Andrew Hathaway discusses the challenges surrounding the regulation of medical marijuana.

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Earlier this summer Vancouver became the first city in Canada to regulate and license the sale of medical marijuana. The controversial bylaw will affect approximately 100 existing businesses, dozens of which are expected to be shuttered for failing to comply with the new regulatory framework. Under the new regulations, retailers of medical marijuana will be charged a license fee of $30,000 and shops will be prohibited from operating within 300 metres of community centres, schools, and other medical marijuana dispensaries. Nonprofit organizations, designated as compassion clubs, will pay a much reduced license fee of $1,000. But all licensed outlets will be fettered by restrictions against the sale of baked goods (e.g., pot cookies, brownies) and other edible concoctions that might appeal to children.

Predictably, the federal government has opposed the move to regulate the city’s burgeoning medical marijuana industry, which has long existed at the sufferance of police. In a strongly worded statement, Health Minister Rona Ambrose slammed the regulatory scheme for undermining the government’s position that marijuana is illegal and asserted the need for uniform enforcement of the law. Ambrose argued that the passing of the bylaw will facilitate increased marijuana use, addiction, and inevitably make the drug more readily available to children.

Equally predictably, proponents of the bylaw have defended it as being the most practical solution—designed precisely to protect children—in a context of expanding unregulated use. For others seeking formal recognition of the health benefits of the drug and to expand medical access to it, the onerous restrictions of the bylaw are excessive. Put otherwise, for advocates of more liberal drug policies, the measures adopted in Vancouver do not go far enough.

Despite increasing recognition of the efficacy of medical marijuana for relieving symptoms of some chronic health conditions, its use remains contentious. The debate surrounding the regulation of medical marijuana sales is reminiscent of the ongoing controversy over harm reduction measures such as medically supervised injection. The controversy surrounding supervised injection in the case of InSite in Vancouver, for example, illustrates the obstacles to policy reform when scientific evidence is trumped by moralism. Research indicates that facilities like InSite reduce needle-sharing and deaths from overdose, while also improving public order and uptake of addiction treatment. Notwithstanding recent changes in priorities apparent in the federal government’s opposition to reform, harm reduction principles have served as the official goal of Canada’s drug strategy for nearly 30 years. Harm reduction recognizes that enforcement of the law is not only ineffective but often counterproductive. Reducing drug-related harm requires more innovative strategies that emphasize public health priorities, as opposed to punishment of people with drug problems.

However, despite the wealth of evidence supporting harm reduction initiatives like InSite, the Harper government’s position is, first, that these send the message that drug use is acceptable, which is inconsistent with the anti-drug values of Canadians and, second, that more research on the efficacy of supervised injection and other harm reduction strategies is still needed. Similarly in the case of medical marijuana, regulation of illicit drugs is threatening to governments committed to existing institutional arrangements in which users of those substances are considered criminals. Medical marijuana users are begrudgingly excused from the law prohibiting non-medical use of the drug. Calls for regulation of the industry beyond the narrow scope of what is permissible by federal jurisdiction represent a ‘Trojan horse’ or wedge to legalization feared by those supportive of the ban on marijuana.

Medical marijuana also represents a threat to experts whose training and authority is derived from the assumption that science will decide what counts as evidence or proof. The use of marijuana as a medicine has been difficult to justify and meaningfully evaluate according to the standards of the medical profession. Its efficacy for patients suffering from chronic illness, for whom standard treatments are often frustrating and futile, requires an understanding of alternative philosophies—promoting personal autonomy, respect for lived experience, and a holistic view of illness, health, and healing—whose values go beyond those of conventional medical science.

The matter of providing legal access to marijuana—much like the question of its efficacy for patients—ought to be a question of what serves the patient best. But much like the controversy over harm reduction services, it has proven difficult to separate empirical questions posed by scientists from normative agendas.

Vancouver’s nascent effort to regulate the medical marijuana industry is a sign of progress in conferring its legitimacy. Yet the new bylaw further illustrates the difficulty in practice of protecting patients’ rights and choices in a climate of conflicting normative and practical concerns. This is an ethical dilemma that will need to be resolved in order for a ‘common sense’ solution to the problem to prevail.

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Andrew Hathaway is an Associate Professor of Sociology at the University of Guelph.