risks to all stakeholders.
The medical cannabis system requires prescriber authorization and these patients deserve the same level of care as every other patient in the province on a medication. There are different strains of cannabis for recreational use which provide the psychoactive effects versus a pharmaceutical grade strain intended for therapeutic use and pharmacists are uniquely positioned to match the right strain for the condition of the patient. This is where Canada’s pharmacists are ready to step up.
As CEO of Neighbourhood Pharmacies, I’ve watched our members earn their reputation for providing fantastic patient care. We have the expertise in medication management and all the essential infrastructure to go along with it. We can keep track of our patients’ medications and can ensure patients use a safe mix of prescription drugs – it’s our job, after all.
We bring something else to the table: an answer to the problem of whether medical drug supplies could be diverted to the recreational market. We have the safeguards in place that will ensure proper inventory management, while preventing theft and diversion. We also bring the experience needed to identify the signs of addiction which breed use and misuse of prescription drugs.
For these reasons, we have urged the federal government to amend the Access to Cannabis for Medical Purposes Regulations (ACMPR) so that pharmacists and pharmacies can be authorized to distribute and dispense medical cannabis, just like hospitals and physicians are authorized to do. This is a request that provinces like Ontario must get behind. It would be a positive step forward if the Minister of Health and Long Term Care were to request an exemption for Ontario under Section 56 of the Controlled Drugs and Substances Act, which would demonstrate the government’s commitment to maintaining access for medical cannabis patients.
For the sake of patients, their families, and all Canadians, it’s important that we get this right. Canadian pharmacies are ready to stand up and do their part. We have the knowledge. We have the experience. We have the capacity. All we need is for our governments to say, “yes.”
Justin Bates is the CEO of the Neighbourhood Pharmacy Association of Canada.
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