High and dry: marijuana’s conflicted legal status leaves patients hurting for the medicine they need

MONTREAL — It was a Thursday afternoon, June 3, 2010, and Francois was about to knock on the door of the Montreal marijuana compassion club when he saw a sign that made his heart race. Closed. By police. So he ran straight to to the mountain to his old scoring grounds in search of a pot dealer. As he got closer, he heard someone whistle — a warning. Everyone scattered. With a trim build and moustache, “they took me for a cop,” says Francois, who is not an addict, a pusher, or a recreational user. He has post-traumatic stress disorder, a condition for which cannabis has recognized therapeutic value. A survivor of family violence, incest and sexual abuse, Francois, 43, struggles with depression, sleep and loss of appetite, anxiety and suicidal tendencies — symptoms that he says are alleviated by marijuana. His doctor and psychiatrist agree. But a decade after Canada legalized marijuana to help treat certain medical conditions, it remains a drug that Francois cannot buy; a prescription he cannot “refill” at the pharmacy. So he relies on compassion clubs, otherwise known as “medical cannabis dispensaries.”

In June, police arraigned 38 people on charges of conspiracy, possession and drug trafficking after raiding five Montreal-area compassion clubs, including two suspected of running high-traffic pot retail stores. But the crackdown stranded hundreds of critically and chronically ill patients, such as Francois, who suddenly found themselves without access to their medication for various painful conditions, including cancer, HIV/AIDS, epilepsy, multiple sclerosis and arthritis. Most users turned to black market sources, “where they don’t feel safe. Some went to Ontario. Some died,” said Marc-Boris St-Maurice, founder and president of the Montreal Compassion Club, who was among those arrested. Standing at the closed door that June day, Francois says he knew instantly that he had to find a dealer on the street or he wouldn’t last the night. “I’m still alive because of it,” Francois says, between sips of black coffee at a cafe near his physician’s clinic. “My father came for me at night,” Francois says. His mother put a sedative in his drinking water “so the neighbours wouldn’t hear me scream and cry.

“Even today, I am apprehensive about going to sleep — I know something bad is going to happen to me.” Marijuana falls into a legal grey zone — it is recognized as therapeutic, but it is still illegal to possess, unless a patient has an exemption from Health Canada. Without an authorization granted by Health Canada, which must first be signed by a doctor, patients such as Francois can be jailed for possessing a drug, even though it is one that helps them function. The number of exemptions issued between January 2010 and Nov. 1, 2011 jumped to 12,225 from 4,884 and Health Canada has hired an additional 28 people to speed up the process. However, the federal government is proposing changes to the program that would give doctors the final say on who receives such authorization. Most doctors do not support the proposed changes and many already were boycotting participating in the current authorization process, citing a lack of proper medical research. Last week, a nervous Francois fidgeted in his doctor’s waiting room. “Today will be the day that my doctor will sign,” he says optimistically, patting the forms in his pocket.

Just last month, however, Canadian Medical Association president Dr. John Haggie rejected Health Canada’s proposed changes to the exemption process, saying it places too much responsibility on the doctors who sign the authorizations. The association says doctors should not be the gatekeepers of a substance that’s largely untested, unregulated and still illegal. Haggie’s concerns were echoed by Dr. Yves Robert of the Quebec College of Physicians, who called the drug policy a political paradox “that seeks, at . . . the same time, to crack down on the societal use of an illegal product and to facilitate its use and access by a vulnerable and suffering patient population.” At recent a consultation on the proposed changes to the Marijuana Medical Access Program, Robert outlined three options: “The status quo, legalizing marijuana, or treating the product as any other drug or therapy. “If marijuana is a drug, then Health Canada should treat it as such, no more no less. If marijuana is not a drug, then physicians should not be asked to use it.” Doctors and patients say Health Canada produces poor quality medical marijuana leaving patients with permits little choice but to turn to illegal sources rather than buy from the government.

In the waiting room, Francois says he has an ace up his sleeve to persuade his doctor to sign the form. He is referring to an affidavit signed by his psychiatrist that states marijuana is as necessary to Francois’ therapy as the medication he takes for depression, psychosis and anxiety. The youngest of three children, Francois was a thin boy with pale hair and round blue eyes. Of his siblings, he suffered the worst abuse. “My father said (that) I wasn’t his real son” — a claim later disproven by a DNA test. “I’m his son,” Francois says as he stares into his coffee. His father, and tormentor, died before Francois could confront him about the abuse. Francois says he never acknowledged the abuse until Quebec singer Nathalie Simard spoke up in 2005 about her own abuse at the hands of manager Guy Cloutier, who served 19 months of a 42-month sentence for sexual abuse. “I never admitted it, not even to myself, until it blew up in the media,” says Francois who suddenly was confronting memories that he couldn’t live with — including a photograph of himself wearing a wedding ring during a mock marriage ceremony to his father when he was 7. There were beatings and broken bones, verbal abuse and nightly visits — and his mother’s complicity. When he was in Grade 2, he confided in a teacher and his priest, but instead of helping him, the intervention led to even more violence at home.

“My father tried to kill me. That broke me. I knew there would be no way out,” Francois says. His breaking point came in 2006 shortly after he started therapy for abused men. A 13-year relationship ended. He couldn’t sleep or eat. He lost 75 pounds. He wanted to die. “But I’m still alive,” Francois says with a smile. It’s something he says often, a reminder of how close he came to not surviving. Francois was already on medical leave of absence from work when he walked past the Montreal Compassion Club, then on Rachel St. “What do I need to do to come here?” he asked at the door. He was told he needed a signed doctor’s noted. At the time, his physician didn’t hesitate. Already as thin as an adolescent, Francois was wasting away, and cannabis reduces nausea and improves appetite. “I was so happy the day my doctor signed,” he says. “I cried. It was the worst moment of my life. I was alone, in crisis,” and continually revisiting painful memories. At the club, Francois was given support, monitoring and a treatment plan. He dropped in every second day. “They tried different varieties to see how it acted on me,” says Francois, who kept notes about the different strains of pot and what effect they had on his appetite, sleep and anxiety. His feeling of isolation started to lift.

“For the first time in my life I saw others with PTSD — I thought I was alone,” says Francois, who credits cannabis and “human resilience” for his return to a full-time job with the City of Montreal after a three-year leave. He is also entitled to a small pension under the Crime Victims Compensation Act. It doesn’t cover a fraction of his monthly $1,000 medical marijuana expenses, which are not reimbursed by health insurers. “At what price is well-being? I know what it does for my life,” he says, as the clinic intercom blasts his name in the waiting room. Tired of living with the fear of getting caught, Francois is now seeking his doctor’s signature on the Health Canada forms. It’s the same physician who years ago, signed off on his diagnosis and has continued to follow his progress. At one point, she had prescribed synthetic cannabis (which is covered by insurers), but it had no effect.Once approved by the federal government, the authorization he is seeking will allow him to grow his own medical marijuana, have someone else grow it for him, or buy it directly from Health Canada. Francois appears a half-hour later, holding a renewal for anti-depressants in his hand. He calmly stares into space at the pharmacy.

Did the doctor sign? His shoulders slump as he lets out a deflated sigh. “She said, ‘I can’t sign, but I know it’s beneficial for you.'” His doctor doesn’t want to become known as the go-to doctor for people seeking marijuana. Francois currently has safe access and consistent quality cannabis at a medical marijuana dispensary that opened discretely after the raid. “I’m so disappointed. If another bust happens I’ll have to go to the mountain again,” he says, head hanging. On the other hand, he says suddenly smiling, “I’m still alive.”

via : montrealgazette.com

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