カナダ

医療カナビス・クラブ・ガイドライン


  目次
I. 背景
II. ディスペンサリーへのアクセス
III. 顧客研修
IV. カナビスの処方
V. カナビスの仕入れ
VI. ディスペンサリーの責任範囲
VII. 情報



I. BACKGROUND



1. Cannabis

Cannabis is a natural herb with a long history of medical use. It has been shown to alleviate suffering from a large number of medical conditions and symptoms and is used as either a complement or an alternative to pharmaceutical, overthe- counter, or “street” drugs. Research and experience have indicated that cannabis can be safely self-administered and self-titrated.

Currently the recreational use of cannabis remains illegal in Canada. Medical use is only legal under severely restricted circumstances through Health Canada’s Medical Marijuana Access Division. Established in 1999, this program has licensed just over 1000 people in Canada to use cannabis legally, and the official legal supply of cannabis remains problematic.
It is often cited that there are approximately 400,000 Canadians currently using cannabis for therapeutic purposes. This estimate is based on one study conducted in Ontario that found that 1.9% of the population aged 18 years and over reported that they use marijuana for medical purposes (Ogborne AC, Smart RG, Adlaf EM. Selfreported medical use of marijuana: a survey of the general population. Canadian Medical Association Journal, June 13, 2000;162(12):1685-1686.) This is most likely an underestimate. In British Columbia alone, it is estimated that about 7%, or 290,000 people, use cannabis for therapeutic purposes (Vancouver Sun. March 22nd, 2004. “Medical Marijuana Coming to B.C. Pharmacies”. Quote from Robin O’Brien, Director of Vancouver’s Pharmacotherapy Consulting Group.)

Health Canada, Marihuana for Medical Purposes - Statistics (April 7, 2006) only 1400 with gonernment premission


2. Community-Based Medical Cannabis Dispensaries

Medical cannabis dispensaries, also called compassion clubs, supply cannabis for therapeutic use upon a valid recommendation or confirmation of diagnosis from a licensed health care practitioner.

Compassion clubs reflect a community-based response to the suffering of critically and chronically ill Canadians who might benefit from the medical use of cannabis. They provide access to diverse strains of high quality raw plant cannabis and cannabis-based products in a secure environment conducive to healing. They also provide education about the safe and effective use of these products. In addition, some dispensaries subsidize access to other natural health care services that would otherwise be unavailable to their clients.

Compassion clubs also advocate for clients in regards to the use of cannabis as a medicine in an illegal and highly stigmatized context. This has included giving input and feedback to Health Canada’s medical marijuana program, and testifying before the Special Senate Committee on Illegal Drugs and the House of Commons Special Committee on the Non-Medical Use of Drugs. Several compassion clubs work with local, provincial and national health care organizations, initiate and participate in research studies, and give presentations to the community at large, colleges and universities, and at international, national and local conferences.
The VICS and BCCCS participated in a consultation with key stakeholders in Health Canada’s medical marijuana program in February of 2004. For this occasion they produced a document titled “Roadmap to Compassion,” which identifies many of the roadblocks Canadians have been experiencing with the MMAR program, and proposes solutions to overcoming them. Additionally, the Senate Special Report on Illegal Drugs report recommends that Health Canada license and work with Compassion Clubs. Links to this document and to the Senate Report can be found in Section VII. 1.

Pre-dating the federal medical cannabis program, the history of Canada’s compassion clubs dates back to 1997, when the British Columbia Compassion Club Society opened its doors in Vancouver as a non-profit medical cannabis distribution organization. Since that time, a number of similar dispensaries have been established throughout Canada, but because of the overwhelming legal obstacles facing these organizations, only a few have been able to remain in operation for an extended period of time. Together, compassion clubs currently serve about 10,000 people living in Canada who use cannabis medicinally.

Communities, law enforcement, and criminal courts across Canada have shown support and tolerance for compassion clubs that self-regulate to ensure their services are strictly for medical purposes.3 The Senate Special Committee on Illegal Drugs and other government bodies have recommended that these organizations be licensed and legally recognized. However, despite the wellestablished and constitutionally protected right for Canada’s sick and suffering to access cannabis, and the crucial and acknowledged role of compassion clubs in providing cannabis to those in need, Canadian dispensaries are currently operating without legal sanction or protection.
The BC Compassion Club’s Operational Standards for the Distribution of Medical cannabis (2003) outlines their practices. It has been used as a reference by other compassion clubs, both nationally and internationally, and has served as the foundation for this document. See Section VII.


3. Harm Reduction

Based on a philosophy of harm reduction and improved public health, compassion clubs effectively balance legal concerns around the criminal prohibition of cannabis with a respect for the personal autonomy of individuals in making important healthcare decisions. Currently, this balance entails engaging in civil disobedience while striving to operate in a manner that addresses the concerns of all relevant stakeholders.

By offering a safe and secure means of access to high quality medical cannabis, compassion clubs reduce the potential harms often associated with illicit distribution. Medical cannabis users who are not clients of compassion clubs must obtain cannabis from other sources. These sources may be unreliable, unsafe, and difficult to find, and the cannabis they have available may be of lower quality, less effective, and/or at higher cost than that provided through most community-based dispensaries.

A well-run compassion club also reduces the risk of potential criminal repercussion associated with illicit cannabis distribution. Law enforcement officers and courts may choose to respect and recognize ID cards from recognized dispensaries as adequate proof of legitimate medical use. Courts have given discharges to compassion club operators who run their clubs in a transparent, accountable and responsible manner.


4. Purpose of Guidelines

It is imperative to protect the rights of Canadians to access medical cannabis strains and products that best suit their particular condition, are cultivated and produced in a method of their choice, and accessed through the source or outlet that best serves their needs.

The following guidelines carefully balance client autonomy, the diversity of individual dispensaries, local community concerns, and adherence to municipal, provincial and federal laws, all within the context of Canada’s current cannabis policy.

These guidelines are designed to:

1. Provide a base-standard for self-regulation of dispensaries based on current best practices in Canadian compassion clubs;

2. Support medical cannabis dispensaries in providing a high standard of care that clients can and should expect;

3. Help both distributors and end-users achieve maximum safety and therapeutic potential within a setting that is conducive to healing;

4. Formalize the good reputation established by compassion clubs, thus ensuring those with medical need have continued access;

5. Promote an understanding of medical cannabis dispensary practices to all levels of government, the justice system, law enforcement, and community partners;

6. Allow for effective cooperation amongst dispensaries utilizing the same base-standards of operation.
Note that individual dispensaries may exceed these base-standards, and that adherence to these may not infer interchangeable membership or exchange of product between dispensaries

7. Organize participating dispensaries into a more cohesive voice for the legitimization and legal acceptance of community-based cannabis production, research and distribution.

These guidelines are not intended to imply that organizations or individuals that are dispensing cannabis in another context or manner are not fulfilling legitimate purposes.

Dispensaries should continue to monitor the political and legal climate, as well as research findings, and adjust these guidelines accordingly.
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