Update on Canadian medical MJ program
Using Marijuana As Medicine
by Peter Downs / April 17, 2004 / The Standard
Thousands of Canadians treat themselves with pot outside the parameters of a legal program critics say is riddled with problems
Mornings bring the greatest agony.
Those seven or eight hours of sleep most people count on for rejuvenation leave Matthew Mernagh in physical torment.
His thin body stiffens during the idle hours he's in bed.
It's as though the cartilage in his joints and between the discs of his spine has been somehow removed during the night and replaced by quick-setting cement.
Rising from bed and trying to unlock his frame from the rigour mortis-like grip of severe osteoarthritis sends currents of pain radiating along his crumbling spine, through his legs and down the bones of his swollen arms to his clenched hands.
At the age of 30, Mernagh sometimes feels as though he's trapped inside the shell of a decrepit old man.
"My spine is 70," the St. Catharines native said last week.
"I can actually feel the grinding of the discs because there's nothing there. The cartilage is really shot."
A journalist and writer, Mernagh has been unable to work full-time in two years and collects disability benefits.
He's tried conventional over-the-counter medications to relieve his chronic pain without much success. The drug that delivers him release is marijuana.
Even with a single puff on his pot pipe over a morning cup of coffee, Mernagh said he feels his rigid hands begin to relax. Another hit and the shooting pains emanating from his spine begin to subside.
"It makes a huge difference in my life," said Mernagh, who has been smoking pot regularly for the past six years to relieve his arthritic symptoms.
"I don't sit around and get high. This to me is making my life better. The effect of marijuana for me is pain relief."
But each time Mernagh fills up the bowl of his small blue pipe with dried pot leaves, lights them up and draws the smoke into his lungs, he's breaking the law.
Mernagh -- similar to thousands of Canadians -- is treating himself with pot outside the parameters of Health Canada's legal medical marijuana program.
In July 2001, the federal government legalized the use of medicinal marijuana for people with terminal illnesses and other serious health conditions, including cancer, AIDS and multiple sclerosis.
But critics complain the controversial program is so badly beset by troubles and bogged down in red tape that it is virtually impossible for people with health problems to access it.
The key stumbling block is a Health Canada requirement that a physician endorse the patient's application, stating the medical benefits to the patient of smoking marijuana outweigh any potential risks.
But without sufficient scientific studies yet complete to give credence to the claim, doctors are extremely reluctant to support applicants.
Both the Canadian Medical Association and the Ontario Medical Association have advised their physician memberships against signing the Health Canada declaration for patients seeking medical marijuana.
"What the Health Canada form requires people to do is sign something which says they know something they don't know and cannot know," said Dr. Ted Boadway, the OMA's executive director of health policy.
"That is a statement that no physician in Canada can answer. They can't answer that with knowledge."
As a result, there are only 78 certified users across the country who are receiving either marijuana from Health Canada or seeds to grow their own pot.
Thousands of other sick and dying Canadians buy illegal marijuana on the street or grow it themselves to ease their symptoms.
"My government is pushing me to black market sources," said Mernagh. "You can still get arrested for marijuana. Whether it's half a gram, half a joint or half a pound, if they want to arrest you they will."
But that threat hasn't stopped Mernagh from patronizing pot dealers in St. Catharines on a regular basis for himself and other sick people around Niagara.
Last September, Mernagh founded the Niagara Compassion Society, a non-profit organization that helps people obtain marijuana for medical reasons.
The group, modelled on similar organizations in Toronto, Vancouver and other Canadian cities, provides pot to 10 people, but Mernagh foresees membership growing to about 100.
"These people are genuinely ill," said Mernagh. "They've tried everything else before."
As a condition of membership, applicants are required to provide a letter of diagnosis from a licensed physician attesting to their medical condition.
But unlike Health Canada's program, physicians are not asked to put in writing their belief that the benefits of taking marijuana are greater than potential risks.
Mernagh acquires pot for the organization's registered users and distributes it to them.
"We're a co-operative of medical marijuana users," he said.
"I'm not interested at all in the recreational pursuit of marijuana."
But the eyes of the law may not see any difference between run-of-the-mill drug dealing and what the Niagara Compassion Society is doing.
Niagara Regional Police won't make allowances for medical marijuana use that falls outside regulations set by the federal government, Deputy Chief Donna Moody said.
"We can't ignore the law. The law's in place," she said.
"We don't support recreational use of the drug. That's creating a criminal enterprise."
Mernagh said he hasn't been contacted by police, but he's already sought legal advice and lined up a lawyer in the event they do.
"If the police want to have a showdown, I'm prepared. Because I'm not willing to go without marijuana," he said.
"There is a fear that in being as public as I am, the police will say, 'We've had enough.' "
Rhonda Thompson, who co-ordinates a needle exchange program for AIDS Niagara, would like to see Health Canada hand over its entire medical marijuana program to compassion organizations such as the one Mernagh launched.
"That federal government program, to be honest, is an absolute nightmare," she said.
"The paperwork is incredible and you also have to get doctors willing to sign on your behalf. A lot of the physicians out there just do not want to get the reputation of being the pot doc."
Many people with HIV or AIDS smoke marijuana to stimulate their appetites, soothe pain and combat feelings of nausea.
But Thompson said she's not met a single client of AIDS Niagara who was able to get approval to buy marijuana through Health Canada's program.
"It just seems to be a logical choice to turn all of this over to compassion clubs," she said. "There are safeguards in place to ensure it's not being abused and it's going to help those who are truly ill and who truly need it."
Health Canada is looking at ways to make its medical marijuana program more easily accessible for people with serious illnesses, said spokeswoman Catherine Saunders.
"The idea is that we want to be making some amendments to streamline the application process," she said.
That could include changing the declaration physicians are asked to sign "to better acknowledge the limited information available on the safety and efficacy of marijuana for medical purposes," said Saunders.
In the meantime, the department is overseeing research into the medical effects of marijuana on people who suffer pain in a clinical study being carried out at McGill University's pain management clinic.
"Marijuana is a controlled substance everywhere around the world," said Saunders.
"The benefits of it as a therapeutic drug have not yet been proven, although there are anecdotal reports."
Federal Public Health Minister Carolyn Bennett saw the anecdotal evidence of marijuana's positive impact on the ill firsthand when she worked as a physician in Toronto before entering politics.
"As a family doctor, there were some patients who were very much helped by marijuana," Bennett said in an interview Thursday, following a meeting with public health officials in St. Catharines.
"There was one patient, for example, with MS who was very much more functional using marijuana."
Bennett, who represents the Ontario riding of St. Paul's, said the government needs to review its medical marijuana program and make it easier for "people on the ground" to use.
"There's no question the medical community has been uncomfortable with it. It's not something they're trained to do," she said.
"We're clear we've got to get going on the clinics and the applied research it will take to show what works and what doesn't, and for what conditions."
It's also important for the government to take another look at regulations that determine how people with serious illnesses register to receive medical pot, she said.
"I think it's clear that these patients ... shouldn't have to go into the streets to buy it. So what are we going to do to get them a safe product?" said Bennett, adding she's in favour of the decriminalization of marijuana.
Regina Szymanski, executive director of the Multiple Sclerosis Society Niagara Peninsula Chapter of Hope, is encouraged by the fact that the federal government is studying marijuana's health benefits.
"We really don't promote something until it's scientifically proven," she said.
"If the medical research shows that it works, then the process for people to get a treatment that might be helpful to them will be so much easier."
But even with improved access, making the decision to smoke marijuana as a medical treatment isn't easy, said one user.
The 46-year-old Niagara woman, diagnosed with MS more than a decade ago, asked not to be identified because of the stigma attached to marijuana use.
Even though she smokes pot frequently throughout the day -- typically every three hours -- she hides it from her young son, her relatives and her friends.
She's licensed by Health Canada to grow medical marijuana for her own use, but she doesn't do it. Instead she buys pot from regular suppliers.
"I wish it was more accepted in that way, but I don't want people saying, 'I don't want my child playing with your child because you have this stuff in your house.' I won't risk that," she said.
However, she's convinced smoking marijuana is the most effective way she can ease the painful spasms that lock her legs on a daily basis -- sometimes powerful enough to tear her muscles.
"They stiffen straight out. No one can bend them and you've got to wait for it to subside," she said. "Marijuana will stop it almost immediately."
But she also worries smoking marijuana is harming her respiratory system and that she may have become addicted to it.
"I definitely have a medical benefit. There's no doubt about it," she said. "But if something better were to come along, I'd abandon it, although I don't know how easy that would be anymore because of the dependency issues."
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