Medical marijuana may be in pharmacies next year

September 12, 2005

Dean Deeby, The Globe and Mail (Canada)

Health Canada's long-delayed plan to sell government-certified marijuana in drugstores appears to be back on track for early next year.

The pilot project would stock medicinal pot in some pharmacies for use by authorized patients, making Canada only the second country after The Netherlands to allow easier access through drugstores.

Currently, 237 patients can get Health Canada's medical marijuana through Prairie Plant Systems Inc., which grows the weed in Flin Flon, Man., under a $5.75-million (U.S.) contract with the federal government. Thirty-gram bags of dried buds, costing $150 each, are couriered directly to patients or their physicians.

But since early 2003, when senior officials visited The Netherlands to investigate that country's marijuana distribution program, Health Canada has looked for a way to insert a pharmacist between the manufacturer and the patient.

The department is scouting out a handful of urban and rural pharmacies to begin the pilot project by the first quarter of 2006, said spokesman Christopher Williams.

Health Canada had initially planned a project for last year but regulations authorizing pharmacy distribution only came into effect on June 7 after a long period of consultation.

"Ideally, we'd like to run it in more than one province," Williams said in an interview. "Once we recruit the pharmacists, we'll make sure [they] receive specialized training in dispensing the marijuana for medical purposes."

Currently, 943 people are authorized to possess marijuana for medical conditions ranging from AIDS to multiple sclerosis, once a doctor has indicated that traditional remedies are ineffective.

Of these, 695 have permission to grow the plant themselves, while Health Canada has authorized 77 growers to produce it for other patients.

Prairie Plant Systems is also distributing a flowering-bud product that currently contains about 14 per cent THC, the main active ingredient. The company's five-year contract ends in December, but is expected to be extended by a year as Health Canada issues a request for proposals for a new long-term arrangement.

The first pharmacies to stock the product are likely to be in British Columbia, said Robin O'Brien, a Vancouver pharmacist who has been asked by Health Canada to participate as a consultant.

It would mark the first time Canadian drugstores are allowed to sell a controlled substance that is not an approved drug.

"I suspect it's going to be a very small pilot, just to work out the kinks," Ms. O'Brien said in an interview.

She said pharmacists can fill a real medical need.

"Most physicians don't have a lot of interest or expertise in using marijuana for medical purposes, so patients have been getting their information most likely from black-market dealers (or) recreational users," she said.

Some lay people may offer advice at so-called compassion clubs, but rarely is a medically trained professional available to advise on methods of ingestion or to warn about drug interactions.

"It's this whole step that's been removed from the medication process. . . You need more than just written materials."

Pharmacists will need specialized training in how medical marijuana can be administered safely and effectively. Smoking has adverse effects and is discouraged, so that professionals may need to prepare tinctures, where the THC is extracted with alcohol and administered as drops.

Medical marijuana will occupy a grey zone between approved drugs available only with a prescription and Plan B, an emergency contraceptive available on demand but only through a pharmacist. Patients will need to show their Health Canada authorization for medical marijuana but will not need a doctor's prescription.

"It's almost like a new category," said Ms. O'Brien.

An internal document from Health Canada says it could take up to three years to implement a national pharmacy distribution program.

A longtime critic of the department's medical marijuana program questioned the value of pharmacy distribution when it's likely to serve fewer than 20 patients in British Columbia alone.

"What we're talking about is a potential multimillion-dollar, multi-year program that would only reach 13 to 18 people in this entire province," said Philippe Lucas in Victoria.

The Dutch program has come under fire for selling marijuana at inflated prices, but the Health Canada marijuana costs less than half the price charged by pharmacies in The Netherlands.

Earlier versions of the Prairie Plant Systems product came under fire for being too weak and full of stems and leaves. The company has since boosted the THC content and restricted it to buds only.

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