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The Canadian government legalized medical marijuana more than a decade ago. However, Kamloops physician Ian Mitchell told the Straight that patients still come to him with basic questions and often have no idea where they can find advice about cannabis.

“I send them to dispensaries, just because there is nowhere else to go,” he said in a telephone interview.

Mitchell explained that the former Conservative government’s mail-order system prevents patients from meeting face to face with experts employed by licensed producers. Meanwhile, the vast majority of medical doctors don’t know enough about marijuana’s medical applications to provide informed opinions.

Storefront dispensaries have filled the gap, Mitchell said. But he and other advocates for medical marijuana are warning that Ottawa’s plan to legalize recreational cannabis risks elbowing experts associated with the dispensaries out of conversations about reform.

Last month, for example, B.C.’s health minister, Terry Lake, came out in favour of liquor stores selling recreational marijuana. His remarks followed similar statements by the premiers of Ontario and Manitoba, among others.

Mitchell said that has patients worried they’re about to lose their friendly neighbourhood dispensary. “People always ask me, ‘What’s going to happen to the medical side of things now that the recreational stuff is going through?’ ” he said.

Dr. Ian Mitchell says that in an ideal world, physicians would learn about the medicinal properties of cannabis in medical school.

Ottawa hasn’t responded to provincial politicians’ suggestions that liquor stores should be selling pot. But a 2013 Liberal Party of Canada draft policy paper provides some hints about how legalization could impact the industry’s medical side.

“The regulations exempting medical use of marijuana are only necessary because of the current law,” it reads. “With the end of prohibition, there will be no need for this legal exemption—which has proven difficult to manage for many patients, doctors, designated growers, municipal authorities and law enforcement personnel.”

Hilary Black is a cofounder of one of Vancouver’s oldest dispensaries, the B.C. Compassion Club Society. She told the Straight that what the country stands to lose is more than two decades’ worth of expertise that has quietly accumulated in storefronts like hers.

“It would be a real travesty,” she said via phone. “It’s not appropriate to send a patient into a liquor store to go and procure their medicine.”

Black emphasized that legalizing recreational marijuana while simultaneously developing its medical applications will require attention to areas beyond the question of access.

“I definitely think that we need a two-track system, because the needs are very, very different for a recreational user and a medical cannabis patient,” she said.

Hilary Black has been involved in Vancouver's medicinal marijuana dispensary scene for more than two decades.

Health Canada declined to grant an interview.

Adolfo Gonzalez is a consultant for a number of Vancouver dispensaries and a former research coordinator for Eden Medicinal Society. He expressed the same concerns as Black. But Gonzalez also emphasized ways that legalizing recreational marijuana could mean a boost for its medical applications.

Legalization will involve removing cannabis from Schedule Two of the Controlled Drugs and Substances Act, he noted, and that will make it significantly easier for researchers to access and use cannabis in trials involving human patients.

“In order to get a [scientific] publication’s approval, you’ve had to be super delicate about how you structure your study, and it has not been easy,” Gonzalez said. “My big hope is, if they deschedule, it will open the door to all sorts of studies.”

Canadians are slowly warming to the federal mail-order system.

During the second quarter of 2014 (the first three months following its implementation), licensed producers together sold 408 kilograms of medical marijuana. That increased to 1,371 kilograms one year later and went up to 1,873 during the third quarter of 2015, the latest period for which data is available.

One of the country’s largest licensed producers is Nanaimo-based Tilray. The company’s CEO, Greg Engel, said if Canada is going to take marijuana as medicine seriously, doctors must—and will, he argued—remain involved.

“In the early days, absolutely, there was a stigma,” he said. “But there is a shift happening. Physicians are becoming much more open to prescribing medical cannabis.…And we are seeing more patients going to talk to their physicians about it.”