Medical Cannabis

1. NORTHERN LIGHTS:
Medical Cannabis Policy and Practice in Canada
PHILIPPE LUCAS
VICE PRESIDENT OF PATIENT RESEARCH & SERVICES, TILRAY
CENTRE FOR ADDICTIONS RESEARCH OF BRITISH COLUMBIA
MARCH 2015

2. University
of Victoria
Centre for Addictions
Research of BC
MEDICAL CANNABIS IN CANADA
• R. v. Parker (2000) - constitutional right to choose
cannabis as medicine without fear of criminal sanction
• In 2001, the Marihuana Medical Access Regulations (MMAR)
• 1 million Canadians used cannabis for self-defined medical conditions
(Adlaf, Begin & Sawka, 2005; Belle-Isle & Hathaway, 2007)
• To date, approximately 50,000 Canadians have obtained an
authorization to possess cannabis for medical purposes

3. University
of Victoria
Centre for Addictions
Research of BC
CANADIAN MEDICAL MARIHUANA SYSTEM
MMAR
ENDED
MARCH 31, 2014
MMPR
STARTED
APRIL 1, 2014

4. University
of Victoria
Centre for Addictions
Research of BC
A STEP IN THE RIGHT DIRECTION
THE MARIHUANA FOR MEDICAL PURPOSES REGULATIONS (MMPR)
The most significant change in medical cannabis access since 2001, the MMPR were
implemented by Health Canada in December 2012, and went into full effect on April 1st
2014
• Simplified/decentralized application process
• NPs can prescribe (maybe)
• Multiple Licensed Producers
• Increased quality control
• Increased strain/symptom awareness

5. University
of Victoria
Centre for Addictions
Research of BC
CURRENT LICENSED PRODUCERS
Aphria
Bedrocan Canada Inc.
Broken Coast Cannabis Ltd.
Canna Farms Ltd.
CanniMed Ltd.
CannTrust Inc.
Delta 9 Bio-Tech Inc.
InThe Zone Produce Ltd.
MariCann Inc.
MedReleaf Corp.
Mettrum Ltd.
OrganiGram Inc.
The Peace Naturals Project Inc
Tilray
Tweed Inc.
Whistler Medical Marijuana Corp.

6. University
of Victoria
Centre for Addictions
Research of BC
TILRAY FACILITY LOCATION

7. University
of Victoria
Centre for Addictions
Research of BC
FACILITY CONSTRUCTION

8. University
of Victoria
Centre for Addictions
Research of BC
FACILITY CONSTRUCTION

9. University
of Victoria
Centre for Addictions
Research of BC
FACILITY CONSTRUCTION
v1.0

10. University
of Victoria
Centre for Addictions
Research of BC
GROW ROOM

11. University
of Victoria
Centre for Addictions
Research of BC
GROW ROOM

12. University
of Victoria
Centre for Addictions
Research of BC
FACILITY CONSTRUCTION
v1.0

13. University
of Victoria
Centre for Addictions
Research of BC
FACILITY CONSTRUCTION
v1.0

14. University
of Victoria
Centre for Addictions
Research of BC
TILRAY FACILITY

15. University
of Victoria
Centre for Addictions
Research of BC
MMPR AUTHORIZED ACTIVITIES PERFORMED BY TILRAY
SEED1
PROCESSING5
SHIPPING / DISTRIBUTION8
GROWING / CULTIVATION3
STORING6
TECHNICAL SERVICES /FINANCIAL INSURANCE10
TESTING/R&D
6
DISPOSAL / WASTE STREAMS9
HARVESTING4
PACKAGING / LABELLING7
PROPOGATION2

16. University
of Victoria
Centre for Addictions
Research of BC
TILRAY SUMMARY
Scale
Investment
Location
Taxes
Product
Technology
Jobs
Nanaimo BC
65,000 SF facility with over 34,000 SF of production space
25+ million invested
over 120 direct jobs
Cutting edge technology & production practices
Dozens of strains, including many high CBD varieties
Significant contribution to local tax base

17. University
of Victoria
Centre for Addictions
Research of BC
TILRAY RESEARCH STRATEGY
Phase 2 placebo-controlled clinical trial agreement with the
University of British Columbia to examine the therapeutic
potential of medical cannabis on the symptoms of PTSD
• 40 participants; military and police veterans and other survivors of physical violence.
• Study will compare vaporized cannabis of varying cannabinoid concentrations to placebo
• Health Canada and UBC review and approval process in Spring 2015
Pilot studies of cannabis-based preparations in
the treatment of paediatric epilepsy
• NewYork State
• New South Wales, Australia
Patient patterns of use research
• University of Victoria

18. University
of Victoria
Centre for Addictions
Research of BC
CANNABIS ACCESS FOR MEDICAL PURPOSES SURVEY (CAMPS)
The CAMPS questionnaire is a 414 question cross-sectional
survey made available to Canadian medical cannabis patients
online and by hard copy in 2011 & 2012.
With 628 responses so far, the Cannabis Access for Medical
Purposes Survey (CAMPS) is the largest polling of Canadian
medical cannabis patients to date.

19. University
of Victoria
Centre for Addictions
Research of BC
CANNABIS ACCESS FOR MEDICAL PURPOSES SURVEY (CAMPS)
DEMOGRAPHICS

20. University
of Victoria
Centre for Addictions
Research of BC
CANNABIS ACCESS FOR MEDICAL PURPOSES SURVEY (CAMPS)
Fig. 1. Primary medical conditions treated
with cannabis by authorization. Note:
Sleep Disorders, Attention Deficit Disorder,
Fibromyalgia, Hepatitis C, Parkinson’s
Disease, Wilson’s Disease, Scleroderma,
Tourette’s Syndrome, and unspecified
Psychotic Disorder Conditions each
comprised less than 2% of the sample and
were aggregated into the category ‘Other’.
The anxiety and mood disorders category
included 35 participants who reported a
primary illness/condition of anxiety, 34 who
reported depression and 40 who reported
both anxiety and depression. Comparisons
of these groups indicated equivalent profiles
with regard to demographic characteristics,
health, and use of CTP, and were therefore
aggregated for statistical analyses; n = 502
* = difference between proportion Health
Canada Authorized and Unauthorized p < 01.
25.00
PERCENTREPORTING
HIV/AIDS
ARTHRITIS
SPINALPAIN
ANXIETY/DEPRESSION*
CANCER
EPILEPSY
MULTIPLESCLEROSIS
GASTRO-INTESTINAL*
CHRONICPAIN
OTHER
20.00
15.00
10.00
5.00
0.00
ALL
HEALTH CANADA AUTHORIZED
NOT HEALTH CANADA AUTHORIZED
PRIMARY MEDICAL CONDITIONS TREATED WITH CANNABIS

21. University
of Victoria
Centre for Addictions
Research of BC
CANNABIS ACCESS FOR MEDICAL PURPOSES SURVEY (CAMPS)
CHARACTERISTICS OF CANNABIS USE BY CONDITION

22. University
of Victoria
Centre for Addictions
Research of BC
SUBSTITUTING CANNABIS FOR PRESCRIPTION DRUGS, ALCOHOL AND OTHER SUBSTANCES
V1.0
80%
PRESCRIPTION DRUGS ALCOHOL
52%
ILLICIT SUBSTANCES
32%87%
PERCENTAGE OF
PATIENTS WHO
USE CANNABIS
INSTEAD OF
OTHER
SUBSTANCES
• Reasons cited: “better symptom management” and “less adverse side-effects”.
• Patients who listed a greater number of symptoms were more likely to report cannabis substitution.
• Younger patients (30 & younger) were far more likely to substitute cannabis for
prescription drugs, alcohol and illicit substances than older patients (50 & older).
MEDICAL CANNABIS PATIENTS’ SUBSTANCE SUBSTITUTION

23. University
of Victoria
Centre for Addictions
Research of BC
DISCUSSION
V1.1V1.0
SUBSTITUTION FOR PRESCRIPTION OPIATES
With the recent rise in pharmaceutical opiate addiction (Dhalla et al, 2009;
Fischer et al, 2008; SAMHSA 2007), and an associated increase in opiate-
related morbidity and mortality (Moore et al 2007), cannabis may prove to be a
safer substitute to address chronic pain issues in patient populations.

24. University
of Victoria
Centre for Addictions
Research of BC
DISCUSSION
V1.1V1.0
SUBSTITUTION FOR ILLICIT SUBSTANCES
Evidence suggesting that cannabis might be an effective substitute for
opiates, crack/cocaine, crystal meth and other illicit substances could be
part of a public health-centered harm reduction strategy aimed at reducing
disease transmission and overdoses stemming from injection drug use.
SUBSTITUTION FOR ALCOHOL
Public policies informed by evidence that cannabis might be a
substitute or actual treatment for alcohol addiction (Lucas 2013; Reiman
2009, 2006; Mikuriya 2004) could have a significant impact on overall
rates of alcoholism, as well as alcohol-related automobile accidents,
violence and property crime.

25. THANKYOU
QUESTIONS?
PHILIPPE LUCAS
VICE PRESIDENT OF PATIENT RESEARCH & SERVICES, TILRAY
CENTRE FOR ADDICTIONS RESEARCH OF BRITISH COLUMBIA
philippe@tilray.ca