EVIDENCE

Standing Committee on Health NUMBER 068 1st SESSION 42nd PARLIAMENT Friday, September 15, 2017 Le vendredi 15 septembre 2017 Standing Committee on Health CANADA [Recorded by Electronic Apparatus] EVIDENCE September 15, 2017 Committee Edited Evidence * Table of Contents * Number 068 (Official Version) Official Report * Table of Contents * Number 068 (Official Version) Témoignages * Table des matières * Numéro 068 (Version officielle) 68 15 09 2017 2017/09/15 08:35:00 House of Commons Comité permanent de la santé Standing Committee on Health HESA Chair Mr. Bill Casey 42 1

(0835) [ English ]

The Chair (Mr. Bill Casey (Cumberland—Colchester, Lib.)) :

We're bringing meeting number 68 of the Standing Committee on Health to order. We're studying Bill C-45 , and our panel this morning will focus on edible products. While I have a minute, I want to tell the committee—and I've been on a lot of committees—and yesterday was 12 hours straight. Nobody lost their focus, nobody lost their interest, everybody was paying attention, and I thought through this week that all members of the committee have done a really good job of asking the right questions and bringing the right issues up. I'm really pleased and proud to be part of this committee.

I just wanted to say that this morning. I was thinking about it last night. In an awful lot of committees, people are not focused, and they lose interest at some point, but nobody has lost interest at all through this whole session, and it's been quite a marathon. I thank you all for doing that. It's been quite a week, and we're not done yet. We have edibles this morning. To start our panel on edible products, we have three witnesses this morning. Dr. Ryan Vandrey by video conference from Maryland. He's an associate professor at Johns Hopkins University.

From the Colorado Department of Public Health and Environment, we have Dr. Daniel Vigil, manager of marijuana health monitoring and research. From Sensible BC, we have Mr. Dana Larsen, director. We're going to ask each one of you to make a statement that's a maximum of 10 minutes long. Then when we're done the three opening statements, we'll ask questions for the next little while. We'll start with Dr. Vandrey to make a 10 minute introduction.

Professor Ryan Vandrey (Associate Professor, Johns Hopkins University, As an Individual) :

I probably don't have 10 minutes here, but I'll give you the brief version. I'm a human cannabinoid researcher at Johns Hopkins. I've been doing cannabis research for 17 years now. Recently I've been focused on evaluating the dose effects of cannabis, their different routes of administration, including oral or edible cannabis products. We look at the pharmacokinetics and pharmacodynamic effects of cannabis through this route of administration. We've also done some product testing research, in which we evaluate the label accuracy of edible products sold in dispensaries in the U.S.

The Chair :

All right thank you very much. We appreciate that. Is that everything you want to say in your opening statement?

Prof. Ryan Vandrey :

That's it.

The Chair :

We'll have some questions for you; don't worry. Now we'll go to Dr. Daniel Vigil, manager of marijuana health monitoring and research at the Colorado Department of Public Health and Environment. Thank you for being here.

Dr. Daniel Vigil (Manager, Marijuana Health Monitoring and Research, Colorado Department of Public Health and Environment) :

Thank you, Mr. Chairman, committee. I also don't have an extensive opening statement. I'd be happy to answer any questions that you have. I'll just say a few brief things. Concerning edibles, as opposed to smokable forms of marijuana, we have recognized a few different concerns that we think are important to address in policy. One is accidental exposure, either by children or by individuals who aren't aware that the product in front of them may have THC in it. The second is over-consumption, primarily by naive users who aren't familiar with the delayed effects of edible products.

Then there are various concerns of contamination with microbials, residual solvents, or pesticides that perhaps could be concentrated in edible products. Concerning accidental exposure, packaging, and.... The product forms are very important to not to appeal to children. Childproof packaging is very important. Labelling is also important, both on the product and the package, to make people aware that it's not, for example, a standard candy bar, that there's something different about it. For various potential contamination, good laboratory regulations are very important.

I have plenty of information about some of the data we've seen etc., and again, I'd be happy to answer any questions that you have.

(0840) The Chair :

Thank you very much. These are the shortest opening statements we've ever had. For Sensible BC, we move to Mr. Larsen.

Mr. Dana Larsen (Director, Sensible BC) :

Thank you very much. I'll take my full 10 minutes. Thanks for having me at this committee. I've been a cannabis activist for all of my adult life. I run a cannabis dispensary, and I've probably sold more cannabis than all the other witnesses combined. It's good to be here today, but I have my doubts that this committee will actually act upon the evidence being brought before them in the testimony they're hearing. I say that because I have been at this a long time.

When I first got started as a cannabis activist in the 1990s, the government was introducing the Controlled Drugs and Substances Act to replace the Narcotic Control Act. At that time, there was a great deal of testimony and hearings, and about two dozen groups came forward who said that prohibition was a failure, the war on drugs was a failure, we should legalize, end prohibition, and approach things differently. The only groups that supported that legislation were the Canadian Association of Chiefs of Police and the Canadian pharmaceutical association. Everyone else was against it.

The government said it would pass this law and have a drug policy review afterwards. That review never happened. Canada's Senate took it upon itself, and it issued a comprehensive and detailed report on cannabis in 2002, a five-volume report that probably remains one of the best analyses of cannabis and cannabis policy today. That report was also completely ignored. I encourage committee members to take a look at that Senate report from 2002 because it is an incredible document. It recommended legalization of cannabis for all Canadians over the age of 16.

These were Conservative senators, not a bunch of pot smokers, and they recommended legalization for everyone over the age of 16. That was ignored. The year I was born, 1971, the Le Dain commission recommended decriminalizing cannabis possession and cultivation and working toward legalization. That was also ignored. For all my life, I've seen our government listen to testimony, do research, have studies, talk to people, and then ignore the results. I hope that doesn't happen here today. The cannabis act is a bad piece of legislation. It is flawed in a great many ways.

It doesn't even decriminalize the joint that I have in my pocket now, which I'm going to smoke after this committee hearing. The idea that we're going to have licit and illicit cannabis and that we're going to have the police trying to decide which cannabis is good and which is not good is simply not going to work. In cities like Vancouver, where it's already effectively decriminalized, we're not going to see much of a change in policy.

In northern areas, first nations communities, or the poor people who are demonized and affected most by cannabis prohibition, you can bet police will be going after them and asking where they got their cannabis from, telling them that it's illicit cannabis and that they're going to charge them with possession. It is absurd at a time when we're talking about decriminalizing all drugs that we're still not even decriminalizing cannabis possession under this legislation. I was asked to speak today about edibles, but to me that's a category that's too restrictive.

We should be also discussing hashish, tinctures, capsules, extracts, creams, drops, suppositories, all the many ways you can use cannabis. At my dispensary, we sell buds and all these other products, and the buds we sell are less than half of everything we sell. When I hear that in Ontario they're saying that they're going to set up these legal shops right next to the dispensaries to put them out of business, I think that's great; it's not going to affect my clients at all. Ninety-five percent of my customers will continue to shop with me even if there's a legal shop next door.

It's simply not going to have the range of products that are really available and necessary. As an activist who wants to see better drug laws in Canada, I don't like this at all, but as a business owner, it's great. This is going to keep me and other dispensaries in business for many years to come. This will do nothing at all to shut down dispensaries or affect the black market. We had a pretty major court case, the Owen Smith case, and Kirk Tousaw, who spoke yesterday, was the lead lawyer on that case.

The courts ruled that medical patients have a right to access not only smokable buds but cannabis in all these other forms as extracts. Health Canada's response was to allow licensed producers to make cannabis extracts with no more than 3% THC, which is a complete disregard of both the letter and the spirit of that court decision. It's not surprising, because that has been the attitude of the government and Health Canada for years. Every time we get a court ruling against...to expand the cannabis access, the government and Health Canada take the most restrictive possible

interpretation of that decision. The result of this is that the government has lost control over cannabis, and it has lost control for many years now. We've been systematically dismantling Canada's cannabis laws for the last 20 years, beginning with the laws against bongs, vaporizers, and pipes, which are still on the books under

section 462.2. That law has never been removed, and yet it would be hard to find a city that doesn't have multiple bong shops in it today. We did that in the 1990s by simply defying the law and opening up bong shops. There were raids and conflict, kind of like now with dispensaries. After time, police and communities realized that the war on bongs was a failure, that nobody wanted to see it happen, and they gave up. As a result, we have effectively legalized bongs and pipes, seed banks, vapour lounges, and we're on the way to doing it with dispensaries as well. In many cities, we already have.

(0845) We're not, then, going to follow these laws. With large aspects of this legislation you're creating laws that are simply unenforceable and you are giving the police a task impossible to do. I'm currently facing charges for giving away cannabis seeds. I've given away more than seven million viable cannabis seeds over the last two years. I've travelled to 22 cities across Canada in the last two years giving away seeds. I was charged in Calgary in 2016 for giving away cannabis seeds. They've set aside a three-day trial for me at the end of October—three days in court in our justice system.

It is letting alleged murderers and rapists go because they don't have space in our courts, but they're going to make three days for me for a trial for giving away low-THC cannabis seeds to those who want them. I believe those charges will be dropped before they go to trial, because what a waste of time this would be, but the fact is, our courts cannot handle the massive civil disobedience campaign that Canadians have been launching. It's simply not going to succeed.

I would like to remind the committee that the origins of Canada's cannabis prohibition in our drug war is not some well-intentioned effort to protect public health or protect children or any of that. Our war on drugs, the war on opium and the war on cannabis, began as a racist and ignorant effort to eliminate Chinese people and other racial communities from Canada. That's how it started; there's no question about that.

There's no time since 1908, when the Opium Act was passed, or since cannabis prohibition came in the twenties and today, when these laws changed from being racist and ignorant and bigoted to being somehow well-intentioned and good for our communities. These laws are bad in their origins and continue to be terrible today. The fact is that the war on drugs is really a war on plants, and cannabis may just be the world's greatest plant. There's no other plant that has the nutritional, industrial, social, and medicinal value that cannabis has.

The other aspect of this war on drugs and the war on plants is the fact that coca leaf, opium poppy, psilocybin mushroom, and peyote cactus are all also good plants with thousands of years of social and cultural use. The war on drugs is really a war against these plants and against nature, and it's time that it comes to an end. Do you want to know who is to blame for the fentanyl crisis that we're experiencing across Canada? It's you. It's our Parliament, which has passed these laws that prohibit reasonable access to opiates. The fentanyl crisis is entirely the fault of Canadian policy.

We don't have a drug problem in Canada; we have a prohibition problem in Canada. When we end prohibition we will see the vast majority of the problems we associate with drug use go away. Cannabis, in fact, is not a problem. Cannabis is part of the solution. In Vancouver we now have two sites that are offering free or discounted cannabis medicines to opiate users as a substitution project. There's evidence out of the U.S. showing that American states that have access to dispensaries have less opiate use and fewer opiate overdose deaths than those that do not.

I believe, from my personal experience and from the research, that cannabis dispensaries are saving lives every day in Canada. At my dispensary, people tell me that I helped them get off opiates, helped them improve their health, helped save their life. This happens all the time. It's similar with alcohol. Many cannabis people find, when they're using alcohol, that they can get off alcohol by using cannabis. Cannabis is a substitute for more dangerous drugs in so many ways. It's easy to regulate edibles and extracts. Give them childproof packaging.

Make sure that the products are properly labelled and that the dosages are correct. It's easy to do; it's not complicated at all. Further, CBD should really be de-scheduled entirely and removed from the CDSA. CBD is highly beneficial. There is no psychoactivity at all; it's an incredibly safe medicine. There's no question that CBD should be removed from the CDSA and allowed entirely. The fact is, we can buy enough alcohol, tobacco, or even aspirin.... Aspirin you can buy without any age limit at a corner store, and one bottle of aspirin can kill you.

The idea that we're treating cannabis so severely and so restrictedly when other more dangerous substances are allowed makes no sense at all. It really shows the failure of this legislation. I would urge this committee to go beyond cannabis; to accept that cannabis is a good plant and that prohibition is wrong; to stop handing over this industry to the black market, as you've been doing for so many decades; and to recognize that it's not just cannabis. The whole war on drugs is an absolute failure, and it's time to legalize and regulate and put policies in place that are based on science.

We've had this research for 40 years or more now. We know that the war on drugs is a failure. We know that cannabis is essentially harmless, and certainly less harmful than the alcohol or tobacco that is used every day. That's what I have to say. Thanks for having me here. I hope that this committee will listen to the evidence presented and make some serious changes to this legislation. Thank you.

(0850) The Chair :

Thank you very much. We appreciate your enthusiasm. We're going to go to questions now. We're going to start with Mr. Ayoub. This will most likely be en français , so if you need translation, we have translation facilities here for you. Mr. Ayoub, you have seven minutes.

Mr. Ramez Ayoub (Thérèse-De Blainville, Lib.) :

Thank you, Mr. Chair. [ Translation ] I want to begin by thanking you for your good comments. Yesterday was, indeed, a long day. I was a little concerned about not seeing my colleague opposite, the one who is always asking for more time to question witnesses, at the end of the meeting. Unfortunately, he missed a good part of yesterday's meeting. I am glad to see that he is in good shape today and that he will be able to ask good questions. It's interesting to hear all the testimony.

It can sometimes be quite different, even though the scope and purpose of our actions relating to the decriminalization and legalization of cannabis are the same, and the most important issue is protecting youth. It's important to ensure that the legalization of marijuana is done properly and that youth are prevented from using cannabis from an unknown origin or of an unknown quality. However, we know where the cannabis people are using now comes from: it comes from organized crime. Today we are talking about derivatives and edible products.

This is an important aspect, since youth can suffer the consequences in a major way. I would like to hear from the representative of the State of Colorado. I would like to know a little more about his experience with labelling, packaging and marketing. I would particularly like to know whether edible products are increasing the number of consumers of marijuana-based products, given that these products are more readily available and can be consumed in ways other than by smoking. Today, most people are aware that smoking is harmful. So there is already a restriction.

However, there is no restriction on eating a cannabis muffin; many people eat muffins the morning. It's the same thing for candy. I would like to understand Mr. Vigil's perspective on this. Mr. Vandrey could also answer my question. [ English ] Go ahead.

Dr. Daniel Vigil :

Did you say there would be some translation available?

Mr. Ramez Ayoub :

The translation is right here. I thought you were fully bilingual and that you were listening.

Dr. Daniel Vigil :

Could you help me with that?

Mr. Ramez Ayoub :

I thought that Mr. Vigil was having full, direct translation, but he didn't have his hearing apparatus.

Dr. Daniel Vigil :

It was regarding increased rates of use among youth. Because smoking is harder to hide than eating, people would eat more cannabis and have more problems because of that. I think that was the question.

Mr. Ramez Ayoub :

Mr. Vandrey, did you have a sense of my question? Maybe we can go ahead in the meantime.

Prof. Ryan Vandrey :

Sure. I got the translation here. You brought up very important points. I think that testing and quality control are absolutely important in any kind of legislation. The other thing is how these products are going to be produced and provided, through what vehicle. Is it a muffin, brownie, gummi bears, soda? Currently, in the U.S., in Colorado, you have an infinite number of consumable products. The appeal to children is certainly important, and I think that's clearly in the legislation here and that it is absolutely paramount to anything that you guys roll out. The other thing, is how do you test it?

If there is one method of testing for a brownie, can you do the same test in a gummi bear and get accurate results? We don't know the answer to that yet. I think science needs to be done to validate test methods through different vehicles for these products. Packaging is absolutely important to prevent unintended consumption. A lot of the problems happen—and I believe Colorado has had this issue and I'll let Mr. Vigil talk about that more—when you get people who consume cannabis-containing products and they are not aware of it, and then they have adverse reactions and things of that nature.

Education about the time course and the delay and onset of effects and the magnitude of effects is key. The other thing that's actually really important also is education about who should or shouldn't be using cannabis. In contrast to what our Sensible BC friends here are saying, it's not a harmless drug, and people with a certain genetic background or family history of psychosis will respond to these substances differently than will other folks. People with cardiovascular disease are at higher risk of cardiovascular problems due to an increase in heart rate and cardiovascular stress.

There are very important considerations that have to be made when you roll out legalization of a drug like cannabis.

(0855) [ Translation ]

Mr. Ramez Ayoub :

I would like to continue along the same lines. We are moving forward in stages, since the regulations are not yet part of the bill. We are not yet intensively exploring edible products to market them. That will probably be the next step. Do you think that proceeding in stages is a good approach?

[ English ]

Prof. Ryan Vandrey :

It all depends on what the step is, don't you think? Without seeing exactly what you're talking about, it's hard for me to comment. If you're going to legalize smokable products and vaporization products first and then approach edibles, it all depends on what you ultimately do with edibles and on whether there's any public health benefit or harm of ingestible products versus inhalable products. When we're not talking about medicinal use, it takes on a different context, and so the thought process needs to be a bit different. That's the challenge here. In the context of medicinal use, edible products are easy. You put them in a gel cap.

Mr. Ramez Ayoub :

The question is whether this is more dangerous than smoking. Is the access easier when eating edibles than when smoking pot?

Prof. Ryan Vandrey :

If it's sold in the store, access is the same. I don't think it's any more or less.... Access to the product is going to be determined by the way retail sales happen. If you're selling smokable products right next to edible products, it's the same. There may be some perception of less harm with edibles versus smokables due to pulmonary concerns, but there's no science—

Mr. Ramez Ayoub :

Let me stop you there. I want to have an answer from Mr. Vigil. Can you give me a short answer?

Dr. Daniel Vigil :

Sure. In Colorado, we see a small portion of marijuana users who use only edibles, but the vast majority smoke. This goes for adolescents, high school students as well, in our surveys there. For the vast majority, their primary mode of use is smoking; we don't see a large portion using vaping or edibles. The thought, as you may have alluded to was that it's easier to hide the latter and to be doing it during school, etc. Aside from a small number of cases, this isn't something that has been widespread.

(0900) The Chair :

Time is up. Ms. Gladu, you have seven minutes.

Ms. Marilyn Gladu (Sarnia—Lambton, CPC) :

Thank you, Chair. I think you did a marvellous job yesterday when we had all of our long sessions. Thanks to all the witnesses who are here. I don't know a lot about edibles, so I'm going to try to learn something from you. I've heard a lot of discussion that we should only be allowing edibles that don't appeal to children, but the only edibles I've heard mentioned so far are cookies, candies, gummies, cakes, milkshakes, suckers, and brownies. My question for you, Mr. Vigil, is, what are the edibles that wouldn't appeal to children?

Dr. Daniel Vigil :

That's a very good question, and I don't have a clear answer for you. I think packaging is very important, along with education, to not leave cookies lying outside of a package, as that would obviously be appealing. Not using the type of packaging that a child might want to really get into is important. In Colorado, we had to put in place some regulations after the fact. They can't be in the shape of humans or animals or fruits; that's a start. But finding where the best line is ultimately is difficult.

Ms. Marilyn Gladu :

Thank you; that's fine. Concerning how much of a dose is reasonable, I've heard conversations suggesting that people sometimes take too much because of the delay time. What is the delay time, and how much is a reasonable dose for a person of x weight. Mr. Vandrey?

Prof. Ryan Vandrey :

In terms of the delay in time, typically you have the onset of effects of an edible after about 30 minutes. The peak effects happen about an hour and a half later and are sustained until about three hours after administration. The total duration of effects is about six to eight hours. That duration is determined by the dose. Exactly what is a unit dose is an important question. In Colorado and in other states in the U.S., it's been established that 10 milligrams is a maximum dose, but lower doses are available as well. It's going to be different across individuals.

Body weight isn't necessarily an important characteristic in terms of defining the effect of a dose. There are sex differences in response to cannabis. Females tend to be more sensitive to its effects than males are. I don't think there's enough data to determine what an appropriate unit dose is. In my lab, we've tested 10-, 25-, and 50-milligram doses in healthy adults. Ten milligrams produces a drug effect without a lot of impairment. But again, that's healthy young adults. In someone who's 65 or 70, that may be different.

In someone who has a certain genetic predisposition, where they metabolize the drug differently, that may be different. Again, my studies were done with a total of 35 people, so it's hard for me to say exactly what that right dose is. Colorado uses 10 milligrams. Perhaps Mr. Vigil can talk about any issues they've had with that unit dose in Colorado.

Ms. Marilyn Gladu :

Before we go there, I want to ask you one more question. One of the concerns we've heard about a home-grow is that there is no quality control, and so the potency can be different. If you're baking your brownies at home from your home-grow.... Have you any experience in terms of the relative percentage of overdoses or other problems we see with that?

Prof. Ryan Vandrey :

The issue there is you have to test the product you're using to make the brownies, or whatever it is you're making. You have to know the potency in order to determine the dose you're putting into the product. The other thing is you have to either make each individual brownie with a known amount of cannabis or have some kind of manufacturing process to ensure even distribution of the drug throughout a batch. You can't just throw cannabis on a brownie sheet, cut it up, and expect the same amount to be in each brownie. There are clear manufacturing and testing practices that have to be put in place.

Home-grow doesn't have any of that. Your home-grow person is not going to be testing the potency of their plant material, testing each individual whatever-it-is that they make. That's a crapshoot in terms of dosing.

(0905) Ms. Marilyn Gladu :

Absolutely. Out of control.

Prof. Ryan Vandrey :

My guess is you're not going to roll out, at the national level, open retail sales of homegrown product. There need to be standards for manufacturing, production, and testing.

Ms. Marilyn Gladu :

I hope we won't even allow it because of the hazard for the people in the home. Mr. Vigil, do you have any experience from the Colorado time frame with people in the home-grows? I know you did that.

Dr. Daniel Vigil :

We do allow a large amount of home-grow, in particular for medical patients, with an extended plant count. Unfortunately, our data is not able to distinguish whether a poison centre call or an emergency department visit is related to homegrown or store-bought. I would certainly agree with Mr. Vandrey that a regulated market is going to be safer from that standpoint. Those individuals who are growing at home and making their own concentrates and edible products are very likely fairly experienced with it and less likely to get into problems over having too much.

The last point I want to make is this: where is the product that more naive users are using going to come from? The more availability there is on a regulated market, the less likelihood there is of that product coming from a black market, where it may be much less clear what's in it, and it is potentially more dangerous.

Ms. Marilyn Gladu :

Do you have statistics on any of the medical calls resulting from edibles or overdoses from edibles, or anything from Colorado?

Dr. Daniel Vigil :

Yes. We have seen an increase in poison centre calls and emergency department visits related to marijuana following legalization, and even somewhat prior with the commercialization of medical marijuana. In the poison centre calls, we are able to distinguish edible from smokable. We can't do that right now in the emergency department visits. For adults, it's about equal numbers between edible and smokable products, which is actually disproportionate because more product is smoked in Colorado. So there is some increased concern with edibles.

Ms. Marilyn Gladu :

There is relatively more overdosing from edibles.

Dr. Daniel Vigil :

Right. Then, of course, among children zero to eight, the majority are edible products.

Mr. Dana Larsen :

Is it possible that people are just more comfortable going to a hospital and saying they use cannabis since it became legal than they were beforehand? Maybe there's not an increase in actual overdoses or people taking too much, but simply an increase in the number of people who are going to go to a hospital and talk about it. Beforehand, they could have been criminally charged if they said they were using cannabis. Is that a possibility, or something you've looked at?

Dr. Daniel Vigil :

Is it okay to...?

The Chair :

No. Time's up. We have to go to Mr. Davies.

Mr. Don Davies (Vancouver Kingsway, NDP) :

Thank you. Mr. Vigil, one of the premises of our question is that if we don't legalize edibles, people aren't going to be using them, manufacturing them, selling them, or distributing them. That's not the case, is it?

Dr. Daniel Vigil :

No.

Mr. Don Davies :

It's unlikely that whoever is producing these products now, particularly if there are criminal elements, is producing edibles in childproof packages. Would you agree with that?

Dr. Daniel Vigil :

I agree, yes.

Mr. Don Davies :

The Canadian task force that looked at this recommended, for a number of reasons, that this government legalize edibles, concentrates, and other non-smokable products precisely for those reasons. You're saying, if I understand your evidence correctly, that it's better to regulate those products so we can try to control dosage, childproof packaging, single-serving, stamped products to minimize the harm. Do I have that correct?

Dr. Daniel Vigil :

Yes, that's correct.

Mr. Don Davies :

We heard evidence that Colorado initially legalized edibles, had some problems with it, understood the problems, and came back and brought in further regulations on edibles. Is that correct?

(0910) Dr. Daniel Vigil :

That's correct, yes.

Mr. Don Davies :

How's it working now? Have they addressed some of those early concerns that originally happened from the legalization of edibles?

Dr. Daniel Vigil :

In our most recent year of data for both poison centre and emergency department visits, we have had a slight decline. We hope that's related to regulation and public education. We can't be certain what the causes are, but we have seen a slight decrease and hope that continues.

Mr. Don Davies :

Mr. Larsen, you sell products. We're talking edibles, and again, all I hear is about brownies and gummi bears. You described a range of products that under Bill C-45 would still be illegal. You mentioned creams, sprays, tinctures, patches, and tablets. These are all forms of cannabis that would remain illegal under Bill C-45 . Can you tell us, in terms of the products you sell: are these products unsafe? Do consumers want them? What percentage of your users prefer these products as opposed to smoking cannabis?

Mr. Dana Larsen :

The ratio of extracts to buds is probably about 60:40. Of course, there are also smokable extracts as well—hash and shatter and things like that—which are also very beneficial but are used in a smoke format. People are more inclined to use edibles when they know it's a safe amount. People do not want to ingest vast amounts of THC and hallucinate. That's not what they're looking for. People tend to smoke because it's easily titrated. You have the amount you need and then you're done. With edibles, it can be a long wait.

Edibles can be very useful for pain relief and for longer-term effects, especially for medical users who don't want to be smoking constantly. They find the right dosage in an edible or suppository, which by the way is an incredible way of using cannabis, with very low psychoactivity and good to get a high dose, medicinally or otherwise. When they talk about legalizing—oh, we're going to sell it in liquor stores—are you going to sell cannabis suppositories in liquor stores? We sell a cannabis cream called MJ creams.

There's no psychoactivity at all; you rub this cream on your skin and it's great for psoriasis, eczema, and topical pain relief. This could be put on a baby or on anybody of any age. I don't see any reason to have an age limit on a cannabis-infused cream that has no psychoactivity. We have to broaden the range of things that we're looking at. At our dispensary it is very rare for somebody to come back and say I took too much of the edible and I had a bad experience. We tell people, as doctors do with prescription drugs, start up with a lower dose. If that doesn't work, work your way up to a higher dose.

Try a little more at a time until you reach the point where you're getting the effect you want, and then you've got enough. If the government is not going to allow edibles and extracts, we're going to continue to sell them through dispensaries, through the black market. They'll be unregulated, but we do our best to make sure these products are safe and labelled.

Given the constraints of legality, we do our best, and I think we do a pretty good job already: a lot of the fearmongering around edibles and extracts simply hasn't materialized in Vancouver, or Toronto, or other cities that have dozens and dozens of dispensaries. We're not really seeing a lot of problems coming out of this, and that's an unregulated, self-regulated market. If we have some proper rules in place, the problems will be minimal.

Mr. Don Davies :

“Mr. Zaid, you put it well.” He talked about how we want to limit the use, in uncontrolled fashion, of products of unknown providence. Mr. Vandrey, you refer to it as a crapshoot. Would we prefer to keep this legal and have Canadians cooking their own edibles in their own kitchens, without any control over the concentration of the THC, for instance, in a tray of brownies? I fail to understand how that's a preferable public policy approach to edibles than putting it into the hands of a tightly regulated market where it's sold in retail fashion by people who can be advising the customers, as you just pointed out.

Mr. Dana Larsen :

They're going to make their own edibles anyway, even in a fully legalized market. People enjoy making their own edibles—it's fun. It's like growing your own cannabis. It's an enjoyable activity to grow a plant in your garden, then harvest it and use it. People like that. Tomatoes, or zucchini, or cannabis, people enjoy it. People are going to make their own edibles even under legalization.

Most won't, they'll go buy it in a store because that's easier, but people brew their own wine and make their own beer, and there's nobody coming in and saying we're going to check the alcohol level of that beer and make sure it's at the right level. That doesn't happen, so I think a lot of these concerns are overblown. I would prefer to see a legally regulated market that's open and accessible for regular Canadians to enter, as it is with other products. Until that day happens, edibles and extracts will continue to be available. We sell pure CBD tincture and pure isolative THC and CBD at dispensaries.

We're years and years ahead of where the legal system is going to be, and you have a lot of catching up to do.

(0915) Mr. Don Davies :

Bill C-45 legalizes dry flour and oil, but I'm not quite sure what that oil will be used for. What's your understanding, Mr. Larsen, of the oil that will be legal under this bill? How will people use it and can it be vaped?

Mr. Dana Larsen :

My understanding is this legislation is only...3% THC is the limit that licensed producers are able to make for their extracts, and I think this is the same thing. There are going to be a lot of problems with this. Vaping is very positive too, by the way, if you have concerns with people smoking. Those concerns are often overblown, but vaporizing eliminates most of them. There are no particulates—it's purely just the active ingredients steamed off the plant. You inhale them. It combines the benefits of smoking, which is a quick action, and being able to get your dosage precise without having any smoke involved.

I think vaping should actually be encouraged and considered a better way of using it. Real legalization would mean that Canadian farmers are able to grow high-THC cannabis by the thousands of hectares. That is what we're working towards. When it comes, smoking buds will be less popular, but you'll be able to make extracts of pure THC or CBD or CBG or CBN or the other cannabinoids in any combination you want and vaporize or use those in a way that will be revolutionary and much safer than what we're doing now.

The Chair :

Ms. Sidhu.

Ms. Sonia Sidhu (Brampton South, Lib.) :

Thank you, Mr. Chair, and thanks to all of you all for being here. There is a lot of new learning that I've never heard about before. My question is for Dr. Vandrey. In your recent study on edible products and labelling, you said that only 17% of edible products had an accurate THC content listed, while 60% were “overlabeled”. What makes accurate labelling of THC content in edible products so challenging? Is it the result of a lack of regulation or of producers not having the resources to accurately provide that labelling?

Prof. Ryan Vandrey :

I think it's a combination of the manufacturing practices not being careful enough to put a precise amount of product in each package or in each dose, as well as difficulties with the lack of standards for testing those products.

Ms. Sonia Sidhu :

You've said “education”. Who should be or who shouldn't be using? You also mentioned cardiovascular stress for cardiovascular patients, so high THC or low THC means something...? What types of education tools do we need to be providing?

Prof. Ryan Vandrey :

I think broad education needs to be disseminated regardless. In terms of THC content, you have to define a dose, and the dose depends on the individual and the reason they're using it. Right now, we're talking about non-medical use, so my presumption here is that you have people looking to get intoxicated. You're likely talking about doses that are higher than what potentially would be needed for medicinal uses, but as for what level that is, it's still up for debate and in need of more research.

As any good researcher will tell you, we need more research, but the fact of the matter is there are very few controlled studies of edible dosing with cannabis. What we've found in our laboratories is that we can give the same dose to 35 different people and half of them tolerate it very well and the other half get severely impaired. We have some individuals who vomit after a really high dose, and they consistently get sick when we vary the route of administration. It doesn't much matter if they smoke it, vape it, or eat it: at high doses of cannabis, they get the same types of effects.

Some people are more sensitive to those effects than others. Again, drawing a parallel with other things like alcohol, you can say the same thing. Some individuals can drink six beers and be fine, and others would be throwing up in the corner. How you manage this and how you factor it into regulation is that you want a unit dose that's low enough and is not going to make most people sick. Let the people who can tolerate higher doses consume more but do so in a manner such that they know what to expect and so it's consistent across episodes of use.

When you go to the liquor store and buy a beer, the beer isn't 5% alcohol one time and 10% the next if you're buying the same beer. There's variety and there are differences in beer, but it's labelled with the alcohol content on it, and you need a similar set-up for cannabis.

(0920) Ms. Sonia Sidhu :

I've heard that Colorado is using 10 milligrams. Is there any way to ensure the THC doses are evenly distributed?

Prof. Ryan Vandrey :

Again, Colorado has their system for evaluating and testing those products and they put the ceiling on there. I'll let Mr. Vigil talk about that process, but as long as you get consistent dosing of 10 milligrams there.... We did not do our testing study in Colorado. It was conducted in California and in Washington state. Also, it was conducted only in medical cannabis dispensaries, not in non-medical retail, and it was done several years ago.

I don't know where things stand now, but I think there needs to be a quality control regulatory agency in place to monitor this stuff and to make sure things are accurately labelled, the dose is appropriate, and all of that. Quality control is imperative.

Ms. Sonia Sidhu :

Thank you. My next question is for Mr. Vigil. In July 2016, the Denver Post published a report on the fivefold increase in children's admissions to hospital due to the ingestion of edibles. How can we protect our kids? What are the challenges with the packaging so that the kids aren't attracted to the packaging? Also, what about food safety? What do you think about other jurisdictions that combine edible production and food inspection regulations?

Dr. Daniel Vigil :

First, concerning children and edibles, to answer an earlier question, the hospital data is a mix, I think, of causes. One is likely some increased exposure, but there's also very likely an increase in the willingness to admit to exposure or use. Of course, we've mentioned that childproof packaging is very important, as well as education for parents about how it is not okay to leave this out. It can be dangerous if children are exposed, so keep it in the childproof packaging once you get home. For the appeal, again, that's not something that I can quickly give you a very clear answer on.

I think it's very important to come up with good guidelines and balancing that with the fact that people want these products and want a variety of these products. If restrictions are too limiting, you'll see products that are outside of the regulated system. It's a tough balance. I don't have a clear answer for you on that. Can you remind me of your last part of the question?

Ms. Sonia Sidhu :

It was the food inspection.

Dr. Daniel Vigil :

I think that varies from state to state. In Colorado, any edibles production falls under the general food inspection that they do for kitchens that produce any products that go on the shelves. They are subject to the food safety inspections. In addition, all marijuana products are required to be tested for content of THC, CBD, and other cannabinoids, and for any microbial contamination, pesticides, and residual solvents.

The Chair :

That completes our first round. Now we go to our five-minute round, starting with Dr. Carrie.

Mr. Colin Carrie (Oshawa, CPC) :

Thank you, Mr. Chair. Again, it's a great panel. Thanks to all of you for being here. I want to get right to my questions, because we know that this is rolling out in 288 days. There's not a lot of time, and I think it's really a really missed opportunity. We had Colorado here earlier saying that, really, before we get this rolled out, we should have our public education program in place, with really good factual information—which we don't see here—and data collection should be in place, along with treatment research and things along those lines.

For the last two years, really, the Liberal government hasn't been doing anything, and again, we're jamming all of this into one week. I want to particularly thank you, Mr. Larsen, for being here. I think you're the first person we've had here who is on the ground and actually integrating with and talking to the public about this very important issue and this transformative piece of legislation. I'm going to throw out all my questions, and I'm going to throw all of them out to you, because I only have five minutes. I have four main questions that I'd like you to answer.

First of all, there are a lot of questions about cannabis from parents and educators. What do you do for your clientele on education? When they have questions for you, do you have basic scientific pamphlets and things along those lines? Where do you get your product? How do you assure quality control? Also, I'm curious as to what you would say a good age cut-off would be, and I'm not talking about medicinal use. I'm talking about recreational use. Those are the four questions. I probably only have four minutes left for my time. Would you be able to comment on those four questions, please?

(0925) Mr. Dana Larsen :

Sure. Can you give them to me one at a time again so that I don't forget all the questions?

Mr. Colin Carrie :

First of all, what do you do for your clientele as far as education is concerned?

Mr. Dana Larsen :

It depends on what they're coming in for, you know, but we try to guide them to the right product. Sometimes people who are experienced with cannabis come in. They've used it a lot. They're just looking for a particular product. They don't need a lot of guidance. We also get senior citizens who come in and say that they haven't used cannabis in 50 years but their grandson says it will be good for their arthritis or something. We don't typically stick a joint in their face.

We normally give them edible products or CBD-based products or creams or tinctures or things that are going to have less psychoactivity and more of a medicinal effect. We try to guide them based on what they're looking for and what their experience is. Like for other things, we always tell them to start off with a small dose and then work their way up until they get to the point where they're getting the benefits or whatever it is they're seeking. That's the kind of guidance we try to give.

Mr. Colin Carrie :

Is that a written type of guidance?

Mr. Dana Larsen :

It's mostly oral. We have some written information and pamphlets and things like that too. It depends. A lot of it is just personal conversations with people in one-on-one discussions like you'd have with a pharmacist or a doctor in looking for guidance on cannabis. Sometimes they have a doctor's advice going in, but Canadian doctors don't really know a lot about cannabis or the endocannabinoid system, which is the part of our body's system that the cannabis interacts with, so mostly—

Mr. Colin Carrie :

Do your employees have training?

Mr. Dana Larsen :

Yes, we try to give them training. It varies. We make sure we talk to everybody. If they can't answer the question, we make sure we have somebody there who can.

Mr. Colin Carrie :

Second, where do you get your product?

Mr. Dana Larsen :

It's from the illegal market. By definition, we have no choice. There's no legal place for us to get it. Some is from people who have been growing cannabis for years. Some of them are licensed under the medical program to grow their own cannabis and might have extra, which Health Canada wants them to destroy or dispose of if they have too much. Well, they dispose of it by selling it to a dispensary. There are many people who make edibles, extracts, and things at home. A lot of them don't meet our standards.

The majority of what gets brought to us we reject because it's not the right quality or doesn't meet our needs. It comes from the black market, by definition, but we do our best to make that the lightest shade of grey it can possibly be.

Mr. Colin Carrie :

I have two more questions. You were talking about how you reject a lot of it. What do you do for quality control? Then I have a really important question I'd like your opinion on: the age for recreational use. What do you think a cut-off age would be?

Mr. Dana Larsen :

For quality control, it's a challenge, because we're not able to access Health Canada's certified labs. They will test our cannabis if we have someone send it in who is legally allowed to possess, but if I put it on my website that a lab tested our cannabis and say “here are the results”, Health Canada will call that lab and say that they're going to lose their licence, that they can't test dispensary cannabis. I can put out whatever results I want, but only I know if I'm telling the truth. I can't tell you which lab did the results. That leaves us in a very difficult position. We also do our own study.

The first thing we do when we get raw buds into our dispensary is look at them under a microscope. I would encourage members to do the same thing. You can see a lot in terms of mould, mildew, the quality of the trichomes and the resinous glands, if they're there and they're ripe. That's just the first step. If it most of it doesn't pass that, we will do a taste test on it. Someone will smoke a bit of it. You can tell if there are chemical contaminants and if it's been over-fertilized. Then we'll send it to a lab, if we can, and after that, if it meets all the standards, we'll put it our shelves.

On edibles and other products, with edibles we typically supply our producers with our cannabis, with an extract, so that we know they're getting a standardized amount and we know where it comes from. We can give them the same strain or a very similar product to help them standardize what they're making. A lot of edibles makers don't use raw buds. They will use an extract so they can make something of a known potency and then put that into their product to help them standardize the dosages. As to age limit, if I were in charge of the world, I'd make it 16 years old to buy cannabis from a legal place....

That being said, I'm happy with the limit being the same as alcohol. That's not a problem. The one thing I see lacking in this legislation is that there is no allowance for a parent to give cannabis to their child. You can give alcohol to your children at pretty much any age. A lot of young kids have half a glass of wine with dinner, and we don't criminalize those parents. If those parents were to give their children cannabis or share a joint with their 17-year-old child or something, they could be criminalized and face some serious repercussions. I think that is an issue.

To me, the use of cannabis by youth is a family issue to be determined at the family level. This legislation doesn't allow for any sort of family decisions on that, which I think is really a big problem.

(0930) Mr. Colin Carrie :

You've been a great help. Thank you.

The Chair :

Mr. Oliver.

Mr. John Oliver (Oakville, Lib.) :

Thank you very much for your testimony. This is our last day of a full week of testimony on this bill from people in the industry and consumers from different walks of life. By the end of this week, we will have heard from 100 or more different witnesses. It's been excellent. If we had done this in our normal process, we would have been at it for about three months. This has really allowed us to delve deeply into the issues, and it's allowed us to compare and contrast testimony, which is often difficult to do when you have it stretched out so much.

When we come to clause-by-clause, I think the edibles will be the one that we're really reviewing. Right now, edibles are excluded from the legal definition of marijuana, so they wouldn't be permitted. I'm going to give you what I've heard in terms of the pros for including and the cons for excluding and ask you if there's anything I'm missing in this analysis. On the positives for including edibles, I've heard it's public health: otherwise, we're encouraging smoking and ingesting of cannabis through smoking. Edibles give you a healthier alternative for ingesting cannabis.

Second, what I've heard is that if we don't bring it into the legal market, it really does allow the black market or whatever market to really continue and to grow in that particular market space. I think Mr. Larsen spoke to that quite pointedly. Those are the two reasons I've heard for inclusion. On the reasons for excluding, I've heard that this is a social change, a social experiment for Canada, so go slow and see how what you have is working before you push on to a greater market. Kids' access and kids' accidental ingestion seems to be higher with edibles than with products that you need to smoke.

Also, this is hard to regulate and hard to inspect. There's more complexity in edibles than in the more raw plant, although with the work they've done in Colorado, I think there are some pretty good and easily adapted regulations in place. The fourth point has been, “What the heck, it's easy to make at home, so if people want the edibles, they can go and get them.” Those are the pros and the cons. I rambled through them quickly, so is there anything else you think I should know as we're thinking about the pros and cons of edibles? Is there anything you'd add to those lists?

Dr. Daniel Vigil :

I have a very slight clarification on your first point. With edibles, you do avoid any of the possible pulmonary effects of smoking. There is one concern that I think is a bit greater with edibles, and that is driving. The fact is that with an inhaled product you can quickly recognize what the effects are and give yourself time to overcome those effects or get back to a safe place to be driving, but with edibles, it's possible that you would not realize that you haven't felt the full effects and potentially would get behind the wheel.

Mr. John Oliver :

The variation in speed of the digestion is different.

Dr. Daniel Vigil :

That's right.

Mr. John Oliver :

Mr. Vandrey.

Prof. Ryan Vandrey :

In the laboratory studies we've done where we acutely dose people with different routes of administration, I think it's important to note that when we give people smoked cannabis versus edible cannabis, the magnitude of drug effects and the types of effects are identical. It's really just the differences in the time course of the effects. I have not seen any evidence that eating it is more dangerous than smoking it, and I would disagree on the argument that you can't perceive the intoxication when you eat it. People are very aware that they're intoxicated.

The challenge is in detecting edible cannabis in a driver who is impaired versus not, but that's a problem across the board independent of route of administration. It is a little different in edibles, in that you get lower blood concentrations.

Mr. John Oliver :

Just quickly, for all three of you, would you recommend that Canada include edibles in their allowables, or would you support the slower pace that has been proposed in the legislation? Mr. Larsen.

(0935) Mr. Dana Larsen :

I support adding edibles and also other extracts as well, such as hashish and all those kinds of things, both smokable and edible. That has to be part of legalization; only allowing the buds is missing out on a large portion of this. Yes, I absolutely think this should be included. On this go-slow thing, we've been going slow since 1971. It's time to act, not to go slow.

Dr. Daniel Vigil :

I think ultimately they should be included, but it's very important to get it right. If that takes some time and some learning from the smoked market, I would be in agreement with that.

Prof. Ryan Vandrey :

My personal recommendation would be in favour of regulation and quality control over all products. I think that's the greater public good, rather than just allowing one version and then continuing to have black market product available where you don't know what's in it. I think that makes the most sense.

The Chair :

Thank you very much. Mr. Webber.

Mr. Len Webber (Calgary Confederation, CPC) :

Thank you, Mr. Chair, and thank you to the panel. My first question is for Dr. Vandrey. As a cannabis researcher, you mentioned that you evaluate label information on products to determine whether it is are accurate or not. That is correct? For Colorado and Washington state licensed producers, have you found that their labelling is quite accurate?

Prof. Ryan Vandrey :

Again, I have not conducted any testing in Colorado. The State of Colorado does their own testing. Maybe Mr. Vigil could talk about the outcomes of the tests they have done. The testing I've done in Washington has been limited to medical cannabis dispensaries, which at the time was distinct from non-medical dispensaries testing. I believe that at that time the regulations over products being sold in medical cannabis dispensaries were not very rigorous, and the testing we found there indicated that most of the products were inaccurately labelled.

Mr. Len Webber :

That's interesting. Mr. Vigil, on accidental exposure, in your remarks, you mentioned incidents. Do you see a lot of that occurring in your neck of the woods?

Dr. Daniel Vigil :

The term “a lot” is I think important to comment on, because we have seen an increase, as I mentioned, in both poison centre calls and emergency department visits, relative to other reasons that people are making those calls—

Mr. Len Webber :

I'm referring specifically to accidental exposure for children—

Dr. Daniel Vigil :

Right, so let's focus on the zero to eight-year age group for accidental exposure. With regard to poison centre calls, at the peak in Colorado, for one in 10,000 children there was a call related to marijuana. I'll also mention that outcomes related to that were not severe. The majority of those were just some concern—

Mr. Len Webber :

Was that through ingestion of an edible?

Dr. Daniel Vigil :

Some portion of those were about smokable marijuana. Children can pick up a bud and put it in their mouth as well. The majority were edibles.

Mr. Len Webber :

What are your thoughts on home cultivation, at four plants per household? Do you think that should be allowed?

Dr. Daniel Vigil :

I think it's going to happen whether you allow it or not, so, again, bringing something into the regulated market is probably better than having it unregulated. In Colorado for home-grows, the real problem we've run into is extended plant counts and the ability for a caretaker in the medical realm to grow for multiple people, so you have these very large grows that on paper are legal but are really contributing to the black market and diversion.

Mr. Len Webber :

Mr. Larsen, I don't know where B.C. is going to go with its distribution decisions, whether it will be with something like the LCBO. I don't even know whether or not they have a liquor control board in B.C., but you've heard where they're going here in Ontario. They've already started to shut down some dispensaries and to arrest the individuals inside. It has occurred in your environment as well, I'm certain. If the B.C. government determines that you cannot do this, you indicate that you will continue to have customers shop with you anyway. I question that. I don't know if you have a storefront right now.

I have no idea about dispensaries, Mr. Larsen, because I've never been in one and perhaps I'll come to visit yours just to learn some more about it. I just don't know how you will continue to operate if your government in B.C. decides to have it in a more controlled environment.

(0940) Mr. Dana Larsen :

It's an interesting point. Let's make it clear. They are trying their hardest in Ontario to get rid of dispensaries already. They've been trying for a while and they are failing miserably. There are dispensaries in every major city in Canada, and in most minor ones now, just as there are bong shops. I told you that bongs are illegal, too, and we fought, and we were raided, and people went to jail over bongs big time in the 1990s. The problem you have in enforcing these laws is that the courts are not willing to give us severe penalties, and we have an overburdened justice system.

They laid dozens of charges in Toronto and they've kept only a handful of them. In the Cannabis Culture raid when they went after Marc and Jodie Emery and a few others, not a single one of their suppliers was arrested or charged. They're selling cannabis from many companies that have labelling, websites, and phone numbers where you can call them, and people are selling extracts. They could easily, if they wanted to spend the time and effort, go after these people. They're not, because the police and our justice system are not able to handle this kind of mass civil disobedience campaign that we're engaging in.

We like the phrase “overgrowing the government”. There are too many of us willing to go to the end on this for you to keep up. Do you really want to put me in jail for selling cannabis? Is that where you think I belong? I'm going to keep doing it, and that's going to be the only option. I'm going to keep giving away seeds, and I'm going to keep using cannabis.

Mr. Len Webber :

Do you charge tax on your products—GST, PST?

Mr. Dana Larsen :

Some dispensaries do, and some don't. We don't right now, but we're transitioning towards that, and I would be happy to do that. We're happy to follow reasonable regulations. I'm not an anarchist who doesn't want to follow the rules, but if the rules are saying that I can't operate and I can't exist, then of course we're going to break those rules.

Mr. Len Webber :

Are you paying taxes? Do you file?

Mr. Dana Larsen :

Oh, yes, we file taxes. All of our staff are registered. We do all the deductions and all those kinds of things as well as we can. I can't speak for every dispensary. There are hundreds across Canada. Some operate in many different ways than do others. But you can't stop us. You don't have the capability and the policing and the courts to deal with what we're doing. That's why it's been so successful, and we're going to keep doing that. The rules have to take that into consideration, that there is already a vibrant and dynamic cannabis industry, and we are committed to what we're doing.

That needs to be incorporated into legalization or else you have to find a way to compete with us and produce better products at a lower price with a higher selection and higher quality. If you do that, we'll go out of business, and I will consider that a victory on my end. If my dispensary can't operate because there is better, cheaper, higher-quality cannabis available from a legal source, then I've won. I don't need to run a dispensary. I just want cannabis to be legal and available, so that's how I see it.

But until that day comes, as long as my dispensary can provide products that aren't legally available, that people want to get, we'll keep doing that.

The Chair :

And now I have to stop you. Doug Eyolfson, it's your turn.

Mr. Doug Eyolfson (Charleswood—St. James—Assiniboia—Headingley, Lib.) :

Thank you very much. I have the disadvantage of being down the list, which means that a lot of the questions I thought of have already been asked. I might have to expand on some of the stuff we've already talked about, so there may be a bit of repetition. We had testimony yesterday from different international experts, in particular from Great Britain. They're watching us quite closely. Again, we're getting competing testimony from different corners about how to go ahead with this. It was pointed out that this is a fairly new thing we're doing. Only one nation on earth has ever legalized this.

On a national level, we're number two. We've heard a lot of evidence saying that we should take a cautious, step-wise approach. We are committed to regulating edibles. We just haven't started with that yet. We understand that Colorado had some challenges. Mr. Vigil, I understand you had challenges with edibles in the beginning. Could you expand on some of the problems you had with edibles at the initial rollout and on whether or not you agree that it's a good idea for us to be rolling this out more gradually?

Dr. Daniel Vigil :

Really, our primary concern initially was seeing an increase in calls to the poison centre and emergency department visits, in particular among younger age groups. We had a few cases of over-consumption leading to accidents. That was the impetus to try to increase regulation. As to the delay in rolling it out, 288 days doesn't seem like enough time for you to get all of the edible regulations together.

I'm not a legislator, so I don't know, but I guess I would recommend erring on the side of giving it more time, not only to work on the legislation but also to continue to learn more from other jurisdictions, like Colorado and the other states in the United States, that have legalized. I mentioned that we've seen, for one year, some decrease in those numbers. We'd like to see what happens with the data that's coming up next spring. The more of that information you have, the better decisions you can make.

(0945) Mr. Doug Eyolfson :

Dr. Vandrey, we talked about packaging. You want to make it non-appealing and childproof for edibles, which I would agree with. Now, we had a discussion yesterday regarding plain packaging and some of the precedents set in the tobacco industry, particularly the success that Australia has had with decreasing smoking. Despite the misinformation from the tobacco industry about this, it does appear to have cut down smoking rates. Would you recommend, not just in edibles but in basically all cannabis products, plain packaging—the way that we're going to be moving, and the way Australia has, with tobacco?

Prof. Ryan Vandrey :

For cannabis, I think it would be very wise to learn from the lessons of tobacco and alcohol regulation, very clearly. Recognizing the harms with over-consumption, recognizing the harms with advertising—it's all relevant here. It seems silly to recreate the wheel for cannabis rather than to learn from or use alcohol and tobacco regulation as a model for how to best roll out cannabis, or to look at what's currently being done in Uruguay or in the states in the U.S. that have already legalized non-medicinal use. You have models there. You have regulations on the books in those states and in Uruguay.

Look at what they've done and talk to them about what their limitations are, about what they would do if they could go back and change it. Potentially you could come up with a maybe slightly improved model. The key here is that you really need to establish, and you need to have confidence in, what your unit dose will be and how you will test and do quality control. If you solve those issues, then I think the rest of it should fall in place.

The Chair :

Time is up. Mr. Davies, you can have the last question.

Mr. Don Davies :

Mr. Vigil, how long has Colorado been regulating edibles?

Dr. Daniel Vigil :

They were part of our initial legalization passed in 2012. Dispensary sales were allowed to begin January 1, 2014.

Mr. Don Davies :

It seems that everything I've heard about the experience of legalizing cannabis, whether in the Netherlands when they did it, or in Colorado, Washington, or Alaska, is that when you legalize, there is a spike in pretty much everything, and then it levels off, and then things drop. Am I correct that that's sort of what happened in terms of the accidental ingestion? When it was legalized, I would presume, more people tried edibles because they were legal; some people had experiences with them; there were more poison control calls; it levelled off, and now you're seeing a drop. Is that correct?

Dr. Daniel Vigil :

We're seeing a slight decline from the peak, but it still remains higher than it was previously. By the way, you say everything, but in terms of use, we have not seen increases in youth or adult use.

(0950) Mr. Don Davies :

We heard evidence from Colorado that there was an increase immediately after legalization and then it started to drop after that. Am I wrong about that?

Dr. Daniel Vigil :

There was not, according to our primary data sources.

Mr. Don Davies :

In terms of regulations, you said we should go slowly. Could we not just adopt Colorado's regulations on edibles? Where are the gaping holes in Colorado's legislation, things we don't know?

Dr. Daniel Vigil :

We don't think we've perfected it, and there are limitations within the system. For example, with our laboratory proficiency testing, we've had challenges. A lot of these come from the federal limitations. There are things, particularly pesticides, that for all other products are regulated at a federal level, and those resources aren't available to us for cannabis. There is a variety of ways in which we would not say that our system is perfect and adoptable.

Mr. Don Davies :

Nothing is perfect; we're in politics. In terms of getting the major things right, the single servings, the childproof containers, the no marketing to children, the stamped products, and some form of regulations about potency and dosage, I presume those are done in Colorado. Are they?

Dr. Daniel Vigil :

Yes.

Mr. Don Davies :

What are we waiting for? What else don't we know about the regulatory framework in Canada that would make it preferable to leave it totally unregulated right now, with none of those things, while we wait to learn exactly what about the regulations? I'm puzzled.

Dr. Daniel Vigil :

You could certainly make a reasonable argument to regulate and to perhaps be more restrictive at first and to allow more later. I think the danger in having looser restrictions is that you would later see that you wanted to tighten those up. I would not unwaveringly argue that you have to wait. I would say that if you can get very solid regulations in place and do that quickly, then it should be fine.

Mr. Don Davies :

That's my question. Does Colorado have solid regulations or does it not?

Dr. Daniel Vigil :

I think we have solid regulations. I think we have some room for improvement still.

Mr. Don Davies :

Sure. Mr. Larson, I think we've heard lots of evidence about the damage criminalization has done to Canadians. Many of the harms associated with cannabis are directly related to the criminalization of cannabis, not cannabis itself. Bill C-45 , I think we all would acknowledge, makes progress, but it retains a criminalized approach. There are criminal sanctions for possession over 30 grams, criminal sanctions for growing over four plants of over 100 centimetres, criminal sanctions over selling, punishable by penalties of up to 14 years. If criminalization has failed and caused harm, won't Bill C-45 continue to do that at least to some degree?

Mr. Dana Larsen :

Absolutely. There is more criminalization in this bill than we already have in some areas, and that 14-year penalty also means there are no conditional discharges available as well, which I think is a big concern. Speaking as a member of the cannabis movement, I know that we don't really need the government's help in getting high-quality cannabis products. We just want the government to stop arresting people, and that really should be the focus of this legislation.

It's shameful to me that we haven't decriminalized cannabis possession already, that this wasn't a big priority and it hasn't happened yet, but that is the flaw in this legislation, and it's treating cannabis much more severely than alcohol is treated. Yet by any measure, cannabis is safer than alcohol, and I think that everybody who has testified would agree with that idea. If we're going to restrict cannabis more than alcohol, that will drive people towards alcohol.

If we're going to restrict advertising and packaging and all these things for cannabis more than we do for alcohol, that means we're saying we want people to drink alcohol instead of using cannabis, and I think it should be the other way around. The idea that we've made mistakes with alcohol and it's too available so we're going to tighten up with cannabis is absolutely backwards. Cannabis is safer and should be treated like that. To continue to criminalize people because of the cannabis they have on them, or any of this, is entirely the wrong way to go.

(0955) The Chair :

Okay, thanks very much. That completes our normal round of questioning.

Ms. Marilyn Gladu :

Yes, Chair, I'd like to move to seek unanimous consent to have another round, because we have about half an hour left.

The Chair :

Do we have unanimous consent for another round? We have unanimous consent. Mr. McKinnon.

Mr. Ron McKinnon (Coquitlam—Port Coquitlam, Lib.) :

Thank you, Chair. Mr. Larsen, I'd like to find the low-hanging fruit, if you will, about edibles. In your shop and in your experience with other shops, what do people want? What are the most popular products, say, perhaps, your top three sellers?

Mr. Dana Larsen :

It really depends on what they're looking for. Some people just want to feel good and get high, and some people have a medicinal need. They have pain or they have cancer or a systemic ailment, and they need a different kind of treatment. So it really depends, but edibles are less used recreationally because of the fact that they can be stronger, and because of the difficulty of titrating the dose. Most people I know who use cannabis smoke it primarily or use extracts as well.

That's something that I keep trying to bring up, that isn't part of this conversation, things like shatter or hash or other forms of inhalable cannabis that are made. Those are also very popular as well, and they allow you to smoke less cannabis to get the same effect. If we're concerned about smoking, if you have one hit off one thing or you have to smoke a whole bunch of something else, probably the stronger one is the safer one in that regard.

Mr. Ron McKinnon :

We're trying to talk about edibles here.

Mr. Dana Larsen :

With edibles, the question is what do people seek or why are they taking edibles?

Mr. Ron McKinnon :

No, what are the most popular?

Mr. Dana Larsen :

The most popular edibles are things that taste good. People like treats. They don't really want to take capsules or things if they can have something that's yummy. We definitely sell more things that are delicious than things that are less tasty, absolutely. That's just human nature.

Mr. Ron McKinnon :

We can't really come up with legislation that says “let's regulate treats.” We need something a little more specific, if you can.

Mr. Dana Larsen :

You could put cannabis into all kinds of food products. Some people like to buy infused butter so they can add it to their own food and put it on toast or put it into foods themselves.

Mr. Ron McKinnon :

Do you sell a lot of infused butter?

Mr. Dana Larsen :

We sell infused butter; we sell infused oils; and we sell different kinds of edible products. We sell savoury things as well, but normally they're kind of snack foods.

Mr. Ron McKinnon :

What are the top three edible products that you sell?

Mr. Dana Larsen :

I'll have to think about that a little bit. We sell some drops that are very popular; those aren't really edibles. They're drops made with infused hempseed oil. They're like an edible. I would say that cookies are incredibly popular, and people like different kinds of cookies. We sell a fair amount of CBD products that have very low or no psychoactivity but have medicinal benefit. CBD edibles are becoming more and more popular as well.

Mr. Ron McKinnon :

Okay. With regard to home-grow or personal cultivation, one of the concerns is the potential for diversion to the illegal market. Do you see that the regulations limiting the number of plants and so forth are necessary to prevent that diversion, and will they in fact prevent that diversion?

Mr. Dana Larsen :

It depends on what you mean by “diversion”. It's hard to sell the cannabis you're going to get from four one-metre plants. You're not going to get that much, but certainly, sharing it with your friends, I think that'll happen. If you really want to stop people from diverting cannabis, make it cheap. The only reason that people grow and sell cannabis is that it's very expensive and very profitable when this plant is worth $5 to $10 a gram. It doesn't matter if it's legal or not. If I can grow a plant in my home that's worth $1,000 and then sell it.... People are going to do that.

The way to stop diversion and to get people to not be doing that is simply to make cannabis much more affordable, to make the price lower, to where it should be for a natural product. It's the only plant we sell by the gram, and not by the pound, so I would like to see cannabis at $1 a gram or something like that. It's still an incredibly high price for a little bit of plant matter, but if there's no profit in it, that would eliminate the vast majority of diversion. If legal cannabis maintains the same price structure as illegal cannabis, then the illegal market will continue.

That's just how it's going to be because of the profitability. That's the real question. I think most people growing four plants at home are going to grow it for themselves or to share with their friends and family. They're not going to be selling it, because the profit margin isn't that great for just a few plants. You're going to want to have a bigger grow to really satisfy the underground market. I think that's where most of the underground market will remain.

(1000) Mr. Ron McKinnon :

Let's go back to packaging, if I have time. For the edible products you sell, what's the packaging like? Are these like home-cooked products or are they manufactured in some way?

Mr. Dana Larsen :

It's sort of halfway between those things. We strive for a professional product, but it's very difficult to access mainstream bakeries or places to make products if you're going to be making cannabis products. As a result, we are forced into this kind of area where they're made at home or on a small scale. We use childproof packaging. We do our best to label our products with an accurate level of the cannabinoids that are in there, although that's a challenge, simply because of the testing available and because dispensaries can't fully access that kind of testing.

Mr. Ron McKinnon :

What do you think of—

The Chair :

Your time is up. Dr. Carrie.

Mr. Colin Carrie :

Thank you, Mr. Chair. I'll be sharing my time with my colleague. Again, Mr. Larsen, I'd like to direct this question to you, and again, thanks for being here. Obviously you're very knowledgeable, and I would think that your input and your knowledge about how things are today in Canada on the ground are very important. I'm curious. As far as you or anybody involved in the production/distribution field goes, was anyone you know consulted in reference to the rollout of this as a public policy or the drafting of this bill? Was any consultation done by the government with anybody you know?

Mr. Dana Larsen :

No. Do you mean the task force that was initially put together and that kind of thing? Some people were. I wasn't invited to speak to that task force. Some of my allies or friends were, but I found that just regular cannabis users aren't really in part of this discussion so much. I use cannabis every day. I used cannabis this morning before I came here, and I'm going to use some afterwards when we're done. I think that voice of the typical users is perhaps missing. No, I haven't seen a lot of consultation among the cannabis community in that way.

Ms. Marilyn Gladu :

I'd like to move:

That, pursuant to standing order 108(2), a minimum of 6 meetings be added to the committee's current study of Bill C-45, (An Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts), and that these meetings be scheduled following the appearance of the Minister of Health, Justice and Public Safety on the week of September 18th.

The Chair :

Dr. Eyolfson.

Mr. Doug Eyolfson :

I move that the debate be now adjourned.

The Chair :

We now have a vote on that issue. We're going to have a vote on Dr. Eyolfson's motion.

Mr. Colin Carrie :

I'd like a recorded vote, please.

The Chair :

All those in favour of the motion to adjourn debate? (Motion agreed to: yeas 5; nays 4)

The Chair :

The motion has succeeded, so we've adjourned the debate on that issue. We'll go back to the regular one. You have a minute and a half to go.

Ms. Marilyn Gladu :

All right. Mr. Vigil, will childproof packaging keep 12- to 17-year-olds from being able to open those packages?

Dr. Daniel Vigil :

Absolutely not. No.

Ms. Marilyn Gladu :

So it's absolutely no protection at all. What kind of recommendations would you have? We're trying with this bill to keep cannabis out of the hands of young children. The concern is that when people bring edibles into the house, they are attractive. They're candies or cookies or suckers, all the things that kids would want to have. In light of the overdose situations we saw in Colorado, should people be locking them up?

Dr. Daniel Vigil :

Yes, I think they should. As far as regulation is concerned, we don't regulate to that degree for products that people bring home. There is regulation that for home-grows they have to be locked in a locked area if anyone under 21 is in the home. Really, within that age range it becomes much more important to have education for parents and others who care for children, or who have children around, that if they're using these products, they should keep them locked up. Then, of course, there's the education for children about the possible dangers of using them.

(1005) Ms. Marilyn Gladu :

Very good. How much time do I have?

The Chair :

You have 28 seconds.

Ms. Marilyn Gladu :

I'll just end with a comment then. Mr. Larsen, with all due respect, I find your lack of respect for the rule of law in this country disturbing. It's clear that it doesn't matter what we come up with in Bill C-45 . You're going to do whatever you like and obey whichever laws you like, and I don't personally approve of that. Thank you.

Mr. Dana Larsen :

I believe in the Charter of Rights.

The Chair :

Now we go to Mr. Davies.

Mr. Don Davies :

Thank you. Mr. Larsen, I want to thank you for being here. You're the only dispensary owner we heard from, out of all the witnesses we heard this week—the only person involved in the actual edible market and familiar with the products on a day-to-day commercial basis. I think it's very valuable to have your perspective here. First, Mr. Larsen, if we don't legalize edibles, there will be no way to test the THC levels, the CBD levels, and all the other different compounds.

Products will still be consumed by Canadians, it appears to me, who will have no real assurance of the content, since, as you said, you can't send these products to accredited Health Canada labs to make sure that these products are what they say they are. Am I missing something there?

Mr. Dana Larsen :

No, that's all accurate.

Mr. Don Davies :

Okay. You mentioned the issue of decriminalizing now. Have you faced any legal charges, or have people who are patronizing your store faced any criminal enforcement actions against them? If not, how has the current criminalized environment affected you and the customers who come into your store?

Mr. Dana Larsen :

Vancouver has had a more progressive attitude towards cannabis for quite awhile. Possession arrests are very, very rare in Vancouver compared with other jurisdictions. You'll be hearing from Hilary Black, who started Vancouver's first dispensary. That was about 20 years ago. We opened ours in 2008. We were the third one in the city. Now there are quite a few. In Vancouver I've been breaking cannabis laws every day for pretty much all my life. The first time I was ever charged was for giving away low-THC cannabis seeds in Calgary last year. It really varies by jurisdiction.

What we enjoy in Vancouver is certainly not the same as the rest of the country. The further north you go in Canada, the rate of possession and trafficking charges increases drastically. I believe that's largely because our first nations population also increases drastically the further north you go. It really varies across the country how these laws are enforced, which is another example of how it's not just. I can do something in Vancouver that I can get away with, but if someone in another part of the country did the same thing, they'd find themselves in a very serious legal situation.

Mr. Don Davies :

We heard Mr. Webber comment today that he's never been in a dispensary. I think he's probably not alone on that in this committee. I have the benefit of being in Vancouver, where I've had the ability to tour several dispensaries, including the Compassion Club and some licensed facilities. We as parliamentarians are studying this bill, and we have to make recommendations to this bill about all sorts of issues. We have not toured dispensaries. We have not toured licensed producer facilities or compassion clubs.

Do you think it would be helpful for the parliamentarians on this committee to actually get out in the community and tour some of these facilities in order to help us evaluate whether this bill is good as it is or whether it could be amended?

Mr. Dana Larsen :

I think that would be very worthwhile. To get an understanding of what's really happening and of the limitations of the laws that you're trying to pass and the limitations of the ability to enforce the laws you're trying to pass, I think it would be very important to see what's actually happening at the grassroots level, and also really to see the people who are benefiting from accessing dispensaries and how it improves their lives and how it benefits our local communities. There are all kinds of dispensaries.

I'm not saying every one is run perfectly by any means, but from what I see, people are glad to have dispensaries. The dispensaries benefit them and provide a lot of positive results. I think it would be very worthwhile to see what's happening at the grassroots level and what people are doing and to understand that the current cannabis laws are already being ignored pretty much all across the country to varying degrees.

If you're not going to take that into consideration when you pass these new laws, they're going to be a failure, because we will continue to ignore these laws, and the courts will back us up on that. You talk about the rule of law. Some people would say that we have a moral obligation to break unjust laws, that when laws are punishing people who do not deserve to be punished, when laws are based on racial bigotry and ignorance of how these laws were founded, that we have a moral duty to break those laws. I personally am glad to have been able to provide cannabis medicines to those who need them.

I believe I am improving people's lives every day, and we will continue to do so.

(1010) Mr. Don Davies :

Some have suggested that once this legislation is in force and it legalizes simple possession and a few other things, that we as a Parliament should take steps to pardon those who have been convicted of crimes that this legislation will render to no longer be crimes. What's your view on that?

Mr. Dana Larsen :

I think we should go further than that. If I were in charge, I would put GST on cannabis and for the first few years, I'd put that money into a fund to make reparations to those Canadians who have been unjustly imprisoned or had their lives negatively affected by cannabis prohibition. I really think that the legalization of cannabis should begin with an apology to the cannabis culture and to cannabis users for a hundred years of punishment and incarceration and harassment and demonization that were entirely undeserved.

Not for me personally but for the people in Canada who have suffered from this, I would like to see not only a pardon but an apology and some kind of restitution made. These laws have been unjust from the beginning and they remain so today. We've known for decades that these laws do not work and that they're a failure, and it's a real shame that people are still being arrested every single day. A guy spent three nights in jail recently for a couple of grams of cannabis in Canada.

It should be shocking to the conscience of parliamentarians that laws are in place that put people in jail for three days for a couple of grams. They say that the time of greatest growth of cannabis use in Canada was in the 1960s, at a time when there was a six-month mandatory sentence for possession and a seven-year mandatory minimum sentence for growing or importing any quantity of cannabis. That was the time of the highest increase of cannabis use in our country's history.

The idea that these laws have an impact on people's behaviour, and that if you say that you can't smoke cannabis anymore, we're all going to stop is entirely backwards. Now we're living under mandatory minimums that were passed by Stephen Harper in Canada. Those haven't stopped the proliferation of dispensaries at all. I think you need to acknowledge the limitations of what Parliament and the police can do in this kind of a situation and write laws, craft laws, that acknowledge those and take those into consideration.

The Chair :

Your time is up, Mr. Davies. Now we go to Mr. Oliver.

Mr. John Oliver :

Thank you very much. One of the advantages of this model we're using is that it is an excellent model for us to hear from many witnesses in a condensed time frame. I think this is the seventh time we've actually been able to do another round of questions, which often in our normal set-up we don't have time to do. It has been a good process for us. I had a town hall in my riding of Oakville and had a good 100-plus people turn up, just people, the general public, who turned up to talk about the legislation and pros and cons. One gentleman really hit home with me.

He was really concerned about second-hand smoke from marijuana. He was worried that if he was exposed to it and he got in a car and drove that he would show trace amounts, and he was worried about different health aspects of it. Dr. Vandrey, I think you have done a study on second-hand smoke from cannabis on non-smokers. Could you share with the committee some of your findings from that study?

Prof. Ryan Vandrey :

We ran a research study where we exposed people to second-hand cannabis smoke under different conditions. One was a ventilated room environment, and one was an unventilated environment, and then within the unventilated environment we varied the potency of the cannabis that people were smoking. We found a substantial impact of room ventilation on the amount of exposure.

In terms of drug testing, whether someone would test positive or not after exposure depended on how we were testing and what cut-offs were used, but we did find that in an unventilated environment positive tests would be possible for both urine and blood, as well as saliva or oral fluid. The duration when you could be positive depended on how you were tested and what cut-off was used. Becoming positive under those circumstances was really limited to the unventilated environment, where the room air was dense with smoke.

When the air conditioning or the HVAC system was turned on, people were not impaired and generally tested negative. Second-hand smoke exposure is a real concern. It's a real thing, but it's hard to be impacted by that unknowingly. Indoor second-hand smoke regulations are appropriate, the same way they are for tobacco use. We have not done the parallel study with vaporization, so we don't really know the level of second-hand exposure with vaped cannabis versus smoked. Then there are obvious limitations beyond that. For the study we did, we exposed people for one hour, one time.

That doesn't tell us anything about what happens if they are exposed for a longer period of time, or a shorter period of time but repeatedly. Again, this is an area where more science is needed, but our study demonstrated that you can get a slight intoxication and test positive in an extreme exposure environment.

(1015) Mr. John Oliver :

Thank you very much for answering my question. Those are my questions.

The Chair :

That completes our additional round and our normal round. On behalf of the committee, I want to thank all the panellists. You brought great perspective and different perspectives than what we'd heard, and we appreciate them very much. I walked down Sparks Street the other night in a cloud of smoke, and I think if somebody had tested me, I would have tested positive by the time I got to the end of the street. With that, I will suspend the meeting until 10:45. Thank you very much.

(1015) (1045) The Chair :

Welcome to our Standing Committee on Health meeting number 68. We're studying Bill C-45,

an act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other acts . We're now going to focus our panel on medicinal marijuana. Our witnesses today are, from the BC Compassion Club Society, Hilary Black, founder, and Marcel Vandebeek, administrator. From the Canadians for Fair Access to Medical Marijuana are Jonathan Zaid, executive director, and Daphnée Elisma, Quebec representative.

From the Department of Health, we have Jacqueline Bogden, assistant deputy minister, cannabis legislation and regulation branch, and David Pellmann, executive director, office of medicinal cannabis. We're going to ask each organization to give an opening statement of 10 minutes. You can share the time with each other, but the maximum is 10 minutes per organization. We'll start with the BC Compassion Club Society.

Ms. Hilary Black (Founder, BC Compassion Club Society) :

Good morning, and thank you for having me here today. My name is Hilary Black, and I'm the founder of the first medical cannabis dispensary in the country, founded in 1997. In the interest of disclosure, I am also employed by a licensed producer, but I am here today representing the BC Compassion Club Society, and thank you for having me. Cannabis legalization will affect some of the most vulnerable members of Canadian society, critically and chronically ill patients. We are offering you seven recommendations in our submission to assist you in prioritizing patient needs.

My comments today are focused on three main areas: transitioning the BC Compassion Club Society into the legal market; facilitating affordability; and supporting research. This submission additionally addresses the need for a legal range of products and advertising education restrictions. My colleague, Marcel Vandebeek, will be making some comments about the need to eliminate barriers for small-scale growers. We have been distributing medicinal cannabis openly and safely for over 20 years. We are a non-profit society with over 11,000 registered patients. We have a subsidized wellness centre.

Last year alone we provided 3,400 holistic treatments like massage, counselling, clinical herbalism, and nutritional counselling for little or no cost to our membership. We are a front-line harm reduction organization. Our clients are often marginalized, have numerous diagnoses, mental health issues, and substance issues. They fall through the cracks of the health care system until we catch them. We have developed a gold standard of education. We know how to maximize benefits, minimize risks, and avoid adverse effects. We offer each member a 60- to 90-minute intake and education session.

This is not possible in a pharmacy. Our community supports us, our neighbours, businesses, local police, health care practitioners, and patient organizations. We are a community. We have Christmas parties, picnics, and neighbourhood cleanups. The courts have repeatedly commended our work. In 2002, the Special Senate Committee on Illegal Drugs toured our facility and recommended that our model be replicated across the country. I was nominated by Senator Pierre Claude Nolin—may he rest in peace—and received a Diamond Jubilee Medal recognizing our significant contribution to Canada.

Our model is enshrined into Vancouver's city bylaws with incentives to encourage the replication of our services because our practitioners have up to a three-year wait-list. Members of the task force visited us last September. You are all also invited to come and visit us.

When they released their report, Anne McLellan said that what they learned there, putting aside certain issues of illegality, is that there can be a holistic, wellness-based, street-level approach that serves generally a highly marginalized population, and that this is a model that the report references and suggests the government should take a look at going forward. Despite this extensive recognition from many levels of government, as cannabis is legalized, we are at risk of becoming more criminalized than we were for the past 20 years.

We have a massive responsibility to ensure that the health care of our members is not interrupted, and we respectfully suggest that you share that responsibility with us. We are a historical medical cannabis institution. We implore you to do everything in your power to protect the roots of this industry. Washington and Colorado prioritized transitioning long-standing medical cannabis dispensaries into the new framework, and we should be following suit.

For decades I have watched patients struggle, choosing between purchasing the medicine that allows them to function and other necessities, such as having groceries in their fridge. The problem is the status of cannabis. It's not an approved medicine. Access has been granted through the courts. It is again a category of one and not treated like other medications, although many patients access it through physician authorization. This status is problematic for both tax and insurance. Both of these could be solved by creating a fast-tracked regulatory pathway for cannabis to be an approved drug or medicine.

For good reason, we do not tax other prescription medications. The courts have stated in Hedges v. Canada that legislation imposing tax on medical cannabis resulted in confusion and uncertainty and needs work. Another solution is to amend the Excise Tax Act to ensure medical cannabis is zero rated like other medical necessities and prescription medicines to relieve this unjust financial burden. I'd like to introduce to you Mounia Lahbabi, who has worked at the House of Commons as a parliamentary assistant to MP Peter Julian for over 12 years.

She has been prescribed cannabis for her medical conditions diagnosed while employed by the House of Commons, including Crohn's disease, osteoarthritis, and cervical degenerative disc disease. She exhausted standard medical treatments for these devastating conditions, which proved to be ineffective and have harmful side effects. Cannabis immediately eliminated the need for immunosuppressants, steroids, non-steroidal anti-inflammatories, and other pain medications. It relieves her symptoms, which include nausea, insomnia, and debilitating, unrelenting neuropathic and chronic pain.

Without cannabis, she can't eat, can't sleep, and she can't function.

(1050) The costs of her medication are unaffordable, but she cannot go without it. Her family has racked up thousands of dollars in debt in order to afford her prescribed medical cannabis. Even though medical cannabis lacks a drug identification number, Sun Life, responsible for the administration of claims under the public service health care plan, informed Mounia that they are set up and ready to cover the costs of this necessary therapy once it is in included in her plan. Now I'd like to introduce you to Mandy McKnight. She's employed by the Canada Revenue Agency.

Her son, Liam, is nine years old and diagnosed with Dravet syndrome, a catastrophic form of epilepsy for which there is currently no cure and the prognosis is unknown. Before trying cannabis, Liam had tried over 10 anti-epilepsy medications that failed to control his seizures. He was still suffering up to 80 seizures a day. The side effects from the benzodiazepines and barbiturates were severe, including brain atrophy. Since being prescribed cannabis when he was just five years old, Liam is doing remarkably well and his seizures are more controlled than on any other medication.

The cost to the family is over $1,000 a month plus HST. The alternative therapies, which are less effective and come with terrible side effects, cost between $2,500 and $3,000 a month, but they are covered. Both Mandy and Mounia have had health claims for coverage rejected by their employer. Give medical cannabis a drug identification number, or something akin to it, perhaps a cannabis identification number, to facilitate fair taxation and insurance. Take care of patients and Canada's public servants. It's the right thing to do.

You could lead this government, the country, and the world by including cannabis in the federal public service health care plan. Treat patients with the dignity, compassion, and support that they deserve. We have an opportunity to be world leaders, expanding the evidence base of benefits and the safety profile of medical cannabis. We are facing an opiate and overdose crisis, and cannabis has tremendous potential as a harm reduction tool.

We urge you to invest significant resources in human clinical research in cannabis and cannabinoids, and to prioritize researching into the potential of cannabis in managing pain and as a harm reduction tool for addiction and substance abuse. The Compassion Club has acquired tremendous experience with people who are struggling with problematic substance use. In using cannabis as a harm reduction tool, we have witnessed the potential of high-potency edibles and resins being substituted for recreational and medical opiates, methadone, alcohol, and cocaine.

This country needs solutions to the opiate epidemic, and cannabis has incredible potential. We implore this committee to do everything in its power to transition the community-based, long-standing, front-line harm reduction organization, the Compassion Club, and other long-standing medical cannabis dispensaries, which pioneered the medical cannabis movement and industry, into the new regulatory framework. Please consider the seven recommendations in this submission to improve the care of patients. Thank you, and I'd like to introduce you to my colleague, Marcel Vandebeek, who will be making some brief comments.

Mr. Marcel Vandebeek (Administrator, BC Compassion Club Society) :

Good morning. My name is Marcel Vandebeek. My role during the 19 years with the BC Compassion Club Society has included front-line dispensing of medicinal cannabis for five years, administrative duties for 15 years, and purchasing for 17 years. I have been working with suppliers of the BC Compassion Club to ensure a consistent supply of high-quality medicinal cannabis to our membership. As my colleague Hilary said, we are a registered not-for-profit society focused on providing holistic health care for those who most need it.

We work with small-scale growers, who cultivate specifically for our members at below-market pricing. They have cultivated specialty strains and have amassed a tremendous amount of expertise including that on organic cultivation methods. None are related to organized crime and all have taken on great personal risk to help us meet the needs of our members. We ensure the ideological values of the suppliers we work with and we reject the producers who are solely profit motivated.

We have a strict cap on pricing which weeds out those who are not aligned with our mission, vision, and values, and we ask them for small things and donations. For example, we have a cultivator named Joe, who lived with a serious disability, and grew organic cannabis for us. He used to donate thousands of dollars' worth of cannabis every Christmas to help us gift it to our members in order to help alleviate their financial hardship during the holiday season. He used the small profits to fund a summer camp for disabled children. Sadly, he was raided by the RCMP.

He was never charged, but as a result, he was forced to end his summer camp. These are the good, honest, hard-working, law-abiding Canadians this government is looking at as the criminals who must have the industry taken out of their hands. In fact, they're people you should be bringing out of the shadows and into the light. The current process for applying to be a licensed producer is inaccessible financially to small-scale producers and to small-business people, who are part of what is needed to fill the supply shortages in licit production.

The pioneers of the medical cannabis movement and industry will not be included in the legal market unless you dissolve the onerous barriers to becoming licensed. Thank you for the opportunity to speak to your committee today. We look forward to your questions.

(1055) The Chair :

Thank you for your comments. We're going to move to the Canadians for Fair Access to Medical Marijuana. Mr. Zaid, you have 10 minutes.

Mr. Jonathan Zaid (Executive Director, Canadians for Fair Access to Medical Marijuana) :

Thank you, Mr. Chairman and the standing committee, for your invitation to appear here today. We will be speaking on behalf of two organizations, Canadians for Fair Access to Medical Marijuana, also known as CFAMM, and the Arthritis Society. I am the founder and executive director of CFAMM, a national non-profit organization focused on the needs of medical cannabis patients. The Arthritis Society is Canada's principal health charity providing education, programs, and support to the over 4.6 million Canadians living with arthritis.

Over the past two years, the organizations have collaborated extensively on important issues surrounding medical cannabis research, access, and affordability. The brief submitted to the committee is a joint submission between the two groups, and any follow-up can be done with me or Janet Yale, CEO of the Arthritis Society. You may recall Janet recently appeared before this committee on other issues including national pharmacare. I would also like to introduce Daphnée Elisma, CFAMM's Quebec representative and a member of our patient advisory board. She'll present in French momentarily.

First, I'd like to share a bit about my personal story. So much of what we hear about cannabis is focused on the harms and risks, which of course are important issues, but my experience and the experience of many other patients is quite the opposite. On April 22, 2007, at the age of 14, I woke up with a constant headache that still remains today, 24-7. This neurological condition known as new daily persistent headache is said to be one of the hardest pain conditions to treat. After trying over 40 prescription medications and all other therapies, I was nearly ready to give up. I had no quality of life.

I could not leave the house due to noise sensitivity and low energy. I dropped out of grade 8 and struggled throughout high school. I finally turned to medical cannabis. It helped reduce painful flare-ups and allowed me to sleep. Although not a cure, the effective symptom management enabled me to concentrate and be successful in my academic studies. I advocated for insurance coverage, and was the first in Canada to be successful in getting insurance coverage for medical cannabis in this manner.

Medical cannabis patients are often looked at as stereotypical stoners, yet to me, Daphnée, and the patients we represent, effective symptom management translates to increased quality of life and functionality. Cannabis is a medicine. There are over 200,000 authorizations for the use of cannabis as a therapy to manage a variety of health conditions, including seizures, pain, insomnia, nausea and vomiting, and side effects from prescription medications. Although there is legal access to medical cannabis, many challenges are still associated with its use. We need more research.

Access to various product forms and retail distribution is an important issue, and affordability remains one of the most pressing concerns facing patients. As the government progresses with legalization, one of the primary goals is to reduce consumption. Although laudable for recreational purposes, the government's goal ought not to be to restrict access to medical cannabis, a medicine, but rather to ensure a safe, reliable, and affordable supply for those who medically require it.

We will be highlighting three issues today: the importance of a distinct regulatory framework, research, and affordability, which Daphnée will speak to. Although we need more research, a recent review by the U.S. National Academies found substantial evidence for the use of cannabinoids in conditions including chronic pain, MS, and chemotherapy-induced nausea. The two most studied cannabinoids are THC and CBD. THC, the cannabinoid that causes the stereotypical high associated with cannabis, has medical properties including analgesia.

CBD, a non-impairing cannabinoid, which has been shown to have anti-inflammatory and anticonvulsant effects, also limits the impairment and side effects caused by THC. Many patients use these two cannabinoids in combination to gain the most effective symptom management while limiting potential impairment. Again, for most people using cannabis for medical purposes, this is not about getting high, but rather effective symptom management and increased quality of life. Cannabis is a legitimate medication and it must be treated that way. It is important that it be treated that way in a distinct regulatory framework.

In crafting Bill C-45 we want to commend the government for recognizing the need to maintain a separate and distinct regulatory approach for medical cannabis, and we want to make sure that this is maintained. Beyond the government's constitutional requirements to provide reasonable access to cannabis for medical purposes, we believe cannabis and patients' needs are best suited to be addressed in a distinct regulatory framework. Moving forward beyond Bill C-45 , it is important that the government prioritize and adequately support the needs of patients by addressing their unmet needs.

(1100) Of course research is a very important issue. There is an enormous deficit of properly funded research and Canadian clinical trials in the therapeutic use of medical cannabis. This creates barriers to patient access, as many physicians express reluctance to authorize medical cannabis in the absence of robust, peer-reviewed research. The lack of scientific and clinical research has also been cited by Health Canada as a key reason why medical cannabis is not yet regulated as a therapeutic product, which affects the ability of patients to access medical cannabis through private or public drug plans.

In particular, more research is needed in terms of dose, indication, and form. To that end, we have asked, as part of budget 2018, for the federal government to commit $25 million over five years to support medical cannabis research. This investment would go a long way towards expanding the evidence base for medical cannabis, and it's a small amount compared to the $274 million already proposed for enforcement.

Although we fully support enforcement and research into the risks associated with recreational cannabis use, we believe it's necessary for the federal government to invest in research specific to the medical use of cannabis. This is an urgent and vital step towards further understanding and recognizing the legitimate medical use of cannabis and ensuring the sustainability of a distinct regulatory framework.

In terms of improving access, in addition to the continuation of mail order and personal production, we believe that pharmacies should have exclusive authority to retail medical cannabis, and that further product forms should be made available. Sales through pharmacies would go towards improving affordability, including the elimination of sales tax based on the Excise Tax Act, and increasing the potential of insurance coverage. Pharmacists will help ensure that patients across the country receive reliable education on safe and effective use from trained health care professionals with regulatory oversight.

While retail and distribution decisions are largely provincial competencies, in order for pharmacy distribution to happen, the access to cannabis for medical purposes regulations will need to be amended. I will now pass it to Daphnée to discuss affordability.

[ Translation ]

Ms. Daphnée Elisma (Quebec Representative, Canadians for Fair Access to Medical Marijuana) :

After over a decade at Health Canada and as a jurist, I advocate for patients who use medicinal cannabis. In fact, I use cannabidiol, or CBD, to successfully ease the complex regional pain syndrome that I suffer from as a result of breast cancer treatment. The issue of low rates is a major challenge for the patients we are representing here today, as medicinal cannabis is the most effective medication to treat their illness. First, we recommend that cannabis for medical purposes be tax-exempt. When a patient purchases prescription drugs and medical necessities, they are exempt under federal law.

Since medicinal cannabis meets those criteria, the government should allow the removal of sales tax, making it more affordable. Next, we are calling for policies and programs to facilitate the coverage of medicinal cannabis costs under public and private regimes. We recommend that the government approve cannabis as a therapeutic product, including giving it a drug identification number, to facilitate reimbursement. Basically, patients who use cannabis to treat their physical or psychological condition feel discriminated against.

The government makes a distinction between these patients and those who use conventional medications, such as opioids, to treat the same disease. As a result, the patient is often forced to use an opiate instead of cannabis because it is less affordable. Taxation and non-reimbursement of medicinal cannabis represent undue hardship for patients. Improving the rights of patients who use medicinal cannabis must remain at the heart of the discussions. I would like to thank committee members for giving me the opportunity to address them today.

(1105) [ English ]

The Chair :

Thank you very much. Now we go to Ms. Bogden. Welcome back.