Proceedings of the Special Committee on
Illegal Drugs
Issue 18 - Evidence for the morning meeting of May 31, 2002
MONTREAL, Friday, May 31, 2002
The Special Senate Committee on Illegal Drugs met this day at 8:05 to reassess Canada's antidrug legislation and policies.
Senator Pierre Claude Nolin (Chairman) in the Chair.
[Translation]
The Chairman: The committee would like to thank the authorities of the City of Montreal for allowing us to use their chambers and, in particular, the President of the District of Ville-Marie, Mr. Lemay, who was with us last evening during the public hearings.
One preliminary remark: most of us have cell phones. We would ask that you please either turn them off or put them on vibration mode. We would prefer that there be no inappropriate noise during the course of our hearings.
A few weeks ago, the committee began an important phase of its work. When we approved our work plan, we decided that we would hear from the broadest possible range of experts, and that it was also incumbent on us to consult Canadians.
In order to make sure that this consultative process was efficient, we released, a few weeks ago, a discussion paper that is available at the back of the room and which is also accessible on the committee's Internet site. This document contains the main scientific observations that the committee has been able to make during the course of its inquiry.
We wanted this information to be available to as many Canadians as possible in order to keep citizens abreast of our meetings and dialogue. Today, we are in Montreal. Last evening, we heard from the citizens. Today, we will be hearing from Quebec specialists who will share their specific area of expertise with the members of the committee. We will first of all be hearing from Mr. Michel Germain, from the Conseil québécois pour la lutte à la toxicomanie (Quebec Council on drug addiction).
Mr. Germain, the rules are simple: your presentation will be followed by a question period. During the course of your testimony or question period, should there be any information that you feel necessary to provide but which you don't have with you right now, we would be pleased to wait for the documents.
Similarly, if our researchers feel that there are certain issues that require further probing, I will write you in the hope that you will be able to respond to the various questions. The floor is yours.
Mr. Michel Germain, Director General, Comité permanent de lutte à la toxicomanie (Standing Committee on the Campaign against Drug Addiction): Mr. Chairman, on behalf of the Standing Committee on the Campaign against Drug Addiction, we would like to thank you for inviting us here this morning to share some of our thoughts on illegal drug issue. I would also like to thank, in particular, the Special Committee on Illegal Drugs for the rigour of their work. In our opinion, this is the key to success in formulating recommendations and in making the most sound observations possible.
In this respect, we have paid close attention to the various studies and documents produced and to the questioning that has occurred. We would, in particular, like to thank you for the highly appreciable scientific rigour evident in this work.
As far as my presentation is concerned, I would first of all like to clarify the first part: this is not a position that the Standing Committee on the Campaign against Drug Addiction has taken publicly. First of all, the committee has already looked into the matter of decriminalizing cannabis or simple possession of cannabis. In 1999, the committee even produced an opinion which was submitted to the Quebec government.
As we have not re-examined this issue since 1999, we are not in any position to submit formal recommendations. However, we do wish to bring several aspects to your attention for your consideration and we would like to talk about other aspects which we feel are more relevant.
I will therefore be dividing my presentation into three main parts. First of all, I would like to talk to you briefly about the Standing Committee on the Campaign Against Drug Addiction, its role, mandate and activities.
I will then be presenting some highlights from a recent study produced by the Standing Committee which will, I would presume, be of interest to you. Finally, I will conclude by drawing to your attention some aspects that are pertinent to the debate.
The Comité permanent de lutte à la toxicomanie (Standing Committee on the Campaign against Drug Addiction), which is called the CPLT, has been given, as its main mandate, the job of advising the Quebec Minister of Health and Social Services on the best way to tackle drug addiction. The committee has been in existence since 1994 and it currently reports to the Minister of Health and Social Services.
In addition to the thinking and exchanges that occur within its ranks, the committee draws upon various sources to fulfil its mandate. It orders studies, receives opinions from various stakeholders and experts from the sectors concerned, and it analyzes data published on drug addiction trends in Quebec.
So our primary activities consist in producing studies on relevant topics. Since 1994, we have produced 70 studies or publications on a variety of subjects which, for your information, are now accessible through the committee's Internet site.
One study produced last February pertained to the trends in alcohol and drug use amongst young people in Quebec, from 1987 to 1998. This morning, I would like to focus on the highlights of the studies. I could table the report with the committee.
This report was produced by Mr. Frank Vitaro, a renowned researcher in the field, here in Quebec, who based his study on the data banks of Health Quebec and the Quebec Statistics Institute, which produces, every five years, studies based on surveys of Quebeckers' level of health.
Thousands of Quebeckers were asked a certain number of questions about consumption, in particular. Three major studies, namely studies produced in 1987, 1992-93 and 1998, were then analyzed. The study focused primarily on youth 15 to 24 years of age.
The data is serious, reliable and, statistically speaking, scientifically accurate. The first highlight noted in the report was that the number of people using alcohol and drugs, marijuana in particular, rose significantly from 1992-93 to 1998 amongst young Quebeckers 15 to 24 years of age.
Indeed, the report talks about an increase that is very significant. The numbers just about doubled. In 1992-93, amongst young people 15 to 24 years of age, it was observed that 15 per cent were regular marijuana users but, by 1998, the percentage had jumped to nearly 30 per cent.
In Quebec, as well, the increase in the number of alcohol users between 1992-93 and 1998 appears to be more prevalent amongst the youngest users, namely, the group from 15 to 19 years of age. The percentage of young people from all ages who reported a high or abusive use increased between 1992-93 and 1998, reaching levels which are, from our point of view, troubling. Currently, 1 out of every 4 persons in this age group have a high or abusive consumption of alcohol.
More particularly, in Quebec, the number of marijuana users amongst young people 15 to 24 years of age has nearly doubled, as I said, from 15 per cent to 26 per cent. The increase in the number of young people using marijuana is responsible in itself for the increase in the number of drug users in general.
So we see that there has been a slight increase in the use of drugs other than cannabis. However, most of the increase can be attributed to an increase in the use of cannabis. And this, in our opinion, is rather exceptional.
I would stipulate that we are being very conservative when we say that the rate of abusive use amongst young people in Quebec is 26 per cent. This is a very conservative figure because the Health Quebec study does not account for young people under the age of 15, and we know that often young people begin using drugs when they are 9, 10, 11 or 12 years old.
Furthermore, the inquiry does not account for street kids, a special clientele that uses abusively. Nor does the inquiry account for the homeless, aboriginal youth and young people sheltered in youth centres who, usually, make more realistic statements about their consumption habits. We know that young people have a tendency not to give a full picture of their consumption.
The figure of 26 per cent is surely very low as a statistic and we would be right to believe, hypothetically speaking, that the percentage of consumers is more likely in the area of 30 per cent.
These figures cause us to ask several questions. Nevertheless, we have observed that Quebec is not alone in this issue. The study that you will be tabling also assesses the situation in several other countries.
We have assessed the consumption of young Canadians in comparison to that of youth in Quebec, and we have also drawn a comparison with the United States and certain European countries. We have seen that during the course of the same years, or more or less the same years, there have also been some similar fluctuations that denote veritable cycles.
The authors correctly point out that the increase or decrease in consumption are in fact cycles that peak at certain points, decline and then the cycle repeats itself. We have tried to pinpoint the variables that could be the basis for these fluctuations in the increase or decrease of consumption.
So we talk about variables associated with the attitudes of young people with respect to psychoactive substances, which appear to account for fluctuations in the rise or decrease in the consumption of various substances.
In addition, the attitudes can be related to a series of other variables, for example, the consent of parents with respect to consumption or the presence of adults who use or who are perceived as models. The level of acceptance of society in general also comes into play. In addition, there is also the question of whether or not the law is being strictly enforced or not, with sanctions that vary in severity.
These attitudes also reflect the perception of risk associated with the use of substances, based on public opinion. Let us use the example of cannabis. It is said that the effects on health are, when all is said and done, perhaps less damaging than other illegal drugs. Young people conclude from that that it is perhaps not so bad for their health. I even recently heard the following comment: ``Listen, cannabis does not really pose any problem, we give it to sick people''. Certain attitudes are formed as a result of a relatively simple perception of the phenomenon, where in fact it is much more complicated.
So we are talking about the perception of risk, the perception of the approval of others and also the accessibility of substances.
I am pleased to table the report and I think that the researchers and analysts will be able to interpret the various aspects contained therein, in relation to other studies that have been tabled with the committee.
I would like to read the conclusion made in this study, which somewhat illustrates the challenges that lie ahead.
The report states that, in Quebec, nothing appears to indicate that the trend to an increased use of alcohol and marijuana, and, to a lesser degree, other drugs, since the early 1990s, will decline or level off in the near future.
The very recent results of a survey conducted amongst Ontario students show, nevertheless, that the consumption of several substances has declined in 2001 in comparison to 1999. It is possible that this may mark the beginning of a new cycle of decline and that 1999 constitutes a new turning point. However, we will have to wait until 2003, when Health Quebec conducts its next inquiry, to verify whether or not we can confirm this downward trend. It is important to note that consumption of cannabis amongst Ontario students is an exception in that it does not illustrate any notable decline. Furthermore, amongst younger people, the trend is rising.
The creation or increase in youth prevention or promotion campaigns could slow down and even reverse the upward trend that we have experienced over the past decade. The increase in drug use among an ever younger segment of the population speaks to the need to mobilize socio-educational, legal and political forces.
Research has shown that early use of drugs produces harmful effects including an increase in addiction and other serious problems such as accidents, poor scholastic achievement, family and legal problems, psychological effects, etc.
A continual, biannual monitoring would determine whether or not prevention efforts have been successful and whether or not the trend in consumption appears to be reversing over the next few years.
At this point, there is more concern than alarm over the significant increase in consumption.
In closing, I would like to raise certain elements that are relevant to the debate. The first thing to consider when you prepare your final report in August will be the legislation that applies to the various products, though this is not the only variable affecting consumption and types of addictions.
However, in Quebec, we have found that some problems have arisen from the legislation as it is applied now, particularly with respect to the administration of justice. It was with that in mind that the standing committee, in 1999, had issued a statement relating to diversion for simple possession. There appeared to be great differences in the way in which the police enforced the act from one region to the next and from one police force to another.
In some regions, among some police forces, there was a systematic diversion for simple possession of cannabis while in other areas, police arrests led to sentences that also varied according to the region.
The problem related to data retrieval which, at this time, does not allow for an exhaustive look at the treatments that are administered to those who are found guilty of simple possession. There is a methodological problem in the way in which statistics are compiled since they do not give a complete picture of the way in which these offences are handled throughout the justice system.
In 1999, the committee drafted a certain number of related recommendations on which there appeared to be general agreement. I believe we should continue to evaluate most of these recommendations as they have set us on the right track.
The second dimension of this debate, which is, incidentally, somewhat worrisome, and which has been raised on a regular basis by many of our partners, involves the availability of substances. You know that, over the past few years, cannabis has been widely available in Quebec. They have managed to develop a high-end product with a high level of THC, the active psychotropic ingredient.
Our producers are so good that Quebec is now self-sufficient in cannabis. There is no longer any need to import it. We have even become exporters ourselves. And, on the street, Quebec cannabis is known as ``Quebec Gold'', suggesting that the province produces cannabis of an exceptional quality.
It is troubling to see that, and we must admit it, organized crime has done a terrific marketing job. It floods the market with high quality product, at a competitive price, in order to attract the most vulnerable and the youngest clientele.
We know full well that organized crime, which controls illegal drugs, is not only involved in the sale of cannabis, but also cocaine and heroin. Consumers buying cannabis are often exposed to other products which, unfortunately, can lead to serious consequences.
Accessibility is an important aspect, because we know that the more available the product, the greater the consumption. Something else to remember is that new synthetic drugs have been appearing over the last few years. We predict that in coming years, the arrival of new drugs, that may perhaps be less harmful physiologically, will still be of concern because of their attractiveness to various groups of consumers.
We see Ecstasy taking a toll at this time. The situation is being closely monitored, and we have noted a significant increase in consumption. The Rave phenomenon is of great concern. Therefore, when we deal with illicit drugs, particularly cannabis, we must not forget the whole sales dynamic and everything that goes with it.
We have to examine the public health variables, the risks associated with the consumption of cannabis and the harm that it can cause. Of course, cannabis is less addictive. There are fewer addicts, although the number of consumers is on the rise. If, out of 1000 users, 3 per cent become addicted, then if the number of users increases to 2,000, that means you will have 30 more addicts. There must be some concern for the number of users.
Over the past years the rate of use among adults has remained stable, while youth are responsible for the fluctuations in the level of increased consumption.
In closing, I would like to say a word about the commodification of drugs. I said earlier that some studies had shown that attitudes among young people with respect to drugs depended on the messages they were getting from their peers, from older people, from their parents, giving them the impression that drugs are more or less acceptable.
Cannabis is on the way to be coming a type of commodity. The more widespread its acceptance, the greater tendency towards a more liberal policy. The focus is on information and individual freedom. We must not lose sight of this phenomenon.
Issue must be closely examined at all levels so as to convey a clear message with respect to acceptability.
This is a very complex debate. We must take into account all of the stakeholders, all of the factors, that are part of the debate. This is no mean feat. But we welcome the possibility of undertaking this debate and delving into these issues.
The question must be asked: Is there a place for psychotropic drugs in the society of the future? We must take a stand and we are very much in favour of widening the debate and exposing the issues so as to determine the scope of the decisions that will have to be made.
In closing, I would like to table before the committee a text on the public use of drugs. It was written by Mr. Pierre Brisson, a Quebec teacher who specializes in drug addiction. It represents a valuable analysis of the commodification of the drug phenomenon.
The Chairman: Thank you, Mr. Germain. Earlier, I forgot to introduce our group: Senator Shirley Maheu from Quebec, Senator Tommy Banks from Alberta, and Senator Michel Biron, who is also from Quebec.
We also have our stenographers, it would be impossible to work without them. We could not possibly remember all of your interventions.
We also have with us the Research Director for the committee, Dr. Sansfaçon; our committee Clerk, Mr. Charbonneau; and Mr. Lafrenière, a researcher with the Library of Parliament.
If you require simultaneous interpretation, it is available, so that we can all understand each other.
First of all, in your report on diversion, did you examine the option that was included in the Senate committee report when we examined Bill C-8 in 1996, that is, the possibility of imposing a fine for possession? Did you look at that option?
Mr. Germain: Yes. Those of us who discussed the report felt that the same sentence should not apply for everything. They felt that for some repeat offenders, there might be a different type of sentence.
I will summarize one of the relevant recommendations. That might make it easier to understand.
That in case of simple possession of marijuana, diversion should be the preferred approach throughout Quebec, in any case where those involved, prosecutors, police officers, social and community workers, agree that from a problem — solving point of view, this is the most appropriate approach [...]
What we meant is that the police did not necessarily want a systemized approach to sentencing. They wanted to be able to examine the case together so as to arrive at the best possible decision.
Of course, this position was adopted according to the following conditions:
That diversion for possession not be systematic but applied according to clearly pre-established parameters that would guarantee fair treatment to all offenders throughout the province of Quebec. A wide range of measures must be available; the practices of various police forces must be uniform; that the lawyers must jointly agree to the diversion process.
Actions must be better coordinated; the lawyers must be able to count on the cooperation of various organizations responsible for the implementation of these measures; a diversity of measures must be designed to respond to the needs of individual addicts requiring treatment as well as to the needs of non-dependent individuals for whom other types of treatment would be more appropriate.
In answer to your question, what we meant was that in the case of a drug addict, the sentence would tend to involve treatment or some type of compulsory help; for others, there could be a fine.
The Chairman: You mentioned the 74 studies that were part of your official record.
Mr. Germain: Yes.
The Chairman: The committee was told that a study sponsored by the CPLT had not received its approval and had remained anonymous. It was the one written by Mr. Nicolas Carrier. Are you aware of this study and would it be possible to have a copy of it?
Mr. Germain: Unfortunately, no. It is true that the committee decided not to publish this study for reasons relating to the methodology. We often commission studies to be done by researchers or university professors. And we often refrain from publishing some of this work, either because the subject was not properly examined or because the product did not meet our expectations, et cetera.
Unfortunately, it will remain a document that —
The Chairman: Shall we call it discreet?
Mr. Germain: That's it!
The Chairman: You recently published a brochure and I see that you have brought one with you.
Mr. Germain: A tiny little book called Drogues, savoir plus, risquer moins.
The Chairman: I have read it from cover to cover, and I find it quite similar, and possibly this was intentional, to a book published in France by the Mission interministérielle.
Mr. Germain: That is correct.
The Chairman: Did you closely examine the entire content of the French publication before proceeding with your own? How did you analyze it?
Mr. Germain: The Standing Committee was given the permission to proceed with a Quebec adaptation of the French book of the same name. Ms Nichole Maestracce told us: ``Why not share it. We have already made a major investment. We see no problem in you using the content.'' So we struck a task force, made up of specialists, to work on the Quebec adaptation. These people may have already appeared before you or may be about to: Mr. Mohamed Ben Amar, who was the publishing coordinator along with others from the group researching the risk factors. We examined Canadian and Quebec statistics in order to find what was relevant. We added some drugs that did not exist or were less popular in France. And some of the writing was adapted to better reflect the language of Quebec.
However, there was no change on the scientific front; it was just for the adaptation. And this little book, I am glad you brought it up, because it is a huge success. Our objective was based on the sound conviction that as far as drugs are concerned, the more informed people are the more capable they are of making an enlightened choice on whether or not to use them.
So if it can be widely distributed, people will be in a better position to make their decision. Right now, the book is hugely successful: it was launched in December and so far over 50,000 copies have been sold. The Quebec police corps is buying a little book for each of its employees, for each police officer.
You can see that stakeholders and the public at large are getting more up-to-date information, because it is a book designed for everyone, even young people. And it is a book that has been hugely successful, especially in France. They have sold two million copies. And it was youths from 15 to 25 years of age who were the most interested in it.
The Chairman: I think my colleagues have questions. I have several myself. So I will write to you when we are back in Ottawa, to get some clarification on this study, among other things. We will read your study. We want to compare it with other studies on Quebec students, which the committee has already received.
Senator Banks: I understood you to say that the committee believes that possession should be a crime. You were talking about the nature of what the consequences of it would be, and you said that there should be various different consequences for — and you used the word ``the crime.'' Does the committee believe that possession ought to remain a crime?
Mr. Germain: In my introduction, I said that the CPLT could not change its official position on the subject. But I can say that in 1999, when the committee published its last notice, it did feel that possession should still be a violation under the Criminal Code.
Senator Banks: My other question concerns a report that the chairman asked you about. Your response was that the report did not meet the requirements of the committee. Would you explain to us the sense in which it did not meet the requirements of the Committee. I am concerned about the obvious question: If the committee is looking for reports that agree with the view of the committee, that is not good science. So was your reservation about that report purely and only methodological?
Mr. Germain: It was only methodological.
Senator Banks: You talked about cycles. I know that you said it has to go on longer in order to determine, but you also mentioned, for example, that the same thing does not seem to obtain at the moment in Ontario, that the downward cycle that seems to have been done in Quebec is not matched in Ontario. Are those studies based on the same kinds of general parameters, so that they are comparable?
Furthermore, have you yet been able to determine what, if any, social factors contribute to these cycles? Do we know anything about what might cause it to go up and what might make it go down?
Mr. Germain: Yes. Based on studies, especially from the province of Ontario, there seems to be a good consumption monitoring system. That is an asset. And in Quebec we are trying to see how we could get a better monitoring system of consumption parameters.
Indeed, it seems that in Ontario, since 1999, there has been a marked reduction in consumption, except for cannabis. And there is scientific proof to that effect in the report.
As for the variables involved, very little work has been carried out to explain the increase or decrease in consumption. Based on the most common research methods, everything seems to indicate that there is no relationship between the two. Unrelated variables were eliminated, such as the person's economic situation or family makeup. None of those socio-demographic variables seem related to the increase or decrease in consumption. Some are now seriously talking about social morals. I think that is one way to explain it.
One could say it is a combination of attitudes, a set of values that are endorsed, it is a group of messages. It is public opinion. And it is also the perception people have of how acceptable drug consumption is, and this relates back to their parents' consumption habits.
It has been clearly shown that if parents take drugs and they encourage the idea that consumption is not a problem, that consumption is acceptable, that has a much greater impact than socio-demographic variables.
It is important to take all that into account, and as we mentioned in our report, I think much more detailed research is required. Our prevention campaigns would benefit from that.
The Chairman: We will write to you, Mr. Germain. We have a myriad of unanswered questions, and we will send them to you.
Mr. Germain: I will be pleased to answer them.
The Chairman: Thank you very much for accepting our invitation. We appreciate your talking the time to come here.
Our next witness is Mr. Pierre Charles Boudria from the Dollard Cormier Centre.
Mr. Pierre Charles Boudria, Dollard Cormier Centre: I would like to give you a copy of a special quote from Marie Andrée Bertrand, whom I am sure you know, as well as excerpts from articles that I feel are extremely interesting on the difference between use and abuse, as well as on the reversal aspect of addictions. I also have for you two articles from the magazine Psychotrope on prohibition, on the costs of prohibition, and so forth. I will leave them with you. It will make for interesting reading afterwards.
It is an honour for me to appear before you this morning. I am a clinician at the Dollard Cormier Centre, the largest institution in this field in the Montreal region. It is clear that a public rehabilitation centre does not express its views on social and political matters.
I am here as a university professor and as an intellectual. I found your document most interesting because, indeed, for a number of years now, and you mentioned this in the document, it has been the case that when you read scientific articles on this topic, there are sometimes inconsistencies and confusing messages. From that perspective, I found the document very interesting.
If you do not mind, I suggest we go through it and that I focus on the questions raised on the last page afterwards. Is that all right?
The Chairman: Yes.
Mr. Boudria: I think that the legislator will be faced with a number of influences, not only intellectual and scientific data. In fact, I think the scientific information we have has been available for a long time.
In the 70s, people starting wondering about the legitimacy of the drug war, etc. A lot of thought was given to those questions.
The legislator will be faced with several influences, not only scientific knowledge. One must also take into account the very obvious question of power relationships. Think of the lobbying on the part of brewers, distillers, tobacco companies, the pharmaceutical industry who, over the years, as you will see in my document, certainly hindered cannabis research.
The pharmaceutical industry obviously wants patents, and so on. So tobacco companies, the industry, the pushers of ethanol and ethyl the brewers, the distillers, the police, who have huge resources and budgets for this drug war, can also resist.
Think of movements such as Alcoholics Anonymous or other similar groups, who advocate virtue, total abstinence, and who see consumption as being a vice in itself.
Legislators think scientific knowledge is important, but do not forget that there are other forms of influence related to this issue.
The Chairman: I will stop you right there. We are fully aware of the possibility of those pressures. Now you must bear in mind that the committee has imposed upon itself a quasi-judicial rigour. When I say ``judicial'', perhaps you are familiar with how courts work. The tribunal recognizes only evidence presented to it in a legal manner.
Mr. Boudria: Yes.
The Chairman: In other words, the evidence must be legal. So an idea cannot be submitted as evidence. A theory, if it is unproven, is not evidence. So it is possible there may be influences. We think there are influences, but as long as there is no proof of that conspiracy, as far as we are concerned, it does not exist. Do you follow me?
Mr. Boudria: Yes, completely.
The Chairman: So that is why we decided from the outset to reject any unproven theories.
Mr. Boudria: Yes.
The Chairman: Now this does not prevent our witnesses from claiming that such a thing exists.
Mr. Boudria: Exactly.
Besides the myths and the lack of information, you also emphasized the contradictions that exist in some of the research. In part, we are only dealing with hypotheses or reflections, but we can still have questions about the interests that motivate the research.
Let us not forget that information is transmitted by media that belong to private companies, etc. And let us keep in mind the fact that sensational stories sell many more newspapers and serve to increase audience ratings.
I think that it is very important to reassure the public when seizures are made in order to justify the millions and billions of dollars that taxpayers invest in this. At the same time, it is important to present an alarming picture.
Now let us talk about what is called in English the stepping-stone theory. As you know, this theory was refuted about 15 years ago. From an epistemological and scientific point of view, if we look at the use of cannabis as compared to the use of other so-called hard drugs, like cocaine and heroin, in fact, the figures do not match at all. This leads us to believe that the stepping-stone theory can be used to alarm the public and to justify the costs.
Some say that the use of cannabis can lead to using other drugs. But we should take note of the fact that all kinds of drugs are available on the same market, from cannabis to heroin, cocaine, mushrooms, LSD and the rest.
Thus, consumer are exposed to all kinds of drugs. And the consumer is exposed to these risks because of the criminal justice system. In fact, a cannabis user runs the risk of using other products. The Netherlands have drawn a distinction between soft drugs and hard drugs, but this is a purely theoretical distinction.
There is no such thing as a hard drug or a soft drug. We should be talking, rather, about soft use and hard use. Why is this? Because a very hard drug can be used in a soft way and a very soft drug can be used in a very hard way. Thus, the entire issue of hard drugs versus soft drugs is a non-issue. However, the Netherlands opted for this choice for the very purpose of telling the two markets apart.
Consumers are thus exposed to drugs, and this is due to the criminalized and clandestine environment.
As you pointed out, it seems that there are psychosocial factors that make people graduate to other drugs. I think that I have read nearly everything that has been published on this matter for the past 15 years or so, and I think that this is one of the first times what we hear, and I am very proud to point this out to you, that a product per se cannot make an individual graduate to other drugs. There are many other factors at play and they must be pointed out.
Now let me go on to page 4, regarding the effects of cannabis on health. There are some clarification to be made: what is called cannabis psychosis, etc., is a problem due to the mental health or the psychological makeup of individuals, far more than to the pharmacological and psychotropic properties of cannabis as such.
Thus, individual differences play a much larger role than does the product itself.
The Chairman: Let me stop you right there. This was not mentioned in the document because we wanted it to be brief and concise. The researchers who helped us to define chronic habitual use, set the benchmark at 30 grams of the drug per month. Does this benchmark seem right to you?
Let us not forget that we are talking about chronic effects, we are dealing with chronic effects in abusers. Does this seem reliable to you?
Mr. Boudria: No.
The Chairman: Because we are trying to validate this data.
Mr. Boudria: We know that drug use is a continuum. Thus, there is a continuum between the non-user and the chronic user.
The Chairman: Yes.
Mr. Boudria: Now you are asking me whether chronic use can be defined as using one gram of the drug per day?
The Chairman: Yes.
Mr. Boudria: I would say that it is much more than that. This can be compared to the use of tobacco. Tobacco is used compulsively from morning until night. That is what chronic use means.
Three times a week or more would be regular use. Using more than one gram a day, in my opinion would be chronic use.
The Chairman: In other words, this would not be intensive use?
Mr. Boudria: No.
Admittedly, this is a daily user. Allow me a footnote: no matter what kind of psychotropic product is consumed, be it caffeine, alcohol or something else, using psychotropic drugs has on impact on sleep, on different parts of the stages of sleep, on recovery, on protein synthesis, and on the ability to encode new information.
In fact, if an individual makes daily use of a substance that affects his central nervous system, this will obviously also impact his moods and other things, whether it be cannabis or anything else.
In the Kouchnes report, in France, amotivational syndrome was studied without any conclusive results. The same applies to cannabis psychosis. Would this be due to the different psychological makeup of each individual?
Are we dealing with someone who is already suffering from problems? Thus, we are mainly dealing with vulnerability due to psychological differences. And I think that it is also important to note that these things vary enormously according to dosage.
Page 5 deals with the costs incurred by criminalizing cannabis. Here again, I was very glad to see that someone dared to print those figures. And I think that the citizens would support us if we told them that we are very concerned with all these costs, especially when the economic climate demands that all expenses be justified.
If we look at the number of arrests and the amount spent on this by the state, I think we have to ask ourselves some questions. Whether or not we are in favour of individual free will, I think that we must ask some questions about these expenditures.
Rather than waging war on drugs, why not wage a war on poverty or on the lack of education, for instance?
On page 6 I put the question of whether our youths are victims of this. Here we must be careful. Just now, my colleague, Mr. Germain, quite rightly emphasized some figures. My text refers to a landmark document from the Department of Health that deals with the very fact that the use of psychotropic substances is not necessarily abuse.
And this is another example that runs counter to the hypothesis that prevailed during the 1980s with regard to cocaine and heroin. Then they were saying that after having taken the drug a certain number of times, the user automatically became depraved and dependent and turned into a delinquent.
This brings us back to your question about habitual use. With regard to all psychotropic substances, there are adverse effects in 10 per cent of cases, impacts on physical health, personal relations and activities as well as the costs incurred by the state for treatment or other things, including referral to court and so forth.
The Chairman: I have to interrupt you once again. Is that 10 per cent of the general population, that is, of all consumers, in all age groups?
Mr. Boudria: Yes, exactly.
The Chairman: In the document, as you know, young people are dealt with separately. Among young people, after all, it may be as high as 30 per cent. We think it is higher, but that is the figure we have, and that is why we asked the question.
Mr. Boudria: But it is important to notice, as the following page shows, that use changes with time. There is a clear curve. Drug use is highest among those aged 15 to 25. But as time goes on, and the baby boomers from the late 1960s are an example of this, people generally turn their attention to other things.
The fact that people have used something does not necessarily mean that they will carry on using it forever. Drug use changes with time.
I showed you this simply to explain that the only psychotropic substance that does not follow this 10 per cent dependency rule is tobacco. There are fewer than 5 per cent of tobacco users who can use it only occasionally.
Where young people are concerned, I think that we need to be very careful about what we hear and the messages in the media; I often give the example that drunk driving, violence in schools, domestic violence and incest are probably not more prevalent than they were before. I think that we talk about them more than we used to — there is no doubt of that — but I do not believe that they are more prevalent. We need to be careful. And I think that the public also needs to be very careful about what is in the newspapers, in some of them more than others, because there is a tendency to try to make headlines.
To continue, at the top of page 7: ``Cannabis is a psychoactive substance and it is therefore better to not use it.'' Human beings have been taking drugs and psychoactive substances, as you know, since the beginning of time. It seems that human beings have a fundamental need to alter their state of consciousness. What do children like to do, for example? They like to swing and get dizzy. And what do adults like to do? They like good food. They like to make love. They like a nice vacation. So we like all the things that stimulate our central nervous system and our psyche.
Using drugs does, of course, involve risk. Whether we are talking about coffee, tobacco, alcohol or medication, it is still the case. But it is important to realize that risk-taking is an inherent part of being human.
In the two minutes I have left, I will deal with the issues raised. I think that it is very important to say that anti-drug laws were not enacted to protect citizens or ensure public safety. I think that intellectuals have become increasingly aware of this because the question has been asked a great deal over the last 30 years. We need to think about when these laws came in. We know that Mackenzie King brought in measures when he was Labour Minister and the United States passed the Marijuana Tax Act.
In Canada our anti-drug legislation has its roots in the Opium Act of 1908 and the various anti-Asian campaigns of that time. As well, it is no coincidence that opium, coca and cannabis are all drugs that come from developing countries. Obviously, other forces were at play here.
In order to have a coherent policy, in my opinion, the state must talk about these other factors, because citizens will support leaders and legislators who dare to take an approach different from the American model. I think that Canada and Quebec should be proud of being a little more pragmatic. We realize that the war on drugs is not effective.
I think that it is important, at the same time, to think about the interests at stake. The interests are the same. In the past, it was the interests of those in power. But today we need to ask ourselves who is benefiting from this war on drugs? We need to realize that every year we are giving billions on dollars on a silver platter to organized crime and we are paying for their trials as well.
This is another clear contradiction. We criminalize drugs. With our laws, we cause crime to proliferate. We force people who take drugs into more dangerous situations. And I will not get into the damage having a criminal record does to someone who wants to work, etc.
I will conclude with a word about ethics. How do these power relationships play out? I think that we need to focus on this. We need to realize that these power relationships and the various interests are very complex. After all, the research that we see is very often sponsored by groups that also have interests.
We need to take into that reality. Drug laws are not aimed at health promotion. I think that the document demonstrates greater openness on the health promotion side; that is why I was very proud to read it and why I am here this morning to talk about it.
I think that you have been very courageous. Congratulations!
The Chairman: If you feel that we have not let you make all the comments you wanted to, please write to us and we will be happy to receive your text. When the researchers read your document, they may raise other points and if you have any additional information, please write to us.
We may send you a collective letter if we have any questions.
Mr. Boudria: Fine.
The Chairman: We now have Dr. Mark Ware, Assistant Professor at McGill University. Mr. Ware, thank you for accepting our invitation. We try to hold the line at 30 minutes, including both your presentation and my colleagues' questions. If any other questions arise, I will write to you.
If there is any information that you would like to send us after your visit here, you can send me a letter or an e-mail. That information will be included in the discussion document.
Dr. Mark Ware, Assistant Professor, McGill University: I am sorry to have to give my presentation in English, but it is easier for me. My conclusions are very complex.
[English]
Good morning, and thank you very much for inviting me to appear before the Senate Committee, I commend you on your work, and it pleases me greatly to see that this important work is being undertaken here in Canada, I am proud to be able to contribute my thoughts in this area.
The Committee has asked us to review current cannabis policy and to consider alternatives ranging from increasing the penalization of cannabis possession to full legalization. Since cannabis policy is based fundamentally on health concerns, it has been reasonably argued that cannabis should remain an issue of health, rather than law.
As a pain physician, and as the principal investigator of a clinical trial of smoked cannabis for chronic neuropathic pain, I have had the opportunity to reflect on many of the issues that are now before the committee. I wish to address three areas: the effects of policy on cannabis research, the future of medicinal cannabis research in Canada, and the legalization of cannabis.
Let us look at the effect that drug policy has had on our understanding of cannabis. All our data on the health effects of cannabis have been collected under a paradigm of prohibition. This may seem self-evident, but it constitutes an important source of potential bias. In examining the health effects of cannabis, an estimate of the use of cannabis in a healthy population is important. When, for example, Statistics Canada phones up and asks a randomly selected individual, ``Have you ever smoked cannabis?'', or ``Have you ever smoked cannabis and driven a vehicle?'', the legal status of cannabis will influence the response that is given. Surveys of illicit drug use are notorious for poor response rates. It hampers our ability to draw conclusions on what cannabis does if we do not really know who is doing it. It is impossible to estimate the size of this bias and the effect it has had, and any good research will always try to minimize it.
However, in my experience of critically reviewing the literature on the cannabis effects of health, examples exist where important estimates of risk are based on studies that have inappropriate control selection. It is therefore important to acknowledge this potential bias when reviewing the health risks of cannabis. The question therefore changes from, ``How has cannabis policy affected health?'' to ``Has cannabis policy affected our understanding of the health effects of cannabis?''
Now let us turn the focus to clinical trials — the ``gold standard'' of medical evidence. There is plenty of demand for clinical trials of cannabis, and I must point to the need for clarity in definition. Cannabis is so often used to describe so many different things. Smoked cannabis? Vaporized cannabis? Cannabis tinctures? Extracts? Single cannabinoid agents? Synthetic agents? Which of these gives evidence of cannabis effects?
Almost exactly three years ago the federal Minister of Health announced a program of medicinal cannabis research. There are three fundamental components of the program: the establishment of a federally appointed cannabis cultivation agency; a new regulatory framework under which patients would be able to apply to possess and cultivate cannabis for medical purposes; and clinical research. Funding was made available for a clinical trial of cannabis for persons living with HIV/AIDS, and additional funds were earmarked for clinical trials to be administered through competitive peer review by the Canadian Institutes for Health Research. Since the inception of the clinical trial process three years ago, only one trial has been funded by the CIHR: a pilot study of smoked cannabis for chronic neuropathic pain, of which I am the principal investigator.
How, then, has the existing cannabis policy framework affected the research that others and I are trying to conduct? In the last two years, we have designed a high quality study, secured the funds, obtained ethics approval, and we have been granted the necessary regulatory approvals to proceed. We have obtained a class 2 medical device licence for a hash pipe. We have built a laboratory to allow patients to smoke cannabis at the Montreal General Hospital. We are ready to go; all we need now is the cannabis.
NIDA, the National Institute of Drug Abuse in the U.S., has assured Health Canada that they will provide us with material, but first NIDA must review the protocol, then the Department of Health and Human Services reviews the protocol, and then the Drug Enforcement Agency must agree to export it to Canada. This may take over a year, if ever.
We are, therefore, also waiting for the Canadian cultivators to obtain their regulatory approvals, and they are trying to make sure that they appreciate what our trial requirements are. I trust that Health Canada is working as hard as we are to see that these trials get done. The irony is, that for all of the excitement of our trial progress, there is a perception that studies such as ours will help provide the answers to these clinical dilemmas. In fact, our small pilot study will only serve to explore some of the issues that we need to tackle in larger studies. Then we can talk about answers. For now we are still dealing with very preliminary research.
Yet one has to start somewhere. Strictly speaking, I cannot even so much as weigh a joint that a patient shows me to determine the dose they are using, because I am committing a federal offense. I am fortunate to look after a small number of patients who have had cannabis experience, and who are willing to share their stories. Meanwhile, thousands of Canadians are getting access to cannabis through the Compassion Club communities. This is where some really exciting pilot research is getting done involving strains specificity, work with tinctures and extracts, and some intriguing vaporizers, which are potentially marvellous delivery systems. The Compassion Club network offers a unique opportunity to gather some very useful information, but the current framework is not encouraging their participation in the process.
Let me finish by trying to unite the medical and recreational cannabis issues. I keep hearing that medical cannabis is a totally separate issue from recreational use. I have grappled with this, but I do not get it. Some of the issues surrounding the medicinal use of cannabis are clearly distinct from public policy, such as questions of dose and effect size, but most of the information on the safety of cannabis has relied on information from recreational users. The safety of cannabis in humans has been extensively studied, thanks in part to a massive Western cohort of ``healthy human volunteers'' of the last 40 years. Cannabis may indeed have undergone the most extensive and unorthodox Phase I clinical trials of any drug in history. An open and honest program of clinical research can only add to a debate in which there has been so much passionate misinformation. The results of clinical trials may not be applicable to the recreational user, but I believe that they will have an impact on global cannabis policy, because medical utility is so clearly stated as part of the international scheduling of these substances.
It is clear that cannabis policy is failing to do what it was originally intended to do. It is not protecting us; it is hurting us. It is costing us deeply in terms of resources and social fallout. What our society needs to do is to undergo a radical and systematic change in the way we collectively perceive cannabis. Instead of reducing it to an illicit and undesirable evil, we should acknowledge the potential of cannabis to improve the health of our ailing planet.
Perhaps in some small way this is already happening. Cannabis sativa has been bred over thousands of years into two major strains: a drug-type and a fibre-type (commonly called hemp). We have recently revised our attitudes towards hemp, and we are trying to tackle the issue of medicinal cannabis use. History will judge the 20th century as having outlawed one of the most useful herbs in our garden based on scant evidence and bizarre logic, and I can only hope and pray that cooler heads will prevail.
In closing, I wish to make a plea for a coherent and transparent cannabis research framework. Any drug development plan has a defined endpoint, the marketing of a new drug. Where are we going with cannabis? I do not know of a clear vision within Health Canada regarding clinical trials. Is the aim to get herbal cannabis onto the pharmacy shelf? Or are studies of smoked cannabis merely stepping stones towards non-smoked preparation? No research strategy will emerge without some vision of what we are trying to do. This, coupled with a profound examination of how broad cannabis can and should be, will place Canada in the front seat of international drug policy, and foster an environment of truly open and public research.
Senator Banks: That is exactly what we were talking about.
Senator Maheu: Dr. Ware, you spoke about assisting the health of our ailing planet. I was wondering how do we correlate that with the health of our 12- to 15-year-olds, when we are talking about usage of cannabis in the end of primary school and the beginning of high school? As a researcher, how do you correlate the two? You want to see those that need drug release for their pain, what do we do about the 12-year-olds that are smoking?
Dr. Ware: I think we have to do the same with the 12-year-olds who are smoking cannabis as we do with the 12- year-olds who are smoking tobacco, or drinking alcohol, or are involved in other activities that we collectively feel to be hazardous. We have to educate them. We have to be able to discuss openly with them, and we have to have an environment in which they can come forward and admit to what they are doing, talk about it openly and freely without feeling that they will get arrested and carry a criminal record with them for the rest of their lives. There needs to be some atmosphere that at least we appreciate what they are doing. We also have to be clear as to what we can tell them about the risks are that they are undertaking.
It is not totally clear to any of us yet what happens to young adolescents who experiment with cannabis and stop when they are 24 or 25 and go on to become doctors and researchers, or whatever else they do. It is not clear yet whether we can say to them, ``Look, you are ruining your health, or you are going to do badly in school.'' I think the only way we are going to get that information is by going back to my first point, and that is to allow that discussion to take place free of legal constraints. These kids are not going to talk to anybody about the problems they are having because they are afraid of getting arrested.
Senator Maheu: I think 12-year-olds are not so much afraid of getting arrested. I disagree, I think they are talking about it. Every teacher that I have met has talked about the problem of drugs in school, and every year that we talk to them they are becoming younger and younger. I do not think prison is a problem for 12- to 15-year-olds, I do not think they are even thinking about that. The problem is being up with their peers and doing what their peers are doing.
Forget about the prison, 12 year olds are not afraid of that. Could you elaborate a little more?
Dr. Ware: You asked me initially to try and reconcile the ailing planet issue with the 12-year-old in school. I know parents of children and adolescents who are struggling with cannabis use. I am not denying that there are problem smokers out there who smoke from morning until night, and who would like to cut down. I am not denying that there are young people of 12 and 14 years of age who are using cannabis in schools, and that it is not a problem.
What concerns me is that what we are trying to do is improve the likelihood that these kids are going to go through school, do well, become functional members of society. I am not sure, and I do not think the research is out there significantly to tell us yet how we should be approaching this. I do not think it is clear that we can say, ``Yes, go ahead, it is all right to do it.'' I think we have to be able to talk sensibly about what the risks and benefits might be. That is what the research is intended to provide.
However, the climate in which we have been trying to gather that research has sort of been skewed; we have a history of certain aspects towards cannabis use that has coloured the way our research has been conducted.
Senator Maheu: Thank you.
Senator Banks: You said that since cannabis policy is based fundamentally on health concerns, it has been argued that cannabis should remain an issue of health, rather than legal. I think that if cannabis policy were based solely on health concerns, the problem that you have outlines would not exist because cannabis policy — as you pointed out — is based on perceptions of morality more than it is on questions of health. I think that people got scared to death by a film in 1936 called Reefer Madness, which is patent nonsense.
That attitude is the foundation of our present Canada's policy. I agree that such a perception is not something on which we ought to base a national policy — be it health policy or anything else. That is merely an observation, and I do not know whether you want to respond to that.
Dr. Ware: I have not seen Reefer Madness, I have obviously heard a lot about it. From what I have heard about the various stages that cannabis policy has been through, they almost always reflect some kind of health concern, be they psychological or psychiatric illness, madness, violent criminal behaviour. There is always a health issue underlying all of that, and I am just trying to keep that health idea up. Surely the idea as was stated in an Ontario Court of Appeal decision two years ago to protect the health of Canadians is a primary goal of the government, and of our health branches. Looking at cannabis with that perspective, I think helps to clear away some of the issues that have clouded it so much over the last 50 years.
Senator Banks: I hope that we can get to the point where Canadians can all look at questions of cannabis — and other related questions — from the standpoint of health. However, I fear that one of the things that we are up against is the fact that many Canadians see it as a moral question.
Dr. Ware: Right.
Senator Banks: You said that problems exist ``where important estimates of risk are based on studies that have inappropriate control selection.'' Would you expand on that, please?
Dr. Ware: Yes, I will do it without relating specifically to the study. I talked about the background prevalence of cannabis use — the idea that we need to know who is out there doing it. If you look at a study of smoking cannabis and lung cancer, you must look not only at the people who smoke cannabis and got lung cancer, you must compare that with those who smoke and have not got lung cancer. It does not make sense to say that of a 100 patients with respiratory tract carcinoma in this ward, 50 per cent of them are cannabis smokers, and say, ``Well, there you go, cannabis smoking causes cancer.''
You need a control group. That control group is usually — in any good epidemiological study — intended to reflect the background population from which that control group is formed. That is a fundamental principle of epidemiological research.
If you draw the control group from blood donors who have a 10 per cent likelihood that they have ever smoked cannabis, there is going to be a very sharp tilt in the risk estimate that you generate because clearly there are five times more smokers in the cancer group than there are in the healthy blood donor population. However, blood donors are not representative of the general population. They are probably healthier; they are probably giving blood because they know they are healthy and because they have not undertaken risks.
With cannabis smokers, we look at the estimate of how many smokers there were in that population. Ten per cent ever having smoked cannabis is lower than what I would expect from a general survey of the population of Canada. We have some statistics that suggest that 30 per cent to 35 per cent — probably higher — have used cannabis in some shape or form.
When I see a control group in which only 10 per cent has ever used cannabis, I say, ``Well, are they telling the truth?'' If they are, then is that really a true representation? When you are bringing the figure for the lung cancer patients down to 20 per cent, it matters hugely if your control group has a 10 per cent prevalence or a 30 per cent prevalence. If they have a 30 per cent prevalence — which is reflective of the background population — and your lung cancer patients have a 20 per cent prevalence of ever having smoked cannabis, the risk, in fact, completely changes direction, and cannabis smoking becomes protective of lung cancer, because less of the population who got cancer were smokers than the general population.
You have to look at this very carefully. Because it is so difficult to collect that data from healthy people, it is the fundamental question when you criticize or examine the research that has been published. We make decisions based on these data. People might say that cannabis causes cancer or other afflictions, but when you read the research carefully, you would be surprised what kinds of problems you can discover.
Senator Banks: We need better research. I mean, you would not find anybody, I do not think, on this committee, who would demur from that view. I must tell you that not only the evidence that we have heard, and the evidence that the Le Dain Commission heard, and probably the evidence that the India Hemp Commission heard in 1894, all have said there is not enough research. This is getting into the realm of ``duh.''
I am speaking only personally now. I will be urging this committee include in its report that the government ought to undertake to be the proprietor of, and the protector of, and the aegis under which that research is done because nobody else is going to do it. Pharmaceuticals are not going to do that unless we can show them some way to patent it. The medical community does not seem particularly interested in doing it; in fact, it seems sometimes — present company excluded — to be rather resistant to it. I will be urging my colleagues that we should include in our final report a very strong recommendation.
The most important thing that we can do is to do large-scale, large sample, long-term, carefully controlled scientifically irrefutable research, at which, as you suggest, we could become a leader. This will let us answer some of these other questions. I am rather loathe to answer many of the other questions that we have been asked until that research is done.
Dr. Ware: Rest assured that the pharmaceutical industry is looking very hard at cannabis, and looking at cannabinoids, and looking at molecules. They are looking at skin patches; they are looking at vaporizers; you can even stick it up your bum if you want to. They are looking at synthetic molecules; they are looking at sprays. They have actually patented large banks of genetic cannabis material in order to hold onto those patents of those strains that might turn out to be useful.
The industry is well aware of the possibility, if you have got a drug that is good for nausea, spasticity, pain, if it turns out to be as good as everyone says it is, it is a gold mine for the industry. It suits them very nicely to have things packaged up and kept fairly quiet, because they can hold the information.
I agree with you entirely that Canada should hold that information publicly and openly, and that it should be out there for all of us to share. It is not something that I believe can be patented and packaged up, it is too important a plant, generally, to let Monsanto or anybody else lock up patents on hemp, or anything else.
On the other hand, we have got to make a living, we have got to be able to generate our livelihoods on it. I think there is enough cannabis for everybody, there is plenty to go around. There are plenty of questions to answer, there is plenty of research to do. Had we had set up a coherent epidemiological follow-up in 1972 after the Le Dain Commission, 30 to 40 years later we would be in a position to answer all of the questions that you have raised.
I do not want to see that happen again now, I want to see some action taken: A clear and coherent research strategy set up that everybody agrees is important to do now. We cannot wait 20 years and sit back and ask, ``Well, did we do the right thing?''
Senator Banks: Exactly. My point is that while the aspects of the devices, and the pills, and the patches, and the humidifiers, et cetera, are patentable, and therefore probably will be pursued by private enterprise, and hallelujah we must also do research on the five plants that I might have in my basement, and its effect, and usefulness.
[Translation]
The Chairman: Dr. Ware, I remember reading a summary of your research protocol. You asserted that the THC content was important in assessing effectiveness for pain relief. The committee has heard witnesses working in various Compassion Clubs across Canada, particularly in Vancouver, where some 15 different products are offered to Club members. The THC levels vary considerably, rising to 25 per cent in some of the cannabis.
If I remember correctly, in your research protocol you mentioned plus or minus 8 per cent.
Dr. Ware: Eight per cent is the maximum.
The Chairman: How can your research be squared with the views of the Compassion Clubs, which I would think have more expertise in using cannabis for therapeutic purposes? The network of Compassion Clubs across Canada and the United States seems much more open to using higher concentrations.
So my question is: What is the importance of THC in your research and how can we relate that to what is already being done in the Compassion Clubs?
Dr. Ware: I will answer in English,
[English]
Dr. Ware: We had to select cannabis based on the THC content that was available to us from licit suppliers. We could not submit a protocol using material from anywhere that was not a legal supplier.
At the time I first designed this study, we had to look at the U.S. Government as the only supplier. They provide cannabis rolled into joints up to 4 per cent THC, tops. I have heard that the reason why they cannot prepare anything higher is because the machines they use to prepare the cannabis joints are unable to handle the resinous material, which is the characteristic of the stuff that is producing higher levels of THC.
However, I understand that they have something up to 8 per cent. I am not asking them to send me joints, I am asking them to send us bulk material that we can package and put into single dose capsules. We have tried, and it is the first time any clinical study using smoked cannabis, has standardized the dose framework, so that instead of changing the amount of cannabis that you use, you change the concentration of THC in the cannabis that you use.
Ideally, you or the patient do not know what that THC concentration is — that is the blinding of the study — and that is an attempt to try and see if there is an adequate credible placebo effect. By using a range of concentrations, from 0 per cent to 8 per cent, we can identify whether we can blind patients; whether they do not know whether they got the 8 per cent, or the 2 per cent, or the 4 per cent or the 0 per cent. That is a key question in this kind of study. If it turns out they all know exactly what concentration they were given, then we can turn around and do a larger study and say ``Well, we cannot adequately blind patients, so we throw out the idea of a placebo.'' That is an important decision in a clinical trial process.
In answer to your question, the study designed was based on pragmatic issues of what we could actually get our hands on. At this point, I cannot tell you that I know what is going to be available from the Canadian cultivation program, in terms of their strengths. I know what was requested in the contract; I have my concept of what is being cultivated down there. They have seized seeds and they use that, they are going to be growing a plant that contains over 20 per cent THC, as well. What is the importance of that in research? If we can standardize and have strengths that go from 8 per cent to 23 per cent, then hallelujah, let us look at the effects.
I think THC levels were pushed up, and bred up, and we have developed techniques to grow cannabis to walloping great levels of THC, mostly because of recreational use, because the high is more intense. I have an important question. I am not convinced that all patients necessarily benefit from ultra-potent THC grade cannabis. I think sometimes that what they are actually looking for is something in between, where they are getting the effect of the cannabinoid without that blasting high, and maybe having too much THC means that even a small puff is going to make them feel a little funny.
We have got to look at the range, we have got to start and look at the range and see where that THC level that most affects patients is. We can only do that when we have material that gives us a little more range. I have a feeling, in defense of my protocol, that 8 per cent THC is not bad. I think that it would do the trick if you smoked a joint of 8 per cent THC, you would know it.
I do not think we are looking at weak stuff, maybe down at the 2 per cent, 3 per cent level, yes, it is not going to be as potent. However, 8 per cent is not bad. Whether we get our hands on it or not remains to be seen.
[Translation]
The Chairman: You confirm what was said by the Compassion Club experts about the need to have a different level of THC from what is available on the commercial market or appropriate for recreational use.
Dr. Ware: Yes.
The Chairman: You are familiar with the opinion of the Canadian Medical Association about using cannabis for medical purposes.
Dr. Ware: Yes, I understand the CMA's opinion.
[English]
The Chairman: Do you have an opinion on what they told us, or the fact that they object to their members signing those forms to get the exemption to have access to the new regulation schemes? Do you have an opinion on that?
[Translation]
If I ask you that question, it is because the Canadian Medical Association bases its opinion on the lack of clinical research.
Dr. Ware: Yes.
The Chairman: When we look at the history of medicine for the past 150 years, we understand why the medical community is keen to base its answers almost entirely on clinical research. I understand that. But you are an important player in the clinical research, and so you must have an understanding of the problems on both sides. That is why I ask you this question.
Dr. Ware: Yes.
[English]
Dr. Ware: One of the groups that spoke of the Canadian Medical Protective Association, CMPA, said that they have to wait until clinical trials ``such as the one in Montreal'' are finished. I have to tell them that my study is not going to give them the answers they want. They should know that, they should know that pilot studies are not going to be definitive. They should know that it is five or ten years before a drug program comes up with a definitive Phase III pivotal clinical trial.
That is not going to happen with our study. There is a perception out there that this pilot study is going to give answers; the Collège des médecins du Québec pointed to it and said this is the sort of thing that we need.
I am happy to do it, but at the same time, there are physicians out there who have patients coming to them who say, ``I am using cannabis, it is helping me where nothing else has worked.'' In these instances, all the CMA needs to do is to educate their physicians about what the risks and benefits can be, given all of the provisos that I have mentioned already.
We know an enormous amount of what the potential risks are. There is plenty of anecdotal evidence to draw from, and plenty of rationale for patients to justify trying to use cannabis, especially if they are terminal and they are suffering with dreadful chronic pain. There is a way to look at it, and they just need to educate physicians. You can find information about cannabis and the associated risks if you go looking for it.
In response to the CMA, there is information out there. Perhaps they need to sit down and put together a focus group and say, ``Here is our statement of what you can tell your patients, based on what we know.'' The other thing is to try and encourage the Federal Government to use the exemption process as a way of collecting some information. There were 780-odd patients last year; with the new regulations, I am hearing there are now 250. I do not know what happened to the other 500. They have narrowed it down again.
Here are these patients who have been using it for two or three years — legally supplied. The family doctors or specialists that are looking after these patients should be handed a protocol and told, ``Okay, here is your patient, here is the exemption, we suggest that you see this patient every three months for one year; and then every six months, follow them up, do an X-ray after five years ...'' There should be some kind of systematic collection of information from patients. I am sure they would be happy to participate. It would give the doctors an opportunity to collect useful information, and centrally absorb. We are currently working on a protocol with which we can do this and we will submit it to Health Canada later this summer.
[Translation]
The Chairman: What you are talking about, basically, is the normal, usual and expected relationship between a doctor and his or her patient when the doctor is trying to find the optimal or most beneficial dosage for that patient.
Dr. Ware: Yes, yes.
The Chairman: That seems to be quite straightforward to me. From what I understand, finding the right dosage is not an exact science.
Dr. Ware: True.
The Chairman: Every individual will react differently to a given quantity or dosage.
Dr. Ware: Yes.
The Chairman: All that the drug company is providing is a measured dose.
Dr. Ware: Right.
The Chairman: Finding the right dosage is based on the relationship between patient and doctor.
Dr. Ware: But there is more...
The Chairman: The Canadian Medical Association tells us that their biggest problem lies not in understanding the dosage protocol but in prescribing the right dosage. What you are telling us is that their position is based either on a lack of information or an unwillingness to read the information.
Dr. Ware: Yes. It is important to listen to patients because they can say exactly what dose they need for their problem.
[English]
We have to look at the Compassion Clubs. Hilary Black has more than 2,000 patients. That is a source of some information about what kinds of doses for what kinds of ills; having 2,000 patients is amazing. I have just had a paper accepted for 15 patients, trying to say what kinds of doses. It turns out the doses are quite small — a few puffs here and there. Is a dosage framework like two puffs three to four times a day as required? That is what we say for Tylenol.
You do not have to have an exact dose framework, say I take this three times a day, exactly this dose. You take one or two as you need it and you see what happens. If it is not working, you take a bit more a few hours later. We know enough about the chemistry of cannabis to be able to construct reasonable dose frameworks, certainly with respect to smoking it. Oral administration is a little different.
I think we have got it out there, it is just a matter of collecting the information. That is what drives me mad, it is out there already; the CMA wants that information, we could get it to them in two months. However, it is getting the clubs, and the doctors, and enough people interested to say, ``Yes, let us get on with it.''
Senator Banks: If there is a reticence on the part of doctors to prescribe, does that, in your candid opinion, have anything to do with insurance? Insuring the practice, insuring the doctor?
Dr. Ware: I would like to clarify that I do not think doctors are being asked to prescribe cannabis. They are being asked to support the application by the patient to the Federal Government to be able to access cannabis. That is not the same thing as writing a prescription for a daily dosage. That is a different relationship. I think the patients are coming in and saying that they want to use it and asking for the doctor's support in signing a form saying that the patient has tried other things and this might be useful.
With that proviso, yes, I believe that the doctors are reluctant. I think that the medical protective agencies have said that they do not know enough about the risks and benefits for the doctors to be able to recommend it to their patents or support their applications. Interestingly, however, they did suggest that doctors refer their patients to physicians who are experts in clinical cannabis. Who are they? Where is the database of cannabis doctors?
Senator Banks: Do you know of one, apart from yourself?
Dr. Ware: For my patients with chronic pain, even I cannot support their applications under the current regulations. I am a family physician; pain is not a specialty in the province of Quebec. I am a family doctor working in a pain clinic. I cannot support it for a patient with chronic low back pain, neck pain, phantom limb pain, or for most chronic neuropathic kinds of pains. I cannot acknowledge their application because it requires the signature of one or two specialists for these kinds of indications, not a family doctor.
Senator Banks: There cannot be such a specialist in Quebec?
Dr. Ware: There is no pain specialist in Quebec. You can get anaesthetists, rheumatologists, or neurologists. There is plenty of opportunity, but it brings back the same point you raised, are they actually going to go ahead and risk their insurance premiums, or the wrath of the Collège coming down on them for recommending these things?
Doctors are in a tough position. I know plenty who would like to participate, and would like to follow up, particularly if they had some guidelines as to how they could follow up the patient.
Senator Banks: You said earlier that what we ought to do, then, is to educate doctors. However, it sounds like that is not entirely the problem, because they are being otherwise constrained by the Canadian Medical Protective Association.
Dr. Ware: They are being cautioned; they are being told to be careful. Even the CMPA probably needs education; the CMA needs education. These people need to educate themselves in the way that the committee here is doing: by hearing from specialists and experts, and getting some clarification, and making decisions in regard to summarizing those risks and benefits. I hope that Health Canada is putting together some guideline documents for interested physicians —at least one pat on what to say to the patient, and how to follow them up.
Senator Banks: Therefore it would not be unfair to say that the medical community is one of the things impedes doing as much research as we could do?
Dr. Ware: I do not see it as an impediment. I see it as a challenge to be overcome. I am here because I have overcome a lot of the possible challenges. To be fair, the people with whom I work with at the hospital, at the university and even in the province, have been supportive. I came to Canada three years ago, I got a licence to practice in Quebec as a foreign medical graduate — which was a challenge unto itself. However, they knew that this is my forté, and I think they want people who are interested to step up to bat and say, ``Okay, yes, I will study smoked cannabis.''
We have physicians who are interested. We have a group — you heard from Mary Lynch, the head of the Canadian Cannabis Consortium last year. It is a matter of creating a framework and providing physicians with something with which to work.
Senator Banks: Thank you very much.
[Translation]
The Chairman: It was a pleasure having you here with us this morning, Dr. Ware.
Our researchers may have other questions for you. If so, we will write to you and hope that you will answer us.
Dr. Ware: Very well.
The Chairman: We will now welcome Mr. Serge Gascon, Assistant Director, Montreal City Police Force.
Mr. Serge Gascon, Assistant Director, Montreal City Police Force: I am the Assistant Director, Investigations, responsible for all the investigation units of the Police Force.
It is a great honour for me to be here to talk to you about the situation in the City of Montreal with respect to illegal drugs. Since your study is focusing on cannabis, I will centre my remarks on that and talk about the Montreal situation.
I would first like to talk briefly about the situation in Montreal regarding the selling of cannabis. Then I will present a few statistics on charges for possession of cannabis and trafficking between 1999 and 2002. Third, I will give a quick overview of the sentences resulting from such charges. Fourth, I will talk about the increasing problem of hydroponic greenhouses in Montreal. I will conclude my remarks by presenting the Montreal City Police Force's position on the legalization of cannabis.
I will begin by telling you a bit about my own involvement in the fight against drugs. From 1994 to 1995, I was the officer responsible for the Organized Crime Division in the Police Force of what was then the Montreal Urban Community. Between 1995 and 2000, I was a member of the Standing Committee on the Fight against Drugs, a provincial advisory committee to the Government of Quebec on the whole issue of illegal drugs. Since 2000, I have been a member of the federal Drug Abuse Committee of the Canadian Association of Chiefs of Police.
I will now address the Montreal situation. Montreal has been and remains the drug-trafficking hub of eastern Canada. Easy access by port, airport and road means that trafficking illegal drugs is a flourishing activity in Montreal. In the little time I have available, I can only briefly mention certain sociological factors that are relevant here: to begin with, major social transformations such as family breakups, the high school dropout rate, unpredictable economic changes and human distress; second, ongoing pernicious infiltration by organized crime, including the traditional mafia, biker gangs, ethnic criminal elements from the Latino, Asian, Jamaican, Haitian and other communities; finally, the desire that many people always have to make easy money by selling or importing drugs and, more recently, by growing marijuana hydroponically.
All these factors exist in our city, and we have to deal with the sometimes sad reality of it. In Montreal, it is almost impossible to count the number of places where cannabis can be bought, including many schools, nearly every neighbourhood, most licensed establishments, many businesses, many subway stations and many parks.
Then there are the special events that bring out the crowds, which is another place where drug dealers gather. The Jazz Festival is just one example.
Right now, marijuana sells on the market for $2,300 a pound, which is about $10 a gram on the street. One marijuana plant can bring in between $1,000 and $1,500 a year. Some will say, of course, that not all plants are so prolific, but that is the current estimate. It is easy to understand why hydroponic systems are so popular, and I will come back to that later.
I will now present some statistics on charges for possession and trafficking of cannabis. From 1999 to April 30, 2002, the number of charges laid for possession of cannabis in Montreal was as follows: 599 in 1999; 999 in 2000; 1,309 in 2001; and 318 since the beginning of 2002.
Possession for the purpose of trafficking resulted in 166 charges in 1999, 226 in 2000, 218 in 2001 and 55 for the first part of 2002.
Although these statistics indicate an upward trend, a study by the Canadian Association of Chiefs of Police, for which the results have not yet been published, indicates that nearly 80 per cent of the charges for possession of cannabis are associated with other charges, such as a suspect in an armed robbery having cannabis on him when arrested.
With respect to sentencing, given the current situation in the criminal justice system, there is a strong tendency toward leniency for possession of cannabis. An accused with no criminal record can receive a discharge by the court for a charge of simple possession of a gram of cannabis, but does have a criminal record as a result.
Someone who already has a criminal record may be fined $100 or ordered to make a donation to charity.
For growing marijuana hydroponically, sentences are much more severe: a fine of between $500 and $1,000 for a first offence without a criminal record, and prison for repeat offenders.
The problem of hydroponic greenhouses is growing with each year that passes. Since the beginning of January 2002, our staff have dismantled 42 facilities and seized 22,069 marijuana plants within our jurisdiction.
According to conservative estimates, each plant can produce marijuana worth between $1,000 and $1,500, as I said earlier. As a result, hydroponic production brought in $20 million for the first four months of 2000 in Montreal.
If we accept the hypothesis that the police seize only 10 per cent of the drugs on the market, it is easy to see why this market is so attractive. Our intelligence service indicates that hydroponic plantations are mainly under the control of the biker gangs and, increasingly over the past few years, Asian organized crime.
As a last point, I want to mention that we are concerned about societal breakdown. The police deal with a wide variety of social problems: human suffering, increasingly violent criminal activity and the fraying of the social fabric. Of course, the overall situation can clearly not be attributed only to the use of marijuana, although there would be no one using it if it was not being sold, and it does cause serious problems at various levels.
Before sharing with you the vision of the Montreal police force regarding legalization, I would like to lay out a few premises. To begin with, the production and selling of marijuana is a very lucrative market for organized crime, constituting we think, their main source of income.
If the state decided to take control of marijuana production, a black market would develop. Take, for example, the black market in tobacco and alcohol. So the police forces must continue their fight against organized crime, which is becoming increasingly powerful and rich, like an octopus extending its tentacles.
To combat this organized crime machine, police forces need tools, and laws are among those tools. I would like to give you an example that clearly illustrates how we see things.
A marijuana trafficking network sets up in a Montreal area. The network, which is generally under the control of organized crime or biker gangs, establishes its dealers, distributors and sales points. Once the network is in place, which happens very discreetly, of course, people start to complain to the police, especially about public disturbances. These complaints often result from increased traffic around an apartment in the evening or during the night. Everything starts with a public disturbance complaint. Thinking that a trafficking network has been set up, the police plan to search the premises in order to dismantle the network. They then need to arrest the dealer operating out of that apartment.
In order to be able to search the apartment, the police need a warrant from a judge. They need to demonstrate to the judge that an illegal substance is being trafficked at that location. In order to do that, the police do surveillance and arrest a customer who is in possession of drugs.
After arresting three or four customers who are all in possession of the same substance, generally in the same type of packaging, the police obtain a search warrant. In order to be able to arrest these three or four customers, the police need a law that makes it illegal to possess drugs. Without that tool, the law, customers could tell the police to mind their own business, even though they are trying to restore peace and respond to the desires of the public.
We feel that any form of legalization would remove the tools that police forces need to be able to fight the ever- increasing invasion by organized crime, which is very involved in drug trafficking.
In 1995, the Montreal Urban Community Police Force recommended to the Standing Committee on Illegal Drug Use that the following approach be adopted:
That in cases of simple possession of marijuana, diversion ...
By the way, it is also called non-judicialization, if the Crown prosecutor is not involved. I will start again:
That in cases of simple possession of marijuana, diversion should be the preferred approach throughout Quebec, in any case where those involved, prosecutors, police officers, social and community workers, agree that from a problem-solving point of view, this is the most appropriate approach ...
I would just like to stop reading in order to give you a quick example: there is certainly no advantage to society if a grade 9 student is arrested and taken to court for possession of two joints. Right now, this young person would be dealt with by school officials, a community police officer, a social or community worker at the school, without the courts necessarily being involved. That is the approach we recommend, a diversion approach, without telling the young person that this kind of activity is acceptable.
The police forces feel that users should no longer be the target. Organized crime is the real target, and only legislation can help us fight this battle against an enemy that is almost as strong.
You are no doubt aware that the standing committee has issued a number of documents, including an opinion on diversion for simple possession of marijuana.
The Chairman: Thank you, Mr. Gascon. I have a few questions. We feel like we are going in circles. Organized crime is providing the money and, as your testimony indicates, most of its income comes from drugs, and therefore the fact that the product is illegal creates that market. It is a sort of vicious circle. Are we going to find a way out of it?
Do you believe that your work as police officers would be much more worthwhile in other types of investigations than in dealing with illegal drugs?
Mr. Gascon: Of course. As I said earlier, any type of legalization would create a black market. Right now, the level of THC in marijuana seized in Montreal is over 25 per cent. That is what is on the market.
If we legalize some sort of state-controlled sale of marijuana with THC levels at a maximum of 8 per cent, many people would be looking for a higher THC content.
The Chairman: That is not what Mr. Ware told us. He said that he based his research protocol on an 8 per cent THC content because access to a legal product cannot be higher than that. We are quite familiar with THC levels. I will let you finish your answer, but you will have to tell us where your information comes from. Do you have studies? How are these assessments and laboratory tests done? Are they done regularly or from time to time? We need to know that. We know what is done in other provinces and we want to be sure about what is done in Montreal.
Mr. Gascon: To answer your question, there is no doubt that people often say that the police will never finish the war against organized crime. And organized crime is very much involved in trafficking all types of illegal drugs, not just marijuana.
Would legalizing this substance make organized crime get out of the drug market? I do not think so. I do not believe that organized crime would abandon a very lucrative market that it controls right now.
Second of all, it is clear that as police services go, we are trying to change our approach. And I am ready to admit quite honestly that in the past we looked at all the users, anyone who possessed. Right now, we do not have the resources and we do not even have targeting the users as an objective.
The user still becomes a resource when you are trying to establish the existence of a network and find the higher-ups. So that is why we are talking about a non-criminalized or diversion approach for the user.
The Chairman: That is the first time I hear this negative argument. One of the reasons we should maintain the prohibition is that it gives access to indirect involuntary informers. By arresting a user, you can go back up to his supplier.
What happens with contraband alcohol?
Mr. Gascon: Right now, for alcohol, it is a matter of stamps. All the criminalization is done at the stamp level. And we investigate cases of possession of unstamped alcohol. So we only look at unstamped alcohol, which is an illegal substance.
The Chairman: Okay, then, let us push this to its limits. We have stamps on packages of cigarettes, we could have them on controlled cannabis substances.
Mr. Gascon: That means you have to legalize the whole illegal aspect or regulate the possession of illegal cannabis on the market as we do with alcohol right now so that we could go after the black market.
The Chairman: That is it. We are pushing this to the limit. Yesterday, one of the witnesses spoke about wine. Let us compare it to wine. In Quebec, you can make wine in your basement for your own personal use. You can give some to your friends, but you cannot sell it.
Mr. Gascon: No.
The Chairman: If you want to sell wine, then you need a permit from the Société des alcools. And you, as police officers on the territory of Montreal, you have a role to play in enforcing all that legislation.
Mr. Gascon: Well, at the present time, we have started a program called ``Access'' with the people from the RCMP and the Sûreté du Québec for everything concerning tobacco and alcohol. We had to establish parallel investigation groups and invest considerable amounts of money to be able to find those who are making illicit spirits or trafficking in tobacco. It is still illegal.
The Chairman: Yes.
Mr. Gascon: And right now, I can tell you we are having problems setting up the investigations we would like to.
The Chairman: Wait a minute, problems getting results or problems investigating?
Mr. Gascon: No, investigating. And that is a major problem because there is confusion between what is a legal substance and what is an illegal substance, in other words the illicit spirits part.
The Chairman: I will put my colleague, Senator Maheu's question to you: Which is the least dangerous of the two, illicit alcohol or marijuana?
Mr. Gascon: I could not tell you which one would be the least dangerous medically speaking.
The Chairman: Because before you mentioned a THC rate of 25 per cent. And your testimony seemed to indicate that was dangerous. So my colleague's question is quite appropriate.
Mr. Gascon: Quite honestly, I could not tell you. I would not like to get into the medical aspect, because I do not know anything about that. It is clear that, as far as we are concerned, using drugs and using alcohol are two different things. That does not prevent the occurrence of those problems related to alcohol. Society admits that there are problems related to alcohol. You just have to see all the costs related to alcoholism.
I am not necessarily saying that alcohol should be regulated to the point that it becomes an illegal substance.
The Quebec government has started investing millions of dollars to prevent pathological gambling. They set up an adjustment program for pathological gambling.
The Chairman: We make a fundamental distinction between users and abusers of a substance. Our concerns as to the negative effects are mainly for those users abusing the substance. I presume that when you make this link with pathological gambling, you are not concerned with the whole clientele —
Mr. Gascon: No.
The Chairman: — of the gambling system set up by the provincial authorities, but rather those who have a dependency problem. I presume that is the case.
Mr. Gascon: Exactly.
The Chairman: You mentioned the market value of hydroponic marijuana. I did a quick calculation: about $600 million on the territory of the Island of Montreal. We have problems reconciling all those numbers to try and understand the market value of marijuana. That would give a sort of a benchmark as to the quality/price ratio between the investment in public funds as compared to the target we are seeking or trying to attain.
So would it be about $600 million?
Mr. Gascon: Well, in fact, if you accept the principle that we only seized 10 per cent —
The Chairman: Yes, I am extrapolating.
Mr. Gascon: So if you accept that principle, then that is our present estimate. And I am just using the fact that the plant can produce only $1,000 worth of cannabis. It can go up to $1,500 per plant, but I used the minimum figure.
The Chairman: How many police officers are tasked with fighting drugs in your service?
Mr. Gascon: We do not have any officers directly tasked for the fight against drugs.
The Chairman: There is no drug squad?
Mr. Gascon: We have a squad, the Organized Crime Division.
The Chairman: Fine.
Mr. Gascon: And for over a year we have been attacking all problems concerning the infiltration of organized crime, drugs being one of them. The Organized Crime Division squad includes over 200 officers investigating fraud attributed to organized crime, large scale organized theft of motor vehicles, in other words everything involving criminality including crimes related to drugs.
And I will admit that of all crimes related to organized crime, the drug item appears to be a permanent one. There is a sort of consistency.
The Chairman: In other words, all police officers must be on the look-out for that?
Mr. Gascon: Yes. And the officers are on the look-out for all the other crimes relating to the possession of drugs or the sale of drugs, for example public order disturbances related to the use or sale of drugs.
The Chairman: When there is an arrest for possession, I understand that in some cases there are arrests for more than possession, but we will get back to that later on.
But when there is an arrest, are fingerprints automatically taken?
Mr. Gascon: That depends on the quantity seized. If it is less than 30 grams, no fingerprints or pictures are taken. That is what the new law says. And even if no fingerprints are taken, there is still the legal side, a file is opened, but no fingerprints or pictures are taken.
The Chairman: If fingerprints are taken, what happens to that information if the person is acquitted?
Mr. Gascon: As soon as a person is acquitted, everything is erased. There is no more file.
The Chairman: When you take those fingerprints, are you the only ones to keep that information or is it sent around to the other police services?
Mr. Gascon: The first set of prints stays with the police force. When the person is found guilty, that set of prints together with the file is sent to the RCMP's central bank.
The Chairman: As for the Compassion Clubs, you know that there has been one in Vancouver for over six years. In Vancouver, relations with the police have not always been harmonious. According to the people managing the Vancouver Compassion Club, those relations are far more positive today.
Have your colleagues from Vancouver ever told you about their relationship with the Compassion Club?
Mr. Gascon: No. Personally, I have not had any contact with the Vancouver people. When the Montreal Compassion Club opened its doors, we ourselves had to take a position. We even contacted the people from the Department of Justice and the Department of Public Security to see what their position would be because there is a medical side to that and also an order, an acceptance or an authorization by a federal minister. So we are talking about something that is already regulated and has a quota on it.
Our position has always been the same for the Compassion Club. Our concerns were mainly with the quality of the product there. The medical side was clear because we knew very well that the objective of a Compassion Club is to show compassion for the public. And people sympathize with that kind of cause because people are suffering. There is an authorization from the federal government.
What was important for us was the quality of the stock circulating there. Who were the people around the Compassion Club? Were they sellers? Did they have ties to organized crime? And we have always told the people we have met at the department that there was a sort of grey zone created by the legislation that seemed to say: you are authorized to take some. You can plant it yourself but if you buy any, we do not know where you are buying it.
It is clear there is a sort of a grey zone. Where can the person get the stuff once they get the authorization from the department?
The Chairman: The regulation is very specific as to access in the sense that you are always talking about legal access or access authorized by the regulation.
Mr. Gascon: Authorized.
The Chairman: The regulation is written in such a way that one presumes that those who need it will grow it themselves.
Mr. Gascon: Grow it, yes.
The Chairman: For them, that is the basic rule. The exception is if the person cannot grow any. Then that person has access to producers, and I emphasize producers, who can produce some for a very limited number of people.
Mr. Gascon: Yes.
The Chairman: And that is provided for in the regulation.
Mr. Gascon: But at this point in time, in fact, those individuals buy drugs but we do not know where the supply comes from. And we do not know where the Compassion Club people get their supply either.
That is the question we had. And we have always said that as long as there is a medical and safety framework around the Compassion Clubs, we have no objection to them because they are authorized for medical purposes.
The Chairman: If I understand correctly, you have no objection to the principle of compassion.
Mr. Gascon: Absolutely not.
The Chairman: What you want is that, first, no criminal organization be part of it nor have anything to do with it from near or far or directly or indirectly?
Mr. Gascon: That is absolutely clear.
The Chairman: Fine. Now, you are concerned with the quality of the product. And here we come back to the famous THC we were talking about before and my question having to do with laboratory analyses. What kind of evaluation process do you have for the quality or the percentage? How does it work? Do you have a central data bank on seizures?
Mr. Gascon: Every time a substance is seized, we have it analyzed at the forensic office to determine the THC level.
The Chairman: Is that done by a provincial body?
Mr. Gascon: Yes.
The Chairman: I see. And when you talk about THC levels of 25 per cent, was this information obtained from these analyses?
Mr. Gascon: Yes. At the moment, the product available on the market contains more than 25 per cent THC.
The Chairman: So, when a case is heading toward a contested trial, where an accused has pleaded not guilty, I assume that it is at this point that you send the seized substance for analysis?
Mr. Gascon: We have to demonstrate, by means of evidence, that is a scientific analysis, the exact nature of the seized substance.
The Chairman: How much time may elapse between the time of the seizure and the time when the person pleads not guilty?
Mr. Gascon: From memory, I would say it is about one and a half months or two months.
The Chairman: Do you think that the way the product is stored can affect its THC concentration?
Mr. Gascon: I do not think so. But you would have to ask a scientist that question.
The Chairman: Let us come back to the Compassion Club. Are you concerned about the quality of the product?
Mr. Gascon: The quality and the safety considerations.
The Chairman: Fine. You spoke about THC levels of 25 per cent.Some witnesses have even mentioned levels as high as 32 per cent. In your opinion, is there an upper limit that should not be exceeded?
Mr. Gascon: I do not know.
The Chairman: What you are concerned about is access to and control of the product itself?
Mr. Gascon: We have found that year after year our analyses show that the THC levels are increasing. And it is clear that the substance currently available on the market is not the same as the one available 10 years ago. So the THC levels have increased. Our view is that since the THC levels are higher, cannabis has become a harder drug, with more significant effects.
When we arrest people who are under the influence of whatever drug following a robbery, we notice that their behaviour is certainly not the same as that of someone who is not under the influence of drugs. And I include alcohol in that category. An individual who commits a crime under the influence of alcohol does not behave in the same way as someone who is completely sober.
The Chairman: I would like to come back to the Compassion Club. Some witnesses have told us that in Compassion Clubs, and I will take the one in Vancouver as an example, the menu is much more extensive. They can offer their members about 15 different cannabis products with various concentrations of THC.
Depending on members' needs, disease or morphology, they will choose a stronger or a weaker product, based on their tolerance or the effect they are trying to achieve.
Mr. Gascon: Earlier, Dr. Ware told us that doctors will certainly not prescribe a THC level. That is governed by the patient's reaction.
The Chairman: I see. Now, if, for the purposes of our very interesting discussion, we were to imagine some sort of control system for the Compassion Club in Montreal, say, would you be in agreement? Provided criminal groups are excluded, you would have no problem with that?
Mr. Gascon: I mentioned two criteria earlier: first, the quality of the substance. There must be some medical or scientific expertise to check the product being offered. Second, our position on Compassion Clubs has always taken into account criminal elements and safety and security considerations.
[English]
Senator Banks: You mentioned that for possession of less than 30 grams, there are no fingerprints taken?
Mr. Gascon: That is under 30 grams.
Senator Banks: 30?
Mr. Gascon: Yes.
Senator Banks: You said that that was under the new law. What ``new'' law is that?
Mr. Gascon: I will give you exactly the information.
The Chairman: My colleague was not in the Senate when we adopted that in 1996.
[Translation]
Mr. Gascon: That is the Controlled Drugs and Substances Act, which has been in effect since May 14, 1997.
[English]
Senator Banks: Then you are talking about the present law?
Mr. Gascon: Yes.
Senator Banks: Thank you. Given the odious and silly choice between the recreational use of liquor, and marijuana, is one more harmful than the other? I am not asking you for an official opinion; I am seeking your personal opinion.
[Translation]
Mr. Gascon: I will speak to you on the basis of my own experience as a police officer. I became a police officer in 1973. At that time, it was fairly rare to arrest individuals under the influence of drugs at the time of the crime. Today, and I am not talking about cannabis only, because some are under the influence of cocaine or other drugs, there is no doubt that in some cases, their behaviour has become much more violent.
The Chairman: Mr. Gascon, you are speaking about cannabis and cocaine at the same time. As far as we are concerned, those are two very different worlds. People who are not familiar with the subject, people other than you and I, are going to make a connection between the words ``cannabis'' and ``violence'' and think that this drug makes people violent. Is that what you are saying?
Mr. Gascon: No, no. I am saying that in the course of our police work, we have noticed that people who are under the influence of drugs, whatever drug it may be, are more violent.
As to whether or not we can say that this behaviour is attributable to cocaine or heroin rather than cannabis — well I do not make any distinctions. Drugs certainly do have different effects. But what we see as police officers, to answer your question, is a difference in the behaviour of those who have been drinking alcohol, compared to those who have taken a drug.
[English]
Senator Banks: Not drugs, cannabis particularly. You just mentioned the type of buy who gets paid, gets loaded and hits his wife. In your personal experience, have you ever heard of anybody getting high on cannabis and hurting somebody?
[Translation]
Mr. Gascon: No. I cannot answer that.
[English]
Senator Banks: Cannabis does not lead to violence?
[Translation]
Mr. Gascon: No, because I have read that, generally speaking, cannabis makes people calmer. I am very aware of that. I am referring to the effects of the drug, and some individuals will use a number of different drugs at the same time. It is very difficult for us to determine whether someone has taken cannabis only. All we know is that the individual is under the influence of a drug or drugs.
[English]
Senator Banks: Our study at the moment is focused specifically on cannabis.
Mr. Gascon: I understand.
Senator Banks: I wanted to make that distinction: the guy who gets paid on Friday night, and gets loaded on cannabis — if that is the word — is not likely to go and hit his wife?
Mr. Gascon: Yes.
Senator Banks: Thank you.
[Translation]
Senator Maheu: Organized crime causes you tremendous problems and causes society tremendous problems as well. If cannabis were decriminalized, would you have less work to do in the area of organized crime? I am not so sure.
Will the black market give you as much work and as much concern as the sale of cannabis gives you at the moment?
Mr. Gascon: I would answer that with another question: Would organized crime be prepared to set aside millions of dollars a year at the moment? Would it be prepared to let this market go?
The Chairman: Of course not!
Mr. Gascon: In that case, it is clear to me that organized crime as a whole is living on narcotics, in all their forms. That is its main source of revenue. The investigations and trials of criminal motorcycle gangs show that they are everywhere, in all the licensed locations, in schools, and in parks. There are places where drugs can be purchased everywhere. This is their main source of revenue.
Clearly, once there was a state cannabis market, organized crime would establish a black market network, either because the product will be cheaper, stronger or different, so as to attract customers.
The Chairman: In other words, there would be no job losses in police forces if we were to legalize cannabis?
Mr. Gascon: I do not expect to lose my job in the next few years, Senator Nolin. I do not think we would be losing any other police jobs in Montreal either.
The Chairman: No, that much is clear. However, if I refer back to my colleague's question, your work would be different. In other words, your work would be much more specific, but also more difficult, as is the case with alcohol and tobacco. You would have to refine your approach.
Mr. Gascon: Our investigation methods would change. We would also have to deal with the influence of this black market on society. Because there would be a black market, that is obvious.
And what THC content would be authorized by government? Would the government say that it should be 8 per cent, or 12 per cent? Studies would have to be done to determine, from the scientific and medical points of view, what level is tolerable, and what level is the best, as is done with alcohol at the moment.
So there would definitely be a black market, because the market already exists. It is very lucrative for organized crime, and it would not give that up.
The Chairman: People who want alcohol do have a wide range of choices. There is everything from beer with a 3 per cent alcohol content to alcohol with a 70 per cent rating. Is that not so?
Senator Biron: The legal rate is 90o and 50 per cent.
The Chairman: There is a huge range in the legal alcohol market.
Mr. Gascon: What do they do with respect to the black market in alcohol?
The Chairman: That is my question to you.
Mr. Gascon: The have changed not only the market, but also the prices. And why is it that they have attracted customers?
The Chairman: Ultimately, the taxes were too high.
Mr. Gascon: The taxes were too high. The same goes for tobacco. They felt there was still a market there. And as long as there are customers, then there will be this market. It is a question of supply and demand.
The Chairman: So prices have a tremendous impact.
Mr. Gascon: Definitely.
The Chairman: For the purposes of our discussion, the government should not be too greedy about its revenue or potential taxes.
Mr. Gascon: Yes.
The Chairman: That would have a direct impact on the black market.
Mr. Gascon: With respect to possible legislation, we have to ask yourselves what message we are transmitting to our children. At the moment, we have anti-smoking campaigns. There will be less cigarette smoking, but we will find it acceptable for people to smoke something other than tobacco. What kind of message are we conveying? What type of education will we be providing for young people in the future?
We are well aware that we no longer want to target users. That is not our objective. And I understand that, because the legislation was recently changed with respect to our efforts to fight organized crime. We have a new act. We need think only of Bill C-24 or C-36, on terrorism. People have always thought that the police were being given more power. The power that the police want is to be able to fight a very strong organization. When we talk about organized crime and terrorism, we are talking about a completely different level compared to small street criminals and small street crime.
And I know very well that all police forces have asked what should be done about drugs of the future. Obviously if young law students go to the Jazz Festival and smoke a joint, between you and me, we do not think they are committing a major offence. They are not the people we want to criminalize; they are not the people we are after. That is very clear. However, we do have legislation.
The Chairman: Do not worry about your comments, you are not the first police chief to tell us that.
Mr. Gascon: I feel very comfortable saying that.
The Chairman: We have heard that throughout the country.
Mr. Gascon: I am saying that that is very clear in our mind. We have discussed this within our police force. What are we after? And the ultimate objective is still organized crime.
The Chairman: The traffickers.
Mr. Gascon: And we obviously must have the tools we need to get to these traffickers. If a black market develops after the introduction of legislation, and if you say that we should change our methods and learn a new way of operating, we will do so. If there is a social will to legalize this substance, and if a black market develops, we will change the way we work.
And in the meantime, organized crime is growing, and it is continuing to organize very clearly and very effectively.
Senator Maheu: In your view, what percentage of the black market does alcohol represent?
Mr. Gascon: I do not have any exact information. I will give you, rather, an approximation. At the moment, the black market probably accounts for close to 20 per cent of the total. What we noticed, because there are many operations already underway or they will be underway soon, is that there are more and more small businesses that use the black market.
And since the cost is much lower, there is an incentive. And it is not a major crime to buy a package of cigarettes or a carton of cigarettes on the black market.
The Chairman: But was your question about tobacco or alcohol?
Senator Maheu: Alcohol.
Mr. Gascon: Alcohol, right. But I make the comparison in terms of the citizens' moral position.
Senator Maheu: I understand.
Mr. Gascon: And we may all know some good, hard-working citizens who have been known to purchase cigarettes or a 40 oz bottle of Rye on the black market because it was cheaper. That is why I say that the market exists, and as long as there is a demand, the market will continue to exist.
The Chairman: Thank you very much, Mr. Gascon. That was very instructive.
Your comments allowed us to confirm some information that we heard from other police forces and to understand what is going on in Montreal. Your testimony was certainly very much appreciated, particularly by my colleagues who are not from Montreal.
Our next witnesses are from the Compassion Club of Montreal. They are Ms Doyer and Mr. Hamel.
Ms Caroline Doyer, President, Compassion Club of Montreal: Thank you for inviting us to make this presentation. I am the President of the board of directors of the Compassion Club of Montreal. I am also the co-founder of the Club.
Unfortunately, our other co-founder, Louise-Caroline Bergeron, was unable to be with us this morning. I would like to introduce Mr. Pierre Hamel, the Executive Director, here in Montreal. I will turn the floor over to Mr. Hamel, who will make the presentation this morning.
Mr. Pierre Hamel, Executive Director, Compassion Club of Montreal: We apologize for not submitting our brief earlier. Unfortunately, we only finished it yesterday.
The Compassion Club of Montreal opened in 1999. From the beginning, and even before the Club opened, the two founders met with representatives from the Montreal Urban Community Police Force to inform them of our intentions.
It is important to make it clear that we never tried to hide what we are doing. We have a street-front operation on Rachel Street in Montreal. And even since the police operation at the Club, our shingle continues to hang very visibly on Rachel Street. We are continuing our operations.
There was a police operation at the Club as a result of which we are still in court. Two years later, two of our volunteers are still in court. So it does seem that there is a problem. To say that the judge does not know which way to turn at the moment —
The Chairman: I would suggest that you not talk about what may be in the judge's mind, if you do not mind.
Mr. Hamel: Fine.
The Chairman: That is not among our concerns.
Mr. Hamel: I will follow your advice, senator. If we decided to continue our activities despite these legal problems, it is because we still believe in our initial fundamental assumption: that anyone who is ill should have the right to resort to the form of medication that is the most likely to ease his suffering, even if the medication in question has not yet gone through the approval process at Health Canada.
We are getting to the story of what happened at Health Canada. First of all, there was a decision announced by Mr. Rock when he was Minister of Health. The decision was to grant exemptions to the Drugs Act for medical reasons. At that point in time, we felt the decision was very promising.
We all know what happened: it was a bitter defeat, which we put down primarily to excessive red tape. You may or may not be aware of the fact that it is quite difficult to get an authorization from Health Canada. Strangely, some people obtain an authorization within a few weeks whereas others wait for more than three months to get one.
The Chairman: I imagine you are referring to section 56?
Mr. Hamel: No, I am talking about the new regulations. They no longer work, it has to be said. Currently, no one can obtain an authorization to use cannabis for medical reasons in Canada. No doctors are signing the applications. You are aware of this, Senator, because some people have turned to you.
The Montreal Compassion Club therefore has problems. We are having trouble paying our bills, in the end, because we are caught up in this situation.
Moreover, we absolutely must discuss the contract that was given to the Prairie Plant Systems company to produce medicinal quality marijuana. At one point, we felt this was indicative of the government's will to act.
Unfortunately, Ms McLellan, the new Minister of Health, has announced a total freeze on this project. Rumour has it, and Ms McLellan has not denied it, that the project was frozen because of the dubious quality of the harvest.
If this proves to be true, we believe that the first step to be taken should be to question the price paid. Five million dollars was spent. Some explanation is required, because we have been in business for two and a half years, and I have to say that it does not cost $5 million.
At the moment, we have products of an excellent quality. The patients we serve are quite satisfied. You were discussing the Vancouver Compassion Club earlier, which offers some 14 or 15 quality products to their clients. This is the level we want to reach as well. One does not give the same product to an AIDS patient that one would give to someone suffering from severe back pain, for example.
I would like to make two preliminary remarks in the light of what I call Health Canada's two failures. The openness shown for a time by Health Canada created a great deal of hope within the population. We believe that there are many unfinished scientific studies on cannabis. We feel that it is now more urgent than ever to put a controlled distribution system into place, if only in the name of the most basic compassion.
Second, in the present context, it does not seem right to us that the decision to grant an authorization for medical use rests with the doctors' ultimate recommendation. Doctors themselves say — and we have heard it often these last few weeks and months — that they have no particular knowledge of cannabis, quite the contrary. Their training encourages them rather to recommend products developed by the pharmaceutical industry.
We do not need to stress that the grounds for opening the Compassion Club of were purely humanitary. This has been clear from the outset, as I was saying.
I repeat that we find it disgraceful that a society as advanced as ours continues to refuse its sick people the right to use a substance which, in many cases, is the sole possible source of comfort.
Senators, I could speak very emotionally about people who suffer from multiple sclerosis. They come to see us at the Club, and they are on the verge of committing suicide. These people suffer terribly. We see them arrive with lists of prescriptions for 10 or 15 medications to be taken in a single day. These medications have significant side effects, and they do not reduce their pain, they do not bring them any comfort. Cannabis can provide them with temporary relief.
We have never claimed that cannabis would cure anything. It does not heal anything, but it allows those who are suffering to have a better quality of life and that is what these people want. It is what they hope for.
You are aware that the debate surrounding the medicinal use of cannabis is not only happening here at home. As you know, several European countries are tyring to find a means to enact legislation or regulations to deal with the issue. In Canada, we are waiting to hear the position of Ms McLellan, the new Minister of Health.
There are people who are currently waiting and who are desperate. We have had to turn away dozens of people because we require a medical prescription. And I can assure you that it is very difficult to refuse. Some people weep because we cannot give them anything.
It has to be said that Health Canada seems to have missed an opportunity, in the sense that this did not work out. We feel that the time has come, in fact it is high time to set up a distribution system. If Health Canada had been able to consult us, we could have offered some suggestions that would have helped them to avoid the unfortunate situation they found themselves in.
We believe there has been a serious misunderstanding. Over the last two and a half years, we have learned a great deal about cannabis, about its medicinal properties, about the various kinds of cannabis and the new technologies related to cannabis. We are not starting from square one. You were talking about the Vancouver Club earlier. They have existed for five or six years. They have even more knowledge and experience than we do. That is why we rely on them.
I believe we can set up a system, a true distribution system as I was saying earlier, that is not based on a doctor's final approval, without of course rejecting the doctors' position on this. On the final page of our brief, you will find the conditions we feel are essential in order to establish an effective distribution system for Canada.
Here are a few of the essential conditions. We feel first of all that a framework agreement must be signed between the Canadian Compassion Clubs and Health Canada, an agreement setting out the provisions by which both parties would have to abide.
As I was saying earlier, the authorizations should be granted upon presentation of a diagnosis. This remains our position. Although scientific studies remain incomplete, we are fairly well aware of the illnesses for which cannabis can provide effective pain relief. The list includes AIDS, cancer, multiple sclerosis, several forms of arthritis, and other similar illnesses. I will not name them all. But we could be satisfied with a medical diagnosis. After having consulted Health Canada, a list could easily be made of the illnesses for which cannabis provides effective pain relief.
We recommend setting up local networks instead of a big national distribution system, in order to avoid what happened with Prairie Plant Systems. In that way, you would avoid a complete disaster if certain problems crop up at a given time. Therefore, Vancouver would have its own production, and eastern Canada could have theirs. It remains to be seen what method would be used. And, of course, we feel it is essential under such conditions that the Compassion Clubs be authorized to produce their own controlled quantities of marijuana. This would ensure that organized crime would not be involved. We can ensure quality control of the product because we will use our expertise. We now know which varieties are the best from a medical perspective.
I believe it should be possible to have minimum guarantees to ensure we have something reliable to help resolve these humanitarian issues.
I now give the floor to Caroline.
Ms Doyer: I would like to add that the Montreal Compassion Club now serves 130 members. They each have either a recommendation or a medical prescription. Of these 130 members, 10 have a government exemption. Most of these people would be unable to grow the product themselves, considering their condition. Therefore, they turn to a designated person who can produce it for them.
The fact is that these 130 people are either on worker's compensation or on social assistance, and they are dealing with serious financial problems, given their condition. These people are not in a position to pay $8 to $10 a gram for medication over a period of months or years. Their concern is that they will not be refunded for the cost of the medication. And of course, this is their medication of choice. This is one of the problems we often see at the Compassion Club.
Another problem is the increased police surveillance. Of course, we are happy to have the police force support us, in the sense that they are protecting us from so-called organized crime. We have never in any way been intimidated by members of the Hells Angels or any other criminal organization.
I have to say that we are also part of organized crime, because of the fact that cannabis is not legalized. One hundred per cent of the people involved in the cannabis world are criminals. We would like to have an agreement with the police in order to try and eliminate this criminal burden, which is hindering our work and which also creates fear for the patients or for people who are closely connected with those using cannabis.
Third, we would like to introduce our growers to the police. As we said earlier, we would like to be able to function as transparently as possible. We have nothing to hide. We do not want to create any dissidence. Unfortunately, we have no protection and there is no protection for the growers. These are all independent people who have a passion for this, and who have some expertise concerning the plant.
As we were saying earlier, some varieties are not necessarily good for dealing with certain conditions, etc. And we would like to work in cooperation with the police network in order to arrive at an agreement and protect our growers.
We would also like to have a deal with Health Canada regarding the distribution of marijuana. We are very open, we are ready to change our eligibility criteria or whatever we need to, so long as it meets the needs of patients. Currently, the system proposed by Health Canada, that is to say the regulations passed in 2001, does not meet the criteria or is not at all representative of the people who must use cannabis for medical reasons.
We are now ready to answer your questions.
[English]
Senator Banks: Would you agree that the government supply of cannabis is not consistent, in terms of its quality, with what you need?
Mr. Pierre Hamel: That is what we heard.
Senator Banks: That is what we were told. However, you now said that your product is satisfactory. Where do you get it? I remind you that you are under the protection of parliamentary privilege.
Ms Doyer: We have specific people who grow it for us. We have specific criteria for the growth of marijuana that they respect. They also respect a certain price range. They are all individuals that grow here in Montreal.
[Translation]
— they are only dealing with us. Therefore, these are not people who are distributing or selling on the open market. They are there to meet our criteria and our needs.
Mr. Hamel: I would add one thing: the people we deal with are people who develop a kind of passion, in the end, for this production. You have to be familiar with the cannabis milieu to know that there are people who are truly passionate, who want to develop new varieties. These are the people we are doing business with. And I can guarantee you that there is no connection with what is generally referred to as organized crime.
[English]
Senator Banks: So you are obtaining it privately?
Mr. Pierre Hamel: Yes.
Senator Banks: You mentioned that doctors are reticent about signing recommendations. Have you formed an opinion as to why that is so? Why do doctors not like to sign the recommendations?
Ms Caroline Doyer: Well, we know that the Board of Physicians here in Quebec does not agree with any recommendation or prescription for marijuana.
[Translation]
— they reprimand all the doctors and they even took away the doctor's corporate or professional insurance from those who signed a recommendation or a prescription. They put their own doctors in an awkward position in the sense that they are not protected, even if they believe that cannabis is the best medication for the person.
They pull the rug out from under their feet, so to speak. They won't dare issue a medical recommendation, considering the fact that they will no longer be insured by the Collège des médecins. And that is the official position of the Collège des médecins, which appeared recently in a newsletter that is sent to all doctors.
Mr. Hamel: What happens is that on the Health Canada application form, in particular the form that has to be filled in by a doctor, it is clearly stated that the ultimate responsibility comes back to the doctor. Does that mean that a patient who has an adverse reaction, for whatever reason — it may not even be caused by the cannabis — would have the right to launch a civil suit against the doctor?
If so, I can well understand why doctors do not want to sign these forms. It is a substance they are not familiar with. We know that scientific research remains to be done. This is a substance that is not officially approved by Health Canada. And we are asking doctors to simply sign, just like that, because they are health professionals.
Ms Doyer: Doctors are even afraid to sign documents for Health Canada. That is what has happened since the new regulations on cannabis came out in 2001.
[English]
Senator Banks: Then that is another reason that the present system — which everybody thought was going to be in place — is not working?
Ms Doyer: No.
Senator Banks: Do you have a concern? We have heard concern about people falsely using the idea of medicinal use of cannabinoids of all kinds to obtain it for purposes other than medical use? I am referring specifically to an example of a person who was growing marijuana ostensibly for the medicinal use of his friends. He was busted, however, with a large quantity of cannabis that would have served a very large number of friends for a very long time. Yet, he was defending his cultivation on the basis that he was doing it for medicinal purposes. How do you deal with that, and how do we solve it?
Ms Doyer: Club Compassion's mission is to serve medical marijuana. That is why we ask for a medical recommendation or advice from a doctor. The recreational use of marijuana does not really concern us. People who use medical marijuana do not use big amounts of cannabis. Our experience with the patients is that a small amount is sufficient. They do not move to a different stage of abuse; they will take the amount that is needed — usually it is under a gram.
In our club, as long as there is a medical expertise it is fine with us. We support the medical side. The recreational side is another issue.
[Translation]
— there's a whole debate concerning recreational use. And this does not come within the scope of the Compassion Club's discussion, as we are there to deal with the medicinal issue.
Mr. Hamel: I would like to clarify one thing. Unlike some drugs, which sometimes have a bad taste, cannabis does not have unpleasant side effects as such. In other words, we have a new product and in order for it to be effective, it does not necessarily have to taste bad. When a person takes it, they do not have nausea while they are taking it.
Is that then truly a medical use? Because cannabis brings a certain sense of peace, a certain sense of well-being to the person. Therefore, we have to be somewhat flexible. This is why I believe we will have to have an effective distribution system. I think that if there is a list of diagnoses for which marijuana is considered to be effective, for the moment, we can be satisfied with that.
We are, of course, counting on the fact that marijuana studies will continue to be done. And while this is happening, we will get new data, and we will refine our strategies.
But we need some interim legislation or regulations. That, in the end, is what we are asking for.
Senator Maheu: I would like to ask a few questions on a single subject. What is the production cost of a pound of cannabis under well-controlled conditions?
Ms Doyer: Since I am not involved in growing it myself, I am going to give you the numbers that I get from my producers. I would say that it can cost up to $3,000 a month to grow cannabis. That includes a place where the person grows the cannabis, which is equipped with a security system to avoid being intimidated by the police, the plants as such, as well as all the equipment required: reflectors, ionizers, etc. I would say that it costs about $3,000 a month.
Senator Maheu: What are you currently paying per pound?
Ms Doyer: We are paying between $2,300 and $2,700 a pound.
Senator Maheu: How much do you sell it for then?
Ms Doyer: We sell it for between $8.00 and $10.00.
Mr. Hamel: A gram.
Ms Doyer: The gram. And our objective, of course, is to reduce the cost, to make it accessible at $5.00 a gram, since some people we serve are in a rather precarious financial situation.
Mr. Hamel: We serve people who are facing serious financial difficulties. We understand that. Often, they are people who are chronically ill and who have no income. These financial difficulties are, for us, a major problem at present.
The Chairman: Ms Doyer, on the issue of costs, if, at my request, you were to go to your producers, you could ask them to do a full breakdown, to use the precisely terminology, of all of the costs.
I am trying to isolate the inherent costs of prohibition, in other words, all of the costs that would not exist if we were in a legitimate urban growing environment, to isolate the real cost of producing a kilo of medicinal grade cannabis. In the end, that is what we want to know.
An alarm system is obviously expensive. But that is not what interests me. I want to know how much it costs to grow a kilo of cannabis.
Ms Doyer: Between $3,000 and $10,000 a month.
Mr. Hamel: Yes, but in the beginning, there is an initial equipment cost: lighting, and so on. After that, once the operation is up and running, the costs should go down.
The Chairman: You do not have to give me an answer right away. You can do it in writing.
Mr. Hamel: Yes, that is what I plan to do.
Ms Doyer: I would also like to add that the Club Compassion de Montréal also serves the eastern part of the country. We have members in New Brunswick, Nova Scotia, on Indian reserves, in Chicoutimi, in Jonquière, and we try to serve as many people as possible.
The Chairman: You do all that by mail?
Ms Doyer: No, not by mail.
Mr. Hamel: We have ways of sending it.
The Chairman: Good. And on the question of quality and supply, we assume that it is like in Vancouver or Toronto: organic quality without additives.
Mr. Hamel: There are none. We check it all the time.
The Chairman: You have heard the debate on rates of THC and production techniques. What are your comments on the THC rates that are around 32 per cent or 35 per cent?
Ms Doyer: Well, when the police was involved with Club Compassion, we had an opportunity to have the cannabis we are selling examined in depth. And what we can tell you is that our cannabis has a minimum THC rate of 18 per cent.
The Chairman: And are you satisfied with that?
Ms Doyer: Yes, we are satisfied with that. I have never seen any at 25 per cent or at 32 per cent. Of course for patients, the higher the THC rate, the less cannabis they have to consume. So for many doctors it is a good thing to have a high THC rate. It is clear that for some people, a 5 per cent THC rate is enough, depending on their condition.
And for others, 18 per cent is more appropriate, and it could even go a bit higher than that.
The Chairman: Now let us talk about the involvement and role of doctors. I understand that the inevitable involvement of doctors in the current regulatory process poses a real problem for you.
Ms Doyer: Yes.
The Chairman: But we are talking about the health of your members. In the end, a doctor somewhere shares your compassion.
Ms Doyer: Yes.
The Chairman: You heard Dr. Ware talk about the lack of information, even though it would be easy for him or for others to adequately inform the various colleges of physicians, in other words the doctors, on the ins and outs of the medicinal use of cannabis.
My question is this: Are you against the involvement of doctors?
Ms Doyer: Not at all, on the contrary. We realized, in clarifying the Club's mission, that we needed not only to provide monitoring for our patients, but also to organize briefing sessions for doctors. As a result, we prepared documents based on different sources, like Dr. Greenspoon and others, with a view to informing doctors about patients' requests.
The Chairman: Now, I am using the term ``doctor'' in the broadest sense of the word. I am talking about the person who has knowledge of the care being provided to an individual. That is a much broader definition than the very strict one used by the college of physicians. I am including herbalists and people who have knowledge of herbology. Are you as broad-minded as I am?
Ms Doyer: Yes.
Mr. Hamel: I can see exactly where you are going. But I must tell you that about a year or a year and a half ago, we tried to bring together doctors to do a briefing session for them. We sent out letters, and no one showed up.
Ms Doyer: Of course, the dosages remain to be defined. Doctors often bring up the issue: ``How can I prescribe medication not knowing the THC content or the quantity that the patient requires?''
So it remains an ongoing medical debate.
The Chairman: But for someone who is not an expert, it is a valid concern.
Ms Doyer: Yes. And that is where we come in.
The Chairman: And what do you tell a doctor who does not have this expertise and who asks you these questions honestly?
Ms Doyer: We tell them to go along with what their patients are requesting, in other words, for the majority of prescriptions, to write: ``As required.'' It is up to the patient to judge.
The Chairman: To judge how much they need.
Ms Doyer: We also advocate taking responsibility for the disease. This person is already making a choice to use medication that is not regulated yet or that is in the process of being regulated. And despite all the social pressures that exists to discourage doctors from prescribing it, some patients do nevertheless choose this medication, because they understand that it is the one that will do them the most good, and not a series of other medications.
Mr. Hamel: I would say that we see it as a way of taking charge of one's health. Some patients decide to use this substance even if their doctor is not entirely in agreement, because it helps them. That always leaves the issue of the dosage.
For people who have never used marijuana, we recommend that they start with a couple of puffs to see how they feel. We use a very cautious approach. Initially, the THC rate will not be very high. Then we are able to determine an appropriate dosage for the individual. Sometimes, with marijuana, tolerance can be established quite quickly. But what is wonderful with marijuana is that by changing the variety, we can counteract tolerance.
The Chairman: When you talk about tolerance, are you talking about dependence?
Mr. Hamel: No, I am not talking about dependence.
The Chairman: In other words, the effect is lessened?
Mr. Hamel: The body gets accustomed to it and so there is less of an effect. As a result, we change varieties.
The Chairman: Perfect. Regarding pain, we have been doing a considerable amount of reading on the effect of cannabis in people who suffer chronic pain. As you know, pain is not in the federal regulations.
Mr. Hamel: Precisely!
The Chairman: So it is the third category.
Mr. Hamel: Yes. And we have a lot of difficulty with it.
The Chairman: I understand. What can you tell us given your experience in pharmacology?
Mr. Hamel: Many people come to see us because they are suffering as a result of an accident. They are suffering terribly and, it seems, there is nothing to help them, except cannabis to relieve some of their pain.
The Chairman: Ten of your 130 members have an official exemption?
Mr. Hamel: Yes.
The Chairman: And I think we know your 10 members who have an official exemption. What do you do for the other 120? Are you still as rigorous in your approach? In the end, do you obtain a doctor's approval?
Mr. Hamel: Yes. They have succeeded in falling through the cracks, as we say. That was before the famous regulation put out by Mr. Rock in 2001, prior to July 30, 2001.
The Chairman: And since then?
Mr. Hamel: Since then, we have perhaps had three new members. That is all.
The Chairman: According to the regulations, the ones who do not have an authorization cannot come to you?
Mr. Hamel: I am going to reveal something here: We have used the categories of exceptions authorized by Health Canada. We know that Health Canada has three categories of exceptions. The first category covers patients whose prognosis has them dying within a year. We do not have a problem with those people.
Seven very specific diseases are included in the second category. There is one exception for the people suffering from one of these seven diseases. We accept these patients upon presentation of a medical certificate describing their condition, or a medical assessment, stating that the patient is suffering from cancer, that the patient has AIDS, that the patient has multiple sclerosis, et cetera. Upon presentation of the certificate, we accept these patients. And the advantage of that is that we do not require a doctor's signature to prescribe cannabis.
The Chairman: The difficulty lies with the third category?
Mr. Hamel: Precisely! Cases of pain. They can just barely fit into the third category, which is kind of a catch-all category.
The Chairman: Yes.
Mr. Hamel: There are very serious cases in that category.
The Chairman: What do you do then?
Mr. Hamel: We do not take them. We have not dared. The Compassion Club of Montreal is recognized as being very rigorous.
The Chairman: Yes, because it is not like that in Vancouver.
Mr. Hamel: They take them? We do not dare to.
Ms Doyer: But the political climate in Montreal is not the same as it is in Vancouver. The tolerance is not the same.
The Chairman: Yes, I understand.
Ms Doyer: And that is what requires that we be more strict.
The Chairman: All right, okay. As for PPS, the Prairie Plant Systems, as far as I know, according to Mr. Rock and the new minister as well, PPS was not initially intended to grow medicinal grade cannabis?
Mr. Hamel: Careful, that issue was raised last December.
The Chairman: Yes, I understand, but in the beginning?
Mr. Hamel: Yes, yes, you are right.
The Chairman: When they decided to award a contract for production, it was production...
Ms Doyer: For clinical trials.
The Chairman: ... for clinical trials.
The Chairman: I wanted to make sure that everyone understood that that was not the initial objective.
Mr. Hamel: Yes.
The Chairman: Of course there may be some product left over.
Mr. Hamel: Precisely.
The Chairman: Then why not use it for people who do not have the means?
Mr. Hamel: Look, we were even told that there would be a distribution system by the end of January or the start of February 2002.
The Chairman: That is because everyone was devoting their attention to the problem with the distribution system, when the initial objective was not to produce cannabis for medicinal purposes.
Mr. Hamel: You are right.
The Chairman: It was for Dr. Ware's studies, among other things.
Mr. Hamel: Originally, yes.
The Chairman: I am saying that because in your brief, you question the appropriateness of having that.
Mr. Hamel: Well, in the beginning, it was destined for scientific studies, was it not?
The Chairman: That was the aim.
Mr. Hamel: But I am under the impression that along the way, they strayed from that. Because in December, the minister confirmed that there would be a distribution system in January or February for people with exemptions.
The Chairman: Well, his idea evolved.
Mr. Hamel: Yes! And I fully understand that.
The Chairman: Initially, that was not the case.
Mr. Hamel: Fine.
Ms Doyer: But it remains a problem for members of the Compassion Club with exemptions because they are still waiting for a legal source of supply.
The Chairman: I understand them. You mentioned the loss of insurance for participating doctors?
Can you give us the name of a doctor who would appear before us?
Ms Doyer: The president, Dr. Yves Lamontagne, signed an official letter in the newsletter for doctors produced by the College of Physicians clearly explaining this procedure.
The Chairman: The loss of insurance coverage?
Ms Doyer: Yes.
The Chairman: Do you have a copy of that letter?
Ms Doyer: No, but I could easily send it to you. The College of Physicians could even send it to you by fax.
The Chairman: We will do both.
Ms Doyer: Yes, certainly.
The Chairman: One final question: you heard Mr. Gascon earlier. Would you agree that your operation be monitored to ensure that you are satisfied with the product and the people coming in and to ensure that no one else except the patients you have agreed to treat would have access to your compassion system, in the end?
Would you agree to monitoring measures like those?
Ms Doyer: We have no problem with that, if it can be of some reassurance.
The Chairman: Yes, but it is perhaps to reassure the rest of the population as well.
Ms Doyer: No, we do not have a problem with that.
Mr. Hamel: I would say that that will also reassure us. I can say that we will have less control over quality. We hope to have permission to produce if that happens. Quality control is a lot easier for us.
Ms Doyer: Yes. And we have no problem with cooperation. We asked for honest cooperation from the outset. That is what we did. Moreover, even producers are quite willing to meet with the police as long as the police does not come and seize their production two weeks later.
The chairman: You are going to see if the alarm system works.
Ms Doyer: Yes.
Mr. Hamel: They have already checked that.
The Chairman: I have no further questions. So we will exchange letters on the issue of production costs?
Ms Doyer: Yes, no problem.
The Chairman: And the letter from the College of Physicians?
Ms Doyer: Yes, we will not forget it.
The Chairman: Thank you.
The Chairman: The meeting is adjourned until 1:30 p.m.
The committee adjourned.