Sue Barnes

HANSARD NUMBER 207

Wednesday, April 14, 1999
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PRIVATE MEMBERS' BUSINESS

LEGALIZATION OF MARIJUANA FOR HEALTH AND MEDICAL PURPOSES

The House resumed from March 4 consideration of the motion and the amendment.

Mrs. Sue Barnes (London West, Lib.): Mr. Speaker, there is a growing body of evidence, most of it still anecdotal, that strongly suggests that marijuana has unique therapeutic properties in the treatment of several
life and sense threatening diseases. For example, some people with multiple sclerosis believe that smoking marijuana helps them to control their spasticity. In certain instances the use of marijuana has helped to reduce
nausea and stimulate the appetite of those living with HIV and AIDS.

Last year the board of directors of the Canadian AIDS Society passed a position statement on the medicinal use of smokable marijuana stating that people living with HIV-AIDS and their physicians should have access to
marijuana for medicinal purposes in the treatment of these conditions.

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There are indications that smoking marijuana can likewise reduce nausea and vomiting brought on by chemotherapy, principally among cancer patients. This is not simply a matter of comfort, as some cancer patients have had to cease treatment because the constant vomiting can make it impossible to continue taking the therapeutic drugs they need. Many chemotherapy patients complain that other anti-nausea drugs are ineffective and in some cases produce unwelcome side effects.

Marijuana is reputed to be helpful in the treatment of glaucoma through the reduction of intraocular pressure caused by fluid accumulation.

Other medical conditions or situations for which marijuana is reputed to have some effectiveness include an anti-convulsant action which may have an application in the treatment of epilepsy, and an analgesic action for pain relief. Marijuana cannot be said to cure any of these conditions but the potential exists with rational, medically supervised use to help alleviate pain and suffering. One recent report would term this belief based
medicine. In Canada we strive for evidence based medicine.

The therapeutics products program, the regulator in Health Canada, has in place an expert advisory committee that since last year has been examining a number of issues relating to the medical uses of marijuana.

I am delighted that Canada will be among those jurisdictions to gather evidence in a safe and controlled manner so that our body of evidence can be evaluated along with that being done elsewhere.

In the U.K., GW Pharmaceuticals has been granted licences by the British Government to cultivate cannabis plants and to store and dispense the cannabis preparations for research. Initially it will develop standardized extracts of cannabis plants grown under controlled conditions. Research will also be concentrated on the best way to give the drug to patients and on which conditions it can safely treat.

They intend to proceed to clinical trials with a smokeless whole plant extract while also supplying marijuana to other investigators interested in medical research and pharmaceutical development.

Earlier this year the International Narcotics Control Board, which is responsible for the implementation of United Nations drug conventions, released its annual report for 1998. In the report the board called for
unbiased research into the possible medical benefits of marijuana.

If the medical usefulness of marijuana is established, which I believe it will be, it would remain a drug no different from any other narcotic drugs. It would still be subject to licensing and other control measures according to international treaties, just like morphine and opiates.

Last month the American Institute of Medicine issued its report entitled "Marijuana and Medicine: Assessing the Scientific Base". It declared that the medical use of marijuana may be one of the most effective treatments
available for people with serious diseases such as AIDS and cancer.

This study, the product of more than 18 months of research, highlights continued concerns about marijuana but says it clearly controls some forms of pain, was not particularly addictive, and did not appear to be a gateway to harder drugs. The report also states that new research on the medical uses of marijuana should try to develop a non-smoked rapid onset delivery system to simulate the action of smoking marijuana.

To assist desperately ill patients who may not want to wait for a safe alternative to be developed, the report suggests doctors be allowed to launch clinical trials of marijuana, telling each test subject the benefits and risks of smoking it, including the negative impact of the smoke itself.

At the present moment a licit supply of medical research quality marijuana for clinical trials in Canada is potentially available and obtainable from the American National Institute on Drug Abuse. GW Pharmaceuticals may also be interested in performing some clinical trials with its developed alternate delivery systems outside its jurisdiction of Britain.

In Canada no scientific evidence that smoked marijuana has medicinal benefit has been submitted to the therapeutic products program. I believe very soon there will be a need for researchers to come forward and present proposals to study the benefits of the medicinal use of marijuana.

Under the Controlled Drug and Substances Act there is sufficient latitude to distribute marijuana without having to now change the law.

Under the CDSA the Minister of Health can enact regulations to authorize the possession, import, export and production of cannabis for medical purposes. Section 56 of the act states the following:

The Minister may, on such terms and conditions as the Minister deems
necessary, exempt any person or class of persons or any controlled
substance or precursor or any class thereof from the application of
all or any of the provisions of this act or the regulations if, in the
opinion of the Minister, the exemption is necessary for a medical or
scientific purpose or is otherwise in the public interest.

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Under the regulations of the CDSA, the minister also has the authority to authorize research on controlled substances. Together with others, specifically those in our social policy caucus at the time, I worked on the
rework of the relevant bill in the 35th parliament. Hansard debates recorded this.

In the summer of 1997 I commissioned the Library of Parliament to prepare a report regarding the use of the new CDSA act and medicinal marijuana. This report was delivered to me in September 1997, at which time I provided it to our Minister of Justice and our Minister of Health.

I have pushed this matter very hard inside my government and since that time with these departments. I, with others, understand that even now there will not be overnight change; but let us not underestimate the progress made. The answer to my question to the Minister of Health on March 3 was a significant embarkment on a new policy direction for Canada.

There are drugs that contain THC, the active ingredient in cannabis, which have received therapeutic drug approval by Health Canada. These drugs went through the drug submission process, received a notice of compliance and then were granted drug identification numbers. The drugs can be sold legally in Canada pursuant to a prescription by a practitioner. Since the active ingredient in cannabis is already available for

medicinal purposes in Canada, expanding its use may seem to be an appropriate development once we have the supportive research in hand.

At the present time in Canada there are two approved drugs that contain the active ingredients derived from the marijuana plants in pill form: Marinol and Cesamet. For many patients these synthetic versions of marijuana's active ingredients are expensive, unpalatable, and if they are trying to control nausea to be able to take oral medications they are ineffective oftentimes.

Smoking marijuana meanwhile appears to provide immediate relief of nausea and a stimulation of the appetite, allowing people to hold down both their pills and some food. There may be better mediums, for example inhalers, that reduce the negative side effects associated with smoking marijuana. These are still under development.

Currently some people who suffer from these diseases discussed above, for whom the legal medical options have proven ineffective or painful, have made choices. Some have obtained marijuana illegally in Canada and therefore risk suffering consequences such as arrest, fines, court costs, property forfeiture, incarceration, probation and criminal records.

Once evidence has been gathered the federal government will need to establish quickly an approach that would provide medical quality, licit marijuana so that people suffering from disease do not have to take further risks with their health by buying potentially impure, contaminated or chemically adulterated marijuana as is the case currently in Canada.

The concept of legalizing marijuana for medical purposes has been debatedon and off in Canada for a number of years. I stress today that it is not the so-called legalization of a controlled substance that is the real
issue. It is the legal access through the CDSA, which could be dealt with easily. In a recent court case in my riding, Regina v Clay and Prentice, Ontario Court Justice John McCart stated:

Parliament may wish to take a serious look at easing the restrictions
that apply to the use of marijuana for the medical uses as outlined
above as well as for alleviating some of the symptoms associated with
multiple sclerosis, such as pain and muscle spasm. There appears to be
no merit to the wide-spread claim that marijuana has no therapeutic
value whatsoever.

It is a welcome step what we are doing. We need solid research efforts to commence soon. We also need to help set up a system so that those on trials are not open to criminal harassment. It is a matter of compassion. It is not fair to these people who have to fight both their disease and the law at the same time.

I applaud members on all sides of the House who have worked on this matter over the years. I think it is very important to recognize them. I also think it is important to recognize the Minister of Health who has taken
this step forward at this time.

I want to also thank my constituents and those across Canada who have brought the poignancy and the tragedy of this issue to my attention. I am proud to be part of our government as we move forward on this issue.