Daria Romanish – Alberta Health Services

Medical Marihuana A Public Health Perspective

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Overview

• SUMMARY OF HEALTH CANADA’S PROGRAM

• AHS INVOLVMENT

• HAZARDS TYPICALLY FOUND – CASE EXAMPLES

• COMPARISON OF LEGAL MGO VS. ILLEGAL MGO

• HEALTH CANADA’S PROPOSED CHANGES

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Marihuana Medical Access Regulations

• Came into effect July 30, 2001

• Health Canada grants access to medical marihuana to

patients suffering from debilitating illnesses

• Patient’s claim must be endorsed by a medical doctor

• Health Canada does not endorse the legalization of

marihuana

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Licenses and Authorizations

• 2 TYPES OF LICENSES:

- License to Produce Marihuana by Applicant

- License to Produce Marihuana by a Designated

Person

• 3 TYPES OF AUTHORIZATIONS:

- Authorization to Possess Marihuana for Medical

Purposes

- Authorization to Obtain Dried Marihuana

- Authorization to Obtain Marihuana Seeds

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Health Canada does…

• review and sign initial and renewal applications

• inform grower how many plants they are allowed

• notify patient how much dried product they are able to possess

• instruct the grower to “take the necessary precautions to protect plants and the dried marihuana from loss or theft.”

• ship dried product/seeds to patient

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Health Canada does NOT…

• provide education on safe growing prior to handing out a license

• carry out inspections of homes whose occupants are in possession of production licenses

• disclose addresses of production locations to anyone other than police

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A Breakdown of Numbers

• Total production licenses issued by year in Canada

– January 2003 ~ 400 - January 2008 ~ 1500

– January 2004 ~ 700 - January 2009 ~ 2300

– January 2005 ~ 800 - January 2010 ~ 4000

– January 2006 ~ 900 - January 2011 ~ 8000

– January 2007 ~ 1200 - January 2012 ~ 12,000

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The numbers, graphically

0

2000

4000

6000

8000

10000

12000

14000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Licenses Issued by Year in Canada

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Production Licenses by Province

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Numbers by Province

• British Columbia ~ 3480

• Prairies and Territories ~ 1320

• Ontario ~ 4440

• Quebec ~ 840

• Atlantic Provinces ~ 1920

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Plant Allowances

• On average HC allows 50-70 plants per license

• USA allowances much stricter

• Can have up to 4 licenses per one house

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# Plants Ounces Grams Est. Value $CAD

# cigarettes Est. supply @ 2/day

1 5 140 $1250 190 3 months

10 50 1400 $12,500 1900 2.5 years

20 100 2800 $25,000 3750 5 years

60 (average

medical grow) 300 8400 $75,000 11,200 15 years

100 500 140,000 $125,000 190,000 25 years

500 (average

illegal grow)

2500 70,000 $625,000 93,500 125 years

Figures have been slightly rounded for simplicity

Some statistics

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Origins of AHS Involvement

• In October 2011, CFD and CPS responded to an explosion in a house

• Found an MGO in the basement

• CPS called HC who confirmed that grow was legal

• CFD requested City of Calgary SCO’s and AHS to inspect the house and assess hazards presented by the MGO

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Findings in the “Legal” MGO

• Numerous health and safety hazards present

• House was deemed unfit for human habitation

• Explosion resulted from cooking hash oil

• Explosion claimed the life of one man and seriously

injured the other

• Discovered that deceased man lived a few doors down

and also possessed an HC production license

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Escalated Involvement

• High potential for many hazards within house

• Better baseline of common hazards found in legal

MGO’s

• HC considering changes to medical marihuana program

• Benefit of strong collaborative effort between CPS, City

of Calgary and AHS in the form of CSRT

• Goal is to mitigate risks to occupants, neighbours and

future residents

• Have inspected 2 additional houses

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Inspection of Affiliated House

• City of Calgary obtained a warrant under the Safety

Codes Act

• AHS and CPS gain entry under City’s SCA warrant

• AHS had visited same house 4 years prior

• At initial inspection, no hazards were present and no

action taken by AHS

• At January 2012 inspection, numerous health and

safety hazards present and house deemed unfit for

human habitation

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Downfalls of this Inspection

• Inspection date and time was prearranged with owner

• Owner had chance to prepare

• May not have seen full impact of hazards

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First “Cold” Inspection - preparation

• CPS came across a house suspected to be an MGO

during routine investigation

• HC confirmed MGO was legally approved

• CPS informed City of Calgary

• City of Calgary obtained SCA warrant in February 2012

• Three door knocks planned to attempt access prior to

using forcible entry

• Occupant (unexpectedly!!) was home and permitted

entry at first door knock

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In the House

• Hazards were VERY prevalent:

- Evidence of a prior chemical fire

- Significant water damage to main floor ceilings

- Growing well in excess of license

- Unsafe electrical tampering

- Unsafe HVAC alteration

• House was deemed unfit for human habitation

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Second “Cold” Inspection

• House was immaculate

• No hazards present

• Precedent-setting case

• AHS will not allow MGO’s, legal or not, in a dwelling

• Decision was appealed

• Appeal withdrawn and occupants chose to comply

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Marihuana Plants in an Illegal MGO

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Marihuana Plants in a Legal MGO

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Electrical Tampering in an Illegal MGO

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Electrical Tampering in a Legal MGO

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Electrical Tampering in an Illegal MGO

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Electrical Tampering in a Legal MGO

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Improper Venting in an Illegal MGO

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Improper venting in a Legal MGO

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CO2 Generator in an Illegal MGO

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CO2 Generator in a Legal MGO

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Interior Damages in an Illegal MGO

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Interior Damages in a Legal MGO

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Water Bypass in an Illegal MGO

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Water Bypass in a Legal MGO

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Backflow Concerns in an Illegal MGO

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Backflow Concerns in a Legal MGO

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Chemical Concerns in an Illegal MGO

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Chemical Concerns in a Legal MGO

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Chemical Concerns (Illegal) cont’d

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Chemical Concerns (Legal) cont’d

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Spider Mites in an Illegal MGO

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Spider Mites in a Legal MGO

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Fire Concerns in an Illegal MGO

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Fire Concerns in a Legal MGO

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Fire Concerns in a Legal MGO

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Concerns with Current MMAR Program

• Legal MGO’s just as hazardous, possibly more

so, than illegal ones

• Lack of inspections

• Lack of disclosure

• Resident/community safety not assured

• Increases criminal activities in neighbourhoods

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Proposed Changes

• New supply and distribution system

• Personal/designate production phased out

• Supply obtained through commercial grower by patient

• HC will audit commercial grower for product quality,

safety and record-keeping

• HC will no longer provide seeds or dried product

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What’s missing?

No plans for operator education

or facility compliance

inspections!!

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Health Canada Seeks Public Opinion

• June 17th 2011 HC disclosed proposed changes to

MMAR

• Asked for public opinion

• October 2011 meeting with CACP and RCMP

representatives to discuss concerns

• have received no follow-up or feedback from meetings

or public opinion request

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Timeframes

• HC intends to begin developing new regulations

sometime in 2012

• Process is expected to take at least 18-24 months

• Will take time to license commercial growers

• Personal production allowed until commercial growers

can satisfy demand

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Lobbying for Change

• Replied to HC request for public opinion

• Sent feedback with CACP representative

• Through CSRT, are constantly working to contact HC

directly and voice concerns

• Calgary Alderman formally requested, via Mayor:

• HC disclose all locations of federal grows to City

• Meeting with Health Minister

• HC places by-law compliance condition on license

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AHS main concerns

• WHO will be inspecting commercial facilities?

• WHAT qualifications/training/expertise will they have?

• WHEN – how often will inspection happen? Will

warning be give or will inspections be unannounced?

• WHERE will commercial producers be located? Will a

commercial grower be allowed in residential areas or

only industrial?

• HOW will they be set up? Will they meet building code?

• HC still not disclosing addresses to regulatory agencies

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In the meantime…business as usual

• AHS will continue to inspect medical marihuana grow

operations for as long as we are notified of them

• Will continue to deem unfit as necessary

• Will continue to work with contractors to ensure

remediation to AHS standards

• Will continue to work with our collaborative partners to

advocate for inclusion of necessary health & safety

precautions in Health Canada’s MMAR

• Working on Demand for Information

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After all…

AHS is mandated to…

Provide, protect and promote a

healthy environment.

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Contact Information

daria.romanish@albertahealthservices.ca

http://www.calgaryhealthregion.ca/publichealth/envhealth/orders_calgary_zone.htm