Medical marijuana patients stymied by systemic barriers are self-medicating

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Medicinal marijuana patients with proper medical documentation still feel they are being pushed toward recreational and unregulated markets to find relief for what ails them, and the situation is worse for patients without documentation.

Not only is there a general need to clear systemic barriers — including cost, stigma and other access issues — patients are also having to make health decisions without the support and advice of professionals.

These are just some of the results from a new survey released today by Medical Cannabis Canada (MCC), a national non-profit patient advocacy organization.

The group’s first-ever such survey, this portion of MCC’s Medical Cannabis Patient Survey (MCPS) reflects input from 1,000 medical cannabis patients polled this summer, as well as a random sample of panellists.

“It is clear that having a medical document can result in positive outcomes for patients and it is essential for Canadians to have access to support from health care professionals that can help them navigate medical cannabis safely and effectively,” Max Monahan-Ellison, MCC board member and MCPS project lead, says in a statement.

While 74 per cent of document-holders say they seek guidance from healthcare practitioners or pharmacists, that percentage plummets to 24 for those who have never had a medical document. / Photo: Getty Images / Photo: Getty Images

That said, just 37 per cent of respondents who use medical marijuana currently have a medical document from a medical practitioner. Adding to the challenge is the fact that only three per cent of patients have full insurance coverage for their treatments, notes MCC, citing previous research by Health Canada.

The divide is also great between patients with and without proper documentation. While 74 per cent of document-holders say they seek guidance from healthcare practitioners or pharmacists, that percentage plummets to 24 for those who have never had a medical document. The default for the latter group is friends and family, websites and “budtenders” at recreational weed stores.

Whether holding medical documentation or not, cost was also regarded as a barrier. In a twist, polled document-holders report spending about $160 a month out of pocket for their medicine, 34 per cent more than those without a document.

Whether holding medical documentation or not, cost was a barrier. / Photo: MJ_Prototype / iStock / Getty Images Plus / Photo: MJ_Prototype / iStock / Getty Images Plus

In all, 24 per cent of patients who accessed recreational markets opted to use an unregulated dispensary, since it was more affordable than the legal system.

Cost is a definite barrier, but there are others. Eight in 10 respondents report that stigma among medical professionals outside cannabis clinics continues to be an issue, and 60 per cent say they feel they have no choice but to access medicine outside the legal system because of hurdles relating to cost, authorization and navigating the structure.

The need, or perceived need, to seek relief outside of the regulated system is worrisome since barriers can directly impact respondent health. Findings indicate that 72 per cent of medical cannabis patients say using it has reduced their reliance on traditional medications, while a minority of both those with documents and those without report decreased reliance on opioid pain relievers.

The survey shows about 90 per cent of patient respondents say they support pharmacists being able to issue medical documents. / Photo: iStock / Getty Images Plus iStock / Getty Images Plus

When the Cannabis Act and medical framework come up for review starting next year, MCC recommends that two key steps must be taken to address treatment barriers and to improve outcomes: push for expanding benefits coverage, and eliminate the excise duty, HST/GST and PST on related medicine; and beyond the existing mail delivery options, expand access points to medical cannabis through pharmacy distribution.

Indeed, the survey shows about 90 per cent of patient respondents support pharmacists being able to issue medical documents, provide medical guidance on cannabis use and risk, and dispense medical cannabis.

FILE: Pharmacist Dina Ghali fills prescriptions for a client at Main Drug Mart in Toronto, Friday afternoon, Apr. 16, 2010. / Photo: Aaron Lynett / National Post

Unsurprisingly, 90 per cent of polled patients also voiced support for eliminating taxes on medical cannabis. About a quarter say that they believe doing so could reduce how much they currently use the unregulated market for medicine.

“If Canada wants to be the global leader in medical cannabis, collaborative efforts are needed by the industry, non-profits and regulators to ensure patients can access this market and afford their treatment,” Monahan-Ellison says.

Full results are expected to be available at

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