title: Medical Marijuana programs: implications for cannabis control policy--observations from Canada.
abstract: While prohibition has been the dominant regime of cannabis control in most countries for decades, an increasing number of countries have been implementing cannabis control reforms recently, including decriminalization or even legalization frameworks. Canada has held out from this trend, although it has among the highest cannabis use rates in the world. Cannabis use is universally criminalized, and the current (conservative) federal government has vowed not to implement any softening reforms to cannabis control. As a result of several higher court decisions, the then federal government was forced to implement a 'medical marijuana access regulations' program in 2001 to allow severely ill patients therapeutic use and access to therapeutic cannabis while shielding them from prosecution. The program's regulations and approval processes were complex and subject to extensive criticism; initial uptake was low and most medical marijuana users continued their use and supply outside the program's auspices. This year, the government introduced new 'marijuana for medical purposes regulations', which allow physicians to 'authorize' medical marijuana use for virtually any health condition for which this is considered beneficial; supply is facilitated by licensed commercial producers. It is expected that some 500,000 users, and dozens of commercial producers will soon be approved under the program, arguably constituting - as with medical marijuana schemes elsewhere, e.g. in California--de facto 'legalization'. We discuss the question whether the evolving scope and realities of 'medical cannabis' provisions in Canada offer a 'sneaky side door' or a 'better third way' to cannabis control reform, and what the potential wider implications are of these developments.
authors.affiliation: Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, 2400 - 515 West Hastings St., Vancouver, Canada V6B 5K3; Social & Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell St., Toronto, Canada M5S 2S1; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Canada M5T 1R8. Electronic address: bfischer@sfu.ca.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
authors.affiliation: Social & Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell St., Toronto, Canada M5S 2S1.
authors.forename: Sharan
authors.initials: S
authors.lastname: Kuganesan
authors.affiliation: Centre for Alcohol Policy Research, Turning Point, Fitzroy, Victoria 3065, Australia; Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Victoria 3010, Australia; Centre for Social Research on Alcohol & Drugs, Stockholm University, SE-106 91 Stockholm, Sweden.
authors.forename: Robin
authors.initials: R
authors.lastname: Room
mesh_terms: D002170:Canada; D002188:Cannabis; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D035082:Federal Government; D033161:Government Regulation; D006801:Humans; D008385:Marijuana Smoking / Q000331:legislation & jurisprudence*; D064086:Medical Marijuana / Q000627:therapeutic use*
chemical_list: D064086:Medical Marijuana
keywords: Canada; Cannabis control; Medical marijuana; Medicalization; Policy