Medical Cannabis Access In Canada Improved With Legalization

A recent report prepared for Health Canada shows that the legalization of cannabis in Canada in 2018 has improved access and information sharing associated with medical cannabis. In doing so, it has also helped to reduce the stigma surrounding it.

The report based itself on two medical cannabis surveys, one of 1,205 Canadians aged 16 and older who have used cannabis for medical purposes since its legalization on October 17, 2018. The second survey sampled 823 physicians and nurse practitioners who have had experiences with or inquired about people accessing medical cannabis.

Recreational Legalization Has Facilitated Access to Medical Cannabis

Among respondents who have used medical cannabis (“patients”), just over half (53%) said they had done so before legalization. Almost half (46%) only started using medical cannabis after the full legalization of cannabis.

Of those who only started using medical cannabis after legalization in 2018, more than half (58%) said they were more comfortable doing so because legalization has made cannabis more readily available. Half (49%) also said they decided to use medical cannabis because they felt more information about medical cannabis was available after legalization and that lower stigmatization was also a factor.

Most (71%) of those who said they had used medical cannabis said they had also used cannabis for non-medical purposes in the past three years since legalization.

Most of these patients (66%) also reported discussing their medical cannabis use with a physician or nurse practitioner. However, fear of stigma was the most common reason among those who did not discuss these issues with a healthcare professional (HCP).

The most common reasons for refusing to prescribe medical cannabis are healthcare professionals refusing to authorize the use of cannabis for patients (38%), lack of evidence to support cannabis as a treatment option (31%), or the fact that the healthcare professional is not familiar enough with the use of medical cannabis (29%).

Types of Medical Cannabis Products Recommended

Cannabis oils, extracts, and capsules are the products most often recommended by a medical professional (68%), followed by edibles (26%) and dried flowers (23%).

Almost a third of respondents said they had been recommended products with high CBD and low THC content, while 24% said they had received recommendations to use equal amounts of THC and CBD. Finally, 19% said they received advice to use CBD, while 17% employed high-THC and low-CBD products.

Despite this, 44% of patients reported smoking their cannabis, while 34% said they preferred edibles, and almost a third (31%) preferred ingesting cannabis extracts or oils. In addition, most patients said they preferred cannabis products containing THC and CBD, but responses were varied.

27% said they preferred higher levels of THC with lower levels of CBD, while 30% said they preferred higher levels of CBD with lower levels of THC. 28% said they preferred equal levels of THC and CBD. Only 13% said they would prefer a product containing only THC.

Frequency of Consumption Among Patients

More than a third (39%) of people who use medical cannabis said they do so almost daily, while 21% said they do so several times a week. Only 14% said they used medical cannabis once a week, and only 10% said they did so several times a month.

60% of patients said they thought legalization positively impacted access to medical cannabis. About half said they thought full legalization had increased the quality and quantity of products, and nearly half said they felt less stigma for cannabis use.

Health Professional Medical Cannabis Beliefs Survey

A second survey focused on the opinion of health professionals. 49% of them said that the use of cannabis had therapeutic value. In addition, 45% said there was therapeutic value at least once in a while.

Of the healthcare professionals who said cannabis use had therapeutic value at least occasionally, three-quarters cited clinical examples that suggested cannabis may have therapeutic value. In addition, more than half (59%) said cannabis was a valuable tool in cases where other treatment options were not tolerable or effective.

Most (89%) of healthcare professionals who believe cannabis has a therapeutic value at least occasionally think CBD is the most therapeutic part of the plant. In comparison, 44% say THC, 13 % other cannabinoids, and 9% that terpenes have therapeutic value.

Most healthcare professionals (90%) said CBD had therapeutic value, while 85% said THC posed risks.

Of those who recommend a maximum daily dose of THC, most recommend no more than 10 mg. However, the maximum amounts of CBD recommended were more varied. About a third (29%) of healthcare professionals said they usually recommend up to 2.5 mg daily.

The most significant proportion (29%) said they recommend up to 2.5 mg of THC daily. Another 22% recommended between 2.6 and 5 mg of THC, while 15% usually recommended between 10.1 and 15 mg. Only 1% of healthcare professionals usually recommend more than 25 mg.

Some Healthcare Providers Remain Naive About Medical Cannabis, Despite Growing Interest

Among healthcare professionals who do not recommend medical cannabis, most (58%) cited a perceived lack of evidence on the effectiveness of cannabis or a lack of information on the appropriate dosage (55 %) to explain why.

Almost half (48%) said they felt they didn’t know enough about medical cannabis or were concerned about adverse side effects (47%). However, 64% of healthcare professionals said they had received more inquiries about the use of medical cannabis since legalization.

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(Featured image by Terrance Barksdale via Pexels)

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