Medical marijuana industry sees boost ahead of legalization — but will it last?

The medical marijuana industry has benefited from the waning stigma surrounding cannabis use as Canada inches toward legalizing recreational pot, but there's expectation that could change as of next week.

It has led some to wonder what the future holds for the country's medical marijuana business and research into a contentious treatment.

"I suspect that once cannabis becomes legal, there will be fewer patients trying to get a medical prescription to justify the recreational use because they'll be able to get it at a recreational dealer such as the NSLC [Nova Scotia Liquor Corp.]," said Dr. Tim Holland, president of Doctors Nova Scotia.

Holland said he's seen a spike in the past year in the number of patients who report using cannabis, but he doesn't believe everyone who comes looking for a prescription is using marijuana as a medical treatment.

In April 2017, Health Canada reported just over 7,600 medical marijuana authorizations in Nova Scotia. By June 2018, that number was over 13,000.

National Access Cannabis on Spring Garden Road in Halifax is seeing an influx of first-time patients.

The clinic, which acts as a go-between for Health Canada's licensed producers and patients, is so busy that people have to wait until December for an appointment, said manager Meghan McIntyre.

"The majority of our patients are not currently cannabis users until they become patients here," she said. "A lot of them have never touched cannabis before or it's been, like, 30 years."

National Access Cannabis has one doctor on staff who can write prescriptions. It accepts referrals and processes medical documents from other doctors, and also works with patients to educate them on what producers, or strains, might work for them.

The clinic is supported by a team of investors. McIntyre said it also makes money through "educational grants" paid by licensed producers when National Access Cannabis refers patients to them.

She anticipates a drop in demand once legalization takes effect next Wednesday. At that point, anyone 19 and over will be able to walk into one of 12 NSLC locations around the province and buy marijuana.

But she believes there's still a need for the clinic.

"At the NSLC and at any recreational dispensing facility, I think they are going to be very limited in what they can talk about, so therapeutic, medical advice is not something you would find in that facility," she said.

"That is where we fill the gap."

Holland said legalization will hopefully allow for "more appropriate use in these cannabis clinics for patients that are looking for a treatment to their problem," rather than just a prescription.

Last month, the Canadian Medical Association — which represents doctors in this country — proposed that the medical marijuana system be phased out once legalization comes into effect. 

Dr. Jeff Blackmer, vice-president of medical professionalism for the CMA, said at the time that most physicians feel uncomfortable prescribing marijuana. He cited a lack of research and evidence of marijuana's effectiveness, as well as a general lack of knowledge around dosing.

He calls the current medical marijuana system a catch-22 — more research is needed but if Canada does away with the medical marijuana system, that research will never take place.

"Cannabis prescription is incredibly controversial within the physician community," he said.

"Within time, hopefully we'll have the evidence to show us where that balance is between the appropriateness of prescription."

Health Canada said it will continue operating the system but it will be reviewed within five years. 

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