B.C.'s provincial health officer is defending the value of marijuana as a medicine after federal Health Minister Rona Ambrose urged the City of Vancouver to shut down all local pot dispensaries rather than regulating them.
Dr. Perry Kendall took issue with various federal policies on pot in an interview with Black Press, particularly Ambrose's suggestion marijuana doesn't have the utility of approved pharmaceuticals.
He said there's "a growing body of evidence" that cannabis is effective as an appetite stimulant, an anti-nauseant and as a chronic pain killer, including against spastic neurological conditions like ALS, among others.
And he suggested access to medical marijuana saves lives when it supplants other pain control drugs that are more dangerous and addictive.
"The U.S. states that have had medical cannabis access provisions actually have about a 20 per cent lower overdose death rate from opioid prescriptions than states that don't have access to medical cannabis," he said.
"It's probably a lot less dangerous than opioids are – less than morphine would be or Oxycodone, which can be highly addictive and quite lethal."
Unlike either alcohol or opiates, Kendall noted, "there is no lethal dose of cannabis."
He said the Supreme Court of Canada was sufficiently persuaded 10 years ago that a medical exemption for marijuana was justified and Health Canada's own website outlines various studies on its medical applications, which he said range from "weak" research to "quite convincing."
Kendall said there's also growing evidence that some young children who suffer from seizure conditions respond better to cannabis than any other medication.
He acknowledged that doctors and their professional organizations are divided on their comfort level in prescribing medical pot, how to make those decisions and the liabilities that may flow.
Ambrose's central argument against storefront dispensaries is that they normalize and encourage pot use for teens who are more vulnerable to its risks.
Kendall agreed developing young minds shouldn't be exposed to pot – or alcohol or other drugs.
He said young people who use any of those substances heavily at an early age are at greater risk for future problems.
"There is some evidence that links heavier cannabis use at a younger age with psychosis and perhaps early onset schizophrenia," Kendall said, adding it's unclear if the link is causal or reflects users who are self-medicating their existing conditions.
"Infrequent use, as with alcohol, is certainly less harmful."
He noted Colorado has seen a huge increase in the number of medical marijuana dispensaries over several years yet marijuana use among youth has actually declined slightly.
Kendall made the comments as final arguments were set to begin Thursday in a court challenge of new medical marijuana regulations imposed by the federal government to outlaw home growing by approved users and force them to buy only from licensed commercial producers.
Asked if he takes issue with any elements of the federal policy on medical marijuana, Kendall listed the ban on home grows, which he said has pushed up the price of the drug for low income patients.
He also took aim at the federal policy that medical pot only be sold in the form of dried leaves, which is also being challenged in court.
"Smoking is not the best way of getting marijuana because you get all the combustion products in your lungs," Kendall said, noting many users would prefer to buy oils, capsules or edible products, which may also offer a more gradual delivery of the active ingredients.
He cautioned that legalization in Colorado has brought overdose "misadventures" because the state didn't adequately regulate edibles like pot brownies.
"You need some quality control over what's in it, how much is in it and how much you'd eat of it," he said.
Another lesson from Washington State's legalization experience, he said, is that differential taxes have made recreational pot much more expensive than medical marijuana sold by dispensaries, which users now favour as a result.
Kendall has been an advocate in the past of some form of legalization and he isn't wavering now.
"It would be preferable to create a regulatory framework to direct product to informed adults who wanted to use it and are going to use it anyway," he said. "You could control the price, you could tax it, you could hopefully develop a legitimate market and potentially take it out of the hands of criminal gangs."
Restrictions can ban advertising and otherwise reduce access to children, but Kendall said teens are likely to obtain marijuana and alcohol one way or another.
"Just because kids get alcohol doesn't mean to say adults shouldn't be able to buy it if they want to," he said, adding adults also abuse alcohol at a significant cost to society.
"Alcohol consumption during pregnancy is probably one of the most easily preventable forms of developmental disability in babies. But we don't ban alcohol because some people use it irresponsibly."