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Wednesday, 09/06/2023 9:37:26 AM

Wednesday, September 06, 2023 9:37:26 AM

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Dr Bonno
06-09-2023
Closure of cannabis dispensaries and clubs amid drug poisoning crisis a mistake

Opinion: A recreational cannabis market does not and will not meet the need of people with chronic pain who rely on cannabis for pain management.


Since B.C. declared a province-wide public health emergency in 2016, close to 12,000 people have died due to the poisoned drug supply. The province recorded over 2,000 deaths in 2021 and again in 2022. In January 2023, an alarming 211 deaths were recorded.

Many have pointed to the role of chronic pain in fuelling this drug poisoning crisis.

Construction workers, who represent 20 per cent of drug poisoning deaths in B.C., have been vocal about the prevalence of chronic pain and the high rates of substance use in the industry.

People living with chronic illnesses and injuries that result in ongoing pain have also faced significant challenges, including being cut off from or denied access to prescription painkillers, experiencing stigma from health-care providers, and resorting to the illicit opioid supply to manage their pain.

Chronic pain is also a recurrent theme in research conducted with people who use drugs in B.C. The prevalence of chronic pain is much higher among people who use drugs (48 to 60 per cent) compared to the general population (11 to 19 per cent) — which explains why self-medicating is also much higher.

Our policies, systems, and practices have created conditions in which people who experience chronic pain are dying.

Unfortunately, B.C. has not learned this lesson.

Despite cannabis being a safe and effective pain medicine that experts say could prevent drug poisoning deaths, the province has been actively working to close long-standing community-level access points, such as cannabis dispensaries and clubs (e.g. cannabis compassion clubs and cannabis buyers clubs).

Leading to cannabis legalization, the B.C. government had an opportunity to develop a regulatory regime that would preserve these storefront community-level access points and uphold compassionate access to cannabis for people experiencing chronic pain.

Instead, it decided to dedicate resources to eliminating dispensaries and clubs, leaving thousands of people who relied on cannabis for pain management without access.

Last month, I listened to members of the Victoria Cannabis Buyers Club describe how cannabis changed their lives and why they need community-level access to cannabis products that meet their pain management needs. Chronic pain was the common denominator among the members.

They explained that without access to the club’s low-cost cannabis products, their pain would be so severe that they would be forced to stay home and unable to carry out their daily activities.

I could hear the emotion in their voices as they talked about the positive impact of cannabis on their health and quality of life, their fear of losing access if the club closes, and the barriers they face in accessing cannabis through the recreational market — a market that was never intended for them and cannot meet their pain management needs (e.g., dosage and products) nor provide.

Concretely, closing dispensaries and clubs means that thousands of people who relied on cannabis for pain management for decades prior to legalization have lost or are at risk of losing access to an effective medicine. It also means that the province is actively cutting off access to a lower-risk alternative to the poisoned supply of opioids, one that has been shown to play a beneficial role in saving lives.

For example, in a B.C. study among people who use drugs, those using cannabis for pain relief had significantly lower rates of overdoses. This study also reported most relied on community-level access points for an affordable source of cannabis. This is consistent with a dozen Canadian studies conducted with people who use cannabis to relieve pain and other symptoms, all of which noted that community-level access points such as dispensaries and clubs served more people than the Health Canada medical cannabis program.


Instead of closing dispensaries and clubs, the province should follow the evidence produced by local researchers and listen to people who rely on these community-level access points to manage their pain. It is not too late to reverse course, starting with the Victoria Cannabis Buyers Club.

Preserving access to cannabis — a safe and effective medicine for chronic pain — should be the priority as British Columbians face a primary care crisis, long delays in accessing pain management, a drug poisoning crisis that is killing seven people every day, and a recreational cannabis market that does not and will not meet the need of people with chronic pain.
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