Medicinal Marijuana -- Canada -- House of Commons debates


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Return to other materials on medicinal marijuana (debates, news reports, research materials) Excerpts from April 14, 1999 House of Commons Debates on Medicinal Marijuana (to see full transcript of the day's Debates, click here) EDITED HANSARD • NUMBER 207 CONTENTS Wednesday, April 14, 1999 . . . PRIVATE MEMBERS' BUSINESS [English] LEGALIZATION OF MARIJUANA FOR HEALTH AND MEDICAL PURPOSES The House resumed from March 4 consideration of the motion and the amendment. Mrs. Sue Barnes (London West, Lib.): Mr. Speaker, there is a growing body of evidence, most of it still anecdotal, that strongly suggests that marijuana has unique therapeutic properties in the treatment of several life and sense threatening diseases. For example, some people with multiple sclerosis believe that smoking marijuana helps them to control their spasticity. In certain instances the use of marijuana has helped to reduce nausea and stimulate the appetite of those living with HIV and AIDS. Last year the board of directors of the Canadian AIDS Society passed a position statement on the medicinal use of smokable marijuana stating that people living with HIV-AIDS and their physicians should have access to marijuana for medicinal purposes in the treatment of these conditions. 1730 There are indications that smoking marijuana can likewise reduce nausea and vomiting brought on by chemotherapy, principally among cancer patients. This is not simply a matter of comfort, as some cancer patients have had to cease treatment because the constant vomiting can make it impossible to continue taking the therapeutic drugs they need. Many chemotherapy patients complain that other anti-nausea drugs are ineffective and in some cases produce unwelcome side effects. Marijuana is reputed to be helpful in the treatment of glaucoma through the reduction of intraocular pressure caused by fluid accumulation. Other medical conditions or situations for which marijuana is reputed to have some effectiveness include an anti-convulsant action which may have an application in the treatment of epilepsy, and an analgesic action for pain relief. Marijuana cannot be said to cure any of these conditions but the potential exists with rational, medically supervised use to help alleviate pain and suffering. One recent report would term this belief based medicine. In Canada we strive for evidence based medicine. The therapeutics products program, the regulator in Health Canada, has in place an expert advisory committee that since last year has been examining a number of issues relating to the medical uses of marijuana. I am delighted that Canada will be among those jurisdictions to gather evidence in a safe and controlled manner so that our body of evidence can be evaluated along with that being done elsewhere. In the U.K., GW Pharmaceuticals has been granted licences by the British Government to cultivate cannabis plants and to store and dispense the cannabis preparations for research. Initially it will develop standardized extracts of cannabis plants grown under controlled conditions. Research will also be concentrated on the best way to give the drug to patients and on which conditions it can safely treat. They intend to proceed to clinical trials with a smokeless whole plant extract while also supplying marijuana to other investigators interested in medical research and pharmaceutical development. Earlier this year the International Narcotics Control Board, which is responsible for the implementation of United Nations drug conventions, released its annual report for 1998. In the report the board called for unbiased research into the possible medical benefits of marijuana. If the medical usefulness of marijuana is established, which I believe it will be, it would remain a drug no different from any other narcotic drugs. It would still be subject to licensing and other control measures according to international treaties, just like morphine and opiates. Last month the American Institute of Medicine issued its report entitled “Marijuana and Medicine: Assessing the Science Base”. It declared that the medical use of marijuana may be one of the most effective treatments available for people with serious diseases such as AIDS and cancer. This study, the product of more than 18 months of research, highlights continued concerns about marijuana but says it clearly controls some forms of pain, was not particularly addictive, and did not appear to be a gateway to harder drugs. The report also states that new research on the medical uses of marijuana should try to develop a non-smoked rapid onset delivery system to simulate the action of smoking marijuana. To assist desperately ill patients who may not want to wait for a safe alternative to be developed, the report suggests doctors be allowed to launch clinical trials of marijuana, telling each test subject the benefits and risks of smoking it, including the negative impact of the smoke itself. At the present moment a licit supply of medical research quality marijuana for clinical trials in Canada is potentially available and obtainable from the American National Institute on Drug Abuse. GW Pharmaceuticals may also be interested in performing some clinical trials with its developed alternate delivery systems outside its jurisdiction of Britain. In Canada no scientific evidence that smoked marijuana has medicinal benefit has been submitted to the therapeutic products program. I believe very soon there will be a need for researchers to come forward and present proposals to study the benefits of the medicinal use of marijuana. Under the Controlled Drug and Substances Act there is sufficient latitude to distribute marijuana without having to now change the law. Under the CDSA the Minister of Health can enact regulations to authorize the possession, import, export and production of cannabis for medical purposes. Section 56 of the act states the following: The Minister may, on such terms and conditions as the Minister deems necessary, exempt any person or class of persons or any controlled substance or precursor or any class thereof from the application of all or any of the provisions of this act or the regulations if, in the opinion of the Minister, the exemption is necessary for a medical or scientific purpose or is otherwise in the public interest. 1735 Under the regulations of the CDSA, the minister also has the authority to authorize research on controlled substances. Together with others, specifically those in our social policy caucus at the time, I worked on the rework of the relevant bill in the 35th parliament. Hansard debates recorded this. In the summer of 1997 I commissioned the Library of Parliament to prepare a report regarding the use of the new CDSA act and medicinal marijuana. This report was delivered to me in September 1997, at which time I provided it to our Minister of Justice and our Minister of Health. I have pushed this matter very hard inside my government and since that time with these departments. I, with others, understand that even now there will not be overnight change; but let us not underestimate the progress made. The answer to my question to the Minister of Health on March 3 was a significant embarkment on a new policy direction for Canada. There are drugs that contain THC, the active ingredient in cannabis, which have received therapeutic drug approval by Health Canada. These drugs went through the drug submission process, received a notice of compliance and then were granted drug identification numbers. The drugs can be sold legally in Canada pursuant to a prescription by a practitioner. Since the active ingredient in cannabis is already available for medicinal purposes in Canada, expanding its use may seem to be an appropriate development once we have the supportive research in hand. At the present time in Canada there are two approved drugs that contain the active ingredients derived from the marijuana plants in pill form: Marinol and Cesamet. For many patients these synthetic versions of marijuana's active ingredients are expensive, unpalatable, and if they are trying to control nausea to be able to take oral medications they are ineffective oftentimes. Smoking marijuana meanwhile appears to provide immediate relief of nausea and a stimulation of the appetite, allowing people to hold down both their pills and some food. There may be better mediums, for example inhalers, that reduce the negative side effects associated with smoking marijuana. These are still under development. Currently some people who suffer from these diseases discussed above, for whom the legal medical options have proven ineffective or painful, have made choices. Some have obtained marijuana illegally in Canada and therefore risk suffering consequences such as arrest, fines, court costs, property forfeiture, incarceration, probation and criminal records. Once evidence has been gathered the federal government will need to establish quickly an approach that would provide medical quality, licit marijuana so that people suffering from disease do not have to take further risks with their health by buying potentially impure, contaminated or chemically adulterated marijuana as is the case currently in Canada. The concept of legalizing marijuana for medical purposes has been debated on and off in Canada for a number of years. I stress today that it is not the so-called legalization of a controlled substance that is the real issue. It is the legal access through the CDSA, which could be dealt with easily. In a recent court case in my riding, Regina v Clay and Prentice, Ontario Court Justice John McCart stated: Parliament may wish to take a serious look at easing the restrictions that apply to the use of marijuana for the medical uses as outlined above as well as for alleviating some of the symptoms associated with multiple sclerosis, such as pain and muscle spasm. There appears to be no merit to the wide-spread claim that marijuana has no therapeutic value whatsoever. It is a welcome step what we are doing. We need solid research efforts to commence soon. We also need to help set up a system so that those on trials are not open to criminal harassment. It is a matter of compassion. It is not fair to these people who have to fight both their disease and the law at the same time. I applaud members on all sides of the House who have worked on this matter over the years. I think it is very important to recognize them. I also think it is important to recognize the Minister of Health who has taken this step forward at this time. I want to also thank my constituents and those across Canada who have brought the poignancy and the tragedy of this issue to my attention. I am proud to be part of our government as we move forward on this issue. 1740 [Translation] Mrs. Pauline Picard (Drummond, BQ): Mr. Speaker, I am pleased to take part in today's debate on the use of marijuana for health purposes. This is a health debate, a justice debate, based on the values of fairness, mutual aid and compassion that we all share as a society. Unfortunately, the motion, as amended by the Parliamentary Secretary to the Minister of Health, no longer mentions the legalization of marijuana, which is a matter of concern. It now talks about the “possible legal medical use of marijuana”. In our view, this is a step backwards since the government has asserted many times that it was open to the idea and eager to look into it further. In fact, more than a year ago, my colleague from Rosemont asked the Minister of Health to set up a parliamentary committee to consider the issue. The minister replied that the question was under consideration, that some people were already studying the matter. He said, and I quote: “The issue is under consideration by my department and by the Department of Justice. Along with my colleague, we are reviewing all the aspects of the issue. We hope to present our policy in the coming months”. Thirteen months after this statement, we are still waiting for some answers and for some concrete measures by the minister or his colleague, the Minister of Justice, who, a year ago, had already started to review all the aspects of this important issue. In our view, at the present time the government is holding hostage thousands of people who are suffering and waiting for a sign of hope while risking six months in jail and a $1,000 fine in order to buy marijuana on the black market. Currently, this debate is about medical issues. But it is also a matter of compassion. More often than not people with HIV/AIDS or other diseases suffer from extreme nausea and are unable to eat. This is a problem, since some of the drugs prescribed to them must be taken with food. If the patient is successful in taking his medication in spite of the nausea and lack of appetite, he might be affected by side effects: more nausea or even total intolerance to the drug itself. For some, the solution to these problems has been to smoke or inhale marijuana. It eases nausea and stimulates the appetite. Currently these men and women must break the law to get relief. This is intolerable in a country boasting one of the best health care systems in the world. Nobody doubts the therapeutic effectiveness of THC, the main active ingredient in marijuana. As a matter of fact, for a number of years already physicians have been prescribing Marinol pills containing synthetic THC. This drug is available in drugstores. However even Marinol is not as effective as inhaled marijuana. Many physicians are asking to be allowed to prescribe THC, arguing they are in the best position to determine in which form marijuana will be the best able to help their patients. The positive effects of THC have been know for a long time, but, strangely enough, it is only recently that medical authorities have started to examine seriously through clinical research these effects and potential medical applications. Last March, the American medical institute published a report that found, once again, that marijuana has an excellent medical potential. In November of 1998, the British science and technology committee of the House of Lords took a strong stand in favour of the legalization of marijuana for therapeutic uses. The chairman of the committee stated “We have enough evidence to be convinced that physicians should be allowed to prescribe marijuana to ease the suffering of the sick or the symptoms of multiple sclerosis, criminal code notwithstanding”. 1745 Recent research has confirmed earlier reports, including those of the World Health Organization, which are more and more dispelling myths about the therapeutic value of marijuana. Since the beginning of his campaign, my colleague from Rosemont has gathered a great deal of support, and more support keeps coming in. The Canadian AIDS Society, the Quebec chapter of the Canadian Hemophilia Society and the Coalition des organismes communautaires québécois de lutte contre le sida support motion M-381 without any reservation. Not too long ago, the National Pensioners and Senior Citizens Federation urged the health minister to act quickly on this issue. The Canadian Medical Association has been defending the decriminalization of simple possession of marijuana since 1981 and deplores the lack of any systematic scientific research on the issue. Support for decriminalization of marijuana for therapeutic purposes does not come just from the medical associations or social groups; according to a survey carried out last month, close to 80% of the population are in favour of this major change. Health Canada has had a program since 1966 whereby certain patients may receive unauthorised drugs so that they do not have to suffer needlessly while awaiting authorisation of a product that could help them. Jean-Charles Parizeau and James Wakeford, among others, have applied to obtain marijuana The government has not, however, given any concrete response as yet. This is a problematic situation, because a recent Ontario Court decision on the Wakeford case almost found the Narcotics Act unconstitutional, since it has the effect of depriving certain individuals of the only effective treatment to alleviate their condition. It did not do so for just one reason: there is a way to obtain marijuana and other drugs, such as morphine and other unauthorized drugs, under the current legislation, via the special access program. This means that, if the government persists in refusing to respond to requests, or refuses access to marijuana through the special access program, part of the Narcotics Act will become unconstitutional, not by law but by fact. Mr. Parizeau and Mr. Wakeford, and others in their position, would have two choices available to them. First, to play the good citizen, to suffer and to die in the near future, or second to improve their condition and their quality of life by an illegal act. This is the impossible choice this government offers to those in needs. It is unacceptable. In conclusion, the government must stop holding sick people hostage, stop waffling, stop letting the courts decide for it. I would therefore like to propose an amendment to the amendment of Motion M-381. If the government is sincere in its desire to settle this important question, it will acknowledge that the change is well-founded. I move: That the amendment be amended by deleting the words “concerning the possible legal” and substituting the following: “to legalize the” Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): Mr. Speaker, I am pleased to rise today to speak to Motion M-381 as well as to the amendment put forward by the Parliamentary Secretary to the Minister of Health. First, I will take a few moments to give the history of Cannabis sativa and to talk about the various reports and commissions on this issue, and I will then explain why I strongly support the motion and the amendment to legalize the use of marijuana for health and medical purposes. To better understand the issue, I did some research and I consulted the Le Dain report, among others. Cannabis sativa is cultivated or grows wild in most countries in tropical or temperate zones, including Canada. 1750 This plant, which probably came originally from Asia, has been cultivated for a very long time. The street language has given marijuana different names, including pot and grass in English. In India, medium quality marijuana is called bang and high quality marijuana is called ganga. It is called kif in Marocco, dagga in South Africa and ganga in Jamaica. Cannabis also produces an amber coloured resin which, in the almost pure state, is a drug called charas in India and hashish in western and middle eastern countries. As for the word marijuana, its etymology is not clear. Some sources say that it is the contraction of two first names that are popular in Mexico, namely Maria and Juana. Other believe that this word comes from the Mexican word mariguano, which means intoxicant, or the Panamanian word managuango, which has the same meaning. Cannabis has many uses. Its stem provides strong textile fibres that are used in the manufacturing of wires and cables. They can also be used to make blankets, clothes, flags and boat sails. The seeds contain a kind of oil similar to linseed oil that is used in the manufacturing of soap and paint. In Canada, people used to grow cannabis to fight erosion and strong winds. After this brief historical overview, I will know look at the medical use of that plant. Our first description of cannabis comes from a medical treatise attributed to the Chinese emperor Chen-Nong, who lived around 2700 B.C. In addition, archeological discoveries at a site in Egypt between 3,000 and 4,000 years old have revealed its use. Herodotus, a Greek historian, mentions in his writings that inhaling the smoke from cannabis was a funeral purification rite of the Scythians, a people speaking Iranian and living between the Danube and the Don starting in the 12th century B.C. The oldest of the Veda, the sacred Hindu books, written in Sanskrit after 1800 B.C., indicates the properties of cannabis. Similarly, the Avesta, the holy book of the Zoroastrians, who originated in Northern Persia, which dates from 600 B.C., mentions that the cannabis resin produces drunkenness. One of the Hindu god Siva's titles is lord of the bongs and even today, the bong plays an important role in many Hindu religious practices, both symbolically and therapeutically. In Europe, interest in the use of cannabis did not really develop socially and medicinally until 1798, or after the return of Napoleon's expeditionary forces from Egypt. In the 19th century, western medicine paid a lot of attention to cannabis because of the influence of two authors: Dr. O'Shaughnessy, an English doctor who returned from India in 1843, and Moreau de Tours, a Frenchman who wrote considerably on the medicinal use and the abuse of cannabis in 1848. In Europe, cannabis only began to gather a following in 1844, when the Club des Hachichins, whose members included Balzac, Hugo, Baudelaire and Gautier, was founded in Paris. In Canada, the French apothecary, Louis Hébert, who arrived with Samuel de Champlain in 1606, was the first colonist to cultivate marijuana in North America. There have been many studies and commissions on the subject, the most exhaustive being the 3,281-page, seven-volume Indian Hemp Drugs Commission report, published in India in 1894. It was followed by the Guardian committee report, named after the mayor of New York, England's Baroness Wootton report, and our own Le Dain commission report. One argument used against legalizing marijuana for medical purposes is that marijuana now exists in the form of a drug, THC or tetrahydrocannabinol, marketed under the name Marinol. The problem is that THC, like most drugs, is absorbed by the gastrointestinal tract slowly and irregularly and its speed of absorption can be affected by the stomach's contents. In addition, THC frequently has undesirable side effects, and patients stop taking it. As for marijuana, which admittedly also has harmful side effects, its rapid absorption by the pulmonary route is a real benefit to certain patients. 1755 Despite all that medicine has done to understand the human being and try to stave off death as long as possible, it seems that compassion for human suffering sometimes falls short. There is still a wide range of treatments, medical cocktails, for the seriously ill, of course. But what good are they if ingesting them makes people sicker. Earlier, its benefits for those with MS, glaucoma, epilepsy or cancer were mentioned. There is also the wasting, or loss of muscle and fatty tissue seen in those with HIV and AIDS. In this particular situation, inhaling marijuana not only brings speedy and significant relief, but also helps patients' physical and psychological recovery. Demonstrating compassion towards the sick is also the role of politicians and that is why I support any legislative measure to provide controlled access to the therapeutic and medical use of marijuana. The Deputy Speaker: Before continuing, I want to point out that debate will now be on the amendment to the amendment moved by the hon. member for Drummond. [English] Ms. Elinor Caplan: Mr. Speaker, I rise on a point of order. It seems to me that the subamendment changes the intent of the motion and the amendment and I question whether it is in order. The Deputy Speaker: In the opinion of the Chair, the subamendment does fall within the amendment that was proposed. It simply clarifies the amendment. If the clarification is such that the House finds it objectionable, the House can reject it when voting on the subamendment. However, I think the subamendment appears to be in order and I have accordingly put it to the House. [Translation] Mr. Grant Hill (Macleod, Ref.): Mr. Speaker, I want to congratulate the hon. member for Rosemont for this motion on the medical use of marijuana. This debate needs to be held. [English] In my view, cannabis for palliation has a place. There are instances of terminal cancer, AIDS, chemotherapy wasting, epilepsy and glaucoma where it looks like cannabis has a positive effect. I especially believe that it has a place when there is no other product that works. We are debating the medical use of marijuana only. I think that good medical practice would say yes to the medical use of marijuana if there were no other choice. As an example, heroin, which is considered to be an illicit drug in Canada, is available to medical practitioners for this very purpose and if heroin, which is a potent illicit drug, is available, the argument would say, why not the medical use of cannabis. There are some difficulties with the medical use of marijuana. This is not a straightforward issue. Smoked marijuana is impure. In fact it is a chemical cocktail. 1800 Many of the medications we use for palliation are in fact a cocktail, but we have some choice over their constituents. The impurity of THC and the other constituents in marijuana is a problem. THC or cannibinoids are but one component of smoked pot, which is the common expression for this medication. There are some new studies that state that cannabis has some positive medical effects. The recent one which I would like to quote from today is from the Institute of Medicine in the U.S. This was reported recently in The Washington Post. The Institute of Medicine is an independent advisory body and the study did take some time. It was quite eagerly looked upon for some help in this debate, a debate that is complex. The basic conclusions of this study were that marijuana smoke can have an important effect on certain disease states. The study states “While we see a future in the development of cannibinoid drugs, we see little future in smoked marijuana as a medicine”. There we have the division. The cannibinoids in marijuana have a fairly positive future. This study suggested that smoked marijuana might well not be the way to go. As the study went on, there were very specific issues raised. Pain relief is probably the biggest commercial marketplace for cannibinoids. It went on to say that for nausea and vomiting caused by chemotherapy, cannibinoids are mildly effective but other preparations may be just as good. For the other things, glaucoma, migraines, Parkinson's, Huntington's disease and whatnot, not nearly as impressive results were found. If I can summarize this report, I would say that cannibinoids or THC in marijuana do have some positive benefits, especially in the treatment of pain. That would suggest to me for pain relief in a palliative sense for serious illnesses such as cancer and possibly AIDS this may well be a useful product. One of the other big difficulties with the medical use of marijuana is the likelihood that recreational use will become more difficult to control. That is not the case with other products, like heroin, which are chemically produced. Marijuana of course can be grown and is fairly easily grown. It can be grown in a house under certain circumstances. It can certainly be grown in the summer in Canada. That makes the control of recreational use more difficult. There are some who say that recreational use should be allowed unfettered. That is not something I agree with at all. I would like to suggest some potential solutions for the problems we have. On the one hand, it looks like cannibinoids may well be useful for palliation. On the other hand, there are some difficulties with control of the recreational use. The potential solutions would be, number one, to isolate these cannibinoids for specific use. There is some new research being done along those lines. We could also find alternate routes of administration. As my hon. colleague across the way mentioned, the oral route is not the best route for this particular preparation. Gastric absorption is not perfect and patients have told me that. There are three other potential routes. There is a new waxy capsule that has been developed. This is from the University of Mississippi in the United States. Initial research there looks very positive. It is absorbed quite rapidly. It is not the ideal way to administer for many people, but for individuals in these tough circumstances I think that might be a fair alternate. An oral or nasal spray of the very specific THC might also be possible. It has been suggested and in fact has been used in research. 1805 A patch which is another mechanism of administration has also been looked at. This would not be a controversy at all if it were not for the recreational use of marijuana. This would have been done long ago under an enlightened medical system. There are a host of individuals who use the medical use of marijuana as a gateway toward a larger use. As a practitioner, I had the opportunity to treat patients for drug problems. I do not go down the road of softening marijuana use for recreational purposes for one second. The reasons are legion but I do not have too much time so I will be narrow in this focus. Some 5% to 15% of the youth using cannabis become habituated. I did not use the word addicted because that is not the appropriate word for marijuana. Habituated is a more appropriate word. There are those who say not to bother with those small numbers because many, many kids who use this preparation go on to become perfectly healthy. I grant that as absolutely true. I would ask those individuals to attend in any city in the country a drug rehab facility. Go to a NarAnon meeting and listen to the youth and sometimes the adults who talk about the problems they have had with marijuana misuse. Ask about the school attendance from youth who have been habituated to marijuana. Ask about the personality changes these youth undergo. Ask about the problems they have undergone with the legal system, not just because of their marijuana use but because of fencing and the other things that go along with the drug subculture. The medical use of the specific components of marijuana have some merit. I am quite cautious about going down the road of recreational use and in fact am vigorously opposed in that regard. Purifying and looking at THC in its purest form is ideal. Smoked marijuana for those who have absolutely no other choice or those at the end of life could be approached. This debate is one that is timely. Ms. Libby Davies (Vancouver East, NDP): Mr. Speaker, I congratulate the member for Rosemont for bringing forward private member's Motion No. M-381, to allow the legal medical use of marijuana. This motion is a very good demonstration of what we can do as parliamentarians to examine an issue. In some ways this institution of the House of Commons is sort of far behind public opinion, even where the medical community is. Certainly people who are suffering from pain and diseases like AIDS or cancer are very eager to see this motion pass. I congratulate the member for his diligence in bringing this issue to the House and seeking out support from other members. I think that support is now quite strong. Many of my NDP colleagues are very supportive of this motion. Our health critic, the member for Winnipeg North Centre, spoke on March 4 and outlined very well the medical evidence that already exists to demonstrate that this motion should be approved in full rather than with the amendment put forward by the government. There is lots of evidence before us to show that the medical profession has made it quite clear there are very good grounds and information to show the medical use of marijuana is actually something beneficial. It helps people who are suffering from HIV, AIDS, cancer, MS and other ailments. We have received communications from groups such as the Canadian AIDS Society. It has very strongly outlined and advocated its support for this motion. 1810 There is no question there have been numerous studies. Also, very brave individuals in our society have taken on the justice system, sometimes almost alone, to challenge the archaic laws when it comes to the medical use of marijuana. People like Jim Wakeford, Terry Parker and others with a lot of expense and anxiety have had to take on the system to get this issue before the courts and to challenge the sanity and the rationale of why this law still exists. Numerous polls show us that even the Canadian public believes very strongly that the medical use of marijuana is something that should be sanctioned and supported. It creates a very strange situation that we have public opinion, and we even have judges making court rulings, we have health professionals, and the medical profession all telling us that this is the right thing to do. The lack of political will and commitment to follow through is now the greatest obstacle we face. I along with other members were very happy to see the Minister of Health make his announcement on March 3 that Health Canada will study and develop a plan around clinical trials for the medical use of marijuana. I do think we have to question whether or not this is simply a stalling tactic that is going to cause people more harm and more suffering as they wait for more studies to be done. We have to be very clear that the Minister of Health has the discretion and the power today. He had it last year and the year before that but he has it today to approve applications on compassionate grounds for the medical use of marijuana. There are applications before him. The Vancouver Compassion Club is an organization in my riding with a membership of about 700 individuals. Marijuana is actually dispensed for medical purposes. They have a lawyer who is signing people up to apply for an application for exemption. They are even prepared to go to a legal challenge based on their constitutional rights to have this medical exemption take place while the trials are taking place. I encourage members of the House, particularly government members, to continue to put pressure on the health minister. It is a useful and good thing to have these clinical trials go ahead as there are things that we need to learn. However, we have enough information now to ask the minister to go ahead with the exemption so that people can get relief, help and support now without having to become criminals if they seek help through places like the Vancouver Compassion Club or other organizations. Why are we afraid of taking immediate action on this? Why is the government afraid of doing that? It is partly wound up in the morals we have. We heard from the health critic of the Reform Party. It is all wound up with people's concerns about recreational use. This is part of a debate which I think is very necessary on Canada's drug laws. We need to have progressive reform in our drug laws. I have been working on an issue that affects my riding very much. It deals with injection drug users, heroin addicts who are literally dying on the streets. I have been advocating for heroin prescription trials as a way of medicalizing support and help to actually prevent people from dying, to get support for those people who now are completely outside of the system. The biggest barrier is not from the medical community, nor even from the public. It is from elected representatives, particularly the government representatives who are afraid to take this issue on. It deals with the taboos around a drug policy. I say very strongly that this is a place to begin in terms of drug reform policy. There is strong public support but we do have to go further. 1815 We can make a very rational, articulate and well reasoned case why the motion should be approved. The Minister of Health should be approving applications today for exemptions so that Canadians do not suffer any longer, so that they can get the relief they need without having to go to all kinds of difficult means and being made to feel like they are being marginalized and stigmatized by having to get medical marijuana illegally. That is a shame. It is something that does not need to exist if we had the political will and the leadership. I thank members of the House who support the motion. We must continue this work. There is a lot at stake here. This is an important debate. We must put pressure on the health minister to provide those exemptions. We must make it very clear that we do not want to wait another two or three years for the trials to be conducted. We do not want to wait for another study or another plan. We want help and relief to be provided now while those trials are going on. That is what we must urge the government to do in the interest of compassion and of providing people with real help and assistance. [Translation] Mrs. Christiane Gagnon (Québec, BQ): Mr. Speaker, I am pleased to speak today on an issue that is important for the well-being of some sick people. Legalizing the use of marijuana for health purposes is an urgent necessity for many sick persons, and the government's reluctance to set up an concrete plan of action is unacceptable to the many sick people who must act like criminals, even though they are using a drug prescribed by a doctor. This debate is a first in the history of the House of Commons. At last, thanks to the motion of my colleague, the hon. member for Rosemont, we have a unique opportunity, as representatives of our fellow citizens, to discuss the legalization of marijuana for medical purposes. But the issue is not a new one. In this regard, we lag far behind our civil society. We want to catch up by making sure that Motion M-381 gets the support of a majority of members from all sides, when we vote on it here, in this House. Let me explain why this is such an important issue. First, the Ontario court has already found part of the Narcotic Control Act to be unconstitutional, including the provisions on the use of marijuana for health purposes. As legislators, we have a duty to make a decision before the current legal vacuum forces judges to make that decision for us. Judges are not elected and should not be forced to make the final decision in a debate involving all of society because we hesitate to play our role as legislators. This is also a matter of compassion towards those who suffer from nausea, vomiting and other symptoms that often accompany chronic illnesses or are side effects of their treatments. Thousands of patients affected by cancer, AIDS, multiple sclerosis, epilepsy and other illnesses reported considerable relief from smoking marijuana. The effects are so positive that many patients and their families are ready to risk jail sentences to buy their drug on the black market. It is always shocking, especially for parents, to see relatives suffering when there is no efficient drug to alleviate pain. For all those who suffer, it is unacceptable that someone having to live with a chronic disease should risk six months in jail and a $1,000 fine for using a drug recommended by a doctor. In several cases, marijuana is the only drug that can effectively reduce some symptoms associated with an illness. Above all, it is unacceptable to make a criminal out of a person who uses for medical purposes a product whose therapeutic virtues are well established. In fact, practitioners have been prescribing Marinol pills for years. This drug is known to contain tetrahydrocannabinol, or THC—that is a lot simpler to pronounce—which is the main active ingredient of marijuana. Indeed, no one will deny the therapeutic value of THC, which is prescribed to relieve terminally ill patients from nausea and to stimulate their appetite. 1820 However, this synthetic pill is not a valid alternative to inhaled THC. According to the famous American medical magazine, the New England Journal of Medicine of January 30, 1997, inhalation is the only way to increase rapidly the level of THC in blood. Hence, inhalation of THC considerably improves the therapeutic efficiency of this substance. Besides, numerous patients who would use marijuana for therapeutic purposes already have to swallow every day an astronomical number of pills. This can cause vomiting and patients are therefore forced to swallow again the medication they have rejected. This is totally inhuman. It is obvious that in such cases, it would be better to administer THC by the pulmonary route rather than by the digestive route. I will now answer a question that many people ask about therapeutic inhalation of marijuana. Are the side effects of this practice acceptable? The inhalation of marijuana has well-known side effects. One only has to think about the damages caused to the lungs by inhalation of noxious smoke or about certain psychotic effects. We must understand that many medications, and not only marijuana, have side effects. Think, for example, of the undesirable and serious side effects of chemotherapy or AZT treatments. Let us consider, as well, the precautions that must be taken by those who use, for therapeutic purposes, by-products of morphine and cocaine. Even in the case of a simple Sudafed tablet, it is recommended not to drive a motor vehicle because of side effects. Indeed, this restriction would probably also apply to those who take marijuana for therapeutic purposes. We must bear in mind, however, that the side effects of marijuana are considered less harmful than those of at least two products that are widely used. As a matter of fact, a report produced by a group of French and foreign experts, and entitled Problèmes posés par la dangerosité des drogues, came to the conclusion that the use of marijuana is less hazardous than the use of alcohol or tobacco. These conclusions are consistent with the results of a similar study conducted on behalf of the UN World Health Organization. The side effects of a drug cannot be dissociated from its benefits. For many patients the various benefits of marijuana far outweigh the side effects known to be less serious than those of alcohol or nicotine. It is in this context that the British Medical Association publicly asked the police and the courts to tolerate the therapeutic use of marijuana. In its report, the association says that some patients are condemned to using an illegal drug to relieve symptoms no existing medication can control and that there is compelling evidence that marijuana can help in some circumstances. The British government responded to this request by allowing a pharmaceutical company to grow and supply cannabis for medical research, which led the Royal Pharmaceutical Society of Great Britain to say she is confident prescriptions will be allowed within the next three years. In the U.S., 28 states already have laws on the therapeutic use of marijuana. During the 1998 elections, six other states held a referendum on the issue. In all six cases, measures favouring the therapeutic use of marijuana got the majority of the popular vote. In Canada and Quebec, physicians are mobilizing to make the medical benefits of marijuana better known. They point out that marijuana relieves nausea and stimulates the appetite, which can help save the life of patients suffering from anemia because of chemotherapy or AIDS treatments. A cross-Canada poll has shown wide support, 83%, for the legalization of marijuana for therapeutic uses. The Globe and Mail commissioned that Angus Reid poll on November 4, 1997. 1825 On the political front, the Progressive Conservative Party, the NDP and the Bloc are in favour of legalization of marijuana for therapeutic uses, and individual members of the Liberal Party and the Reform Party are also in favour. As far as the federal government is concerned, the health and justice ministers stated in the House in March 1998 that this important issue was under consideration in their departments. There is no place here for petty politics, for this question is too important for thousands of patients. Nine months have gone by, and the federal government has still not come up with a policy, and the ministers have not yet given a date for one. This is cause for concern, because people are suffering. I urge all legislators to support this motion so that people affected by diseases like AIDS or multiple sclerosis who do not have any suitable drug available to them can at last be relieved of their pain. I ask for a unanimous vote on this motion. Ms. Diane St-Jacques (Shefford, PC): Mr. Speaker, first of all, I want to commend the hon. member for Rosemont for putting this private members' motion before the House and for the key role he has played these last few weeks in urging the federal government to take concrete measures to support the use of marijuana for therapeutic and medical purposes. I also want to congratulate all those who, in their own way, have constantly put pressure on the elected representatives so that this debate could be held and concrete measures could be implemented to help the people who need to use marijuana for medical purposes, who need to find some relief from pain and suffering or to deal with the symptoms of chronic or terminal illnesses. Of course, I am glad to join all those who have worked together to urge the federal government to have the political courage and the leadership to recognize the medicinal value of marijuana by immediately implementing measures to legalize the use of marijuana for therapeutic purposes. As my colleague from New Brunswick Southwest said, this issue must be addressed from a compassionate point of view. We must keep an open mind and show compassion throughout this debate. We have to keep in mind that for the sick who need marijuana for therapeutic purposes, every day they suffer is one day too many. Do not think I am talking in abstractions. I know what I am talking about, because my mother died of cancer after many long years of suffering. I will never forget how useless I felt as I watched her suffer and I wish I had known the therapeutic effects of marijuana at the time. However, it was unfortunately only a few years later that I learned about its therapeutic use, and I support the actions of those fighting for its medical use. I will tell you that this decision was very easy when I learned that the leaders of this campaign were those who were themselves sick and had to obtain marijuana illegally at the risk of being arrested. I think it is totally unacceptable that someone who is chronically ill or in the final stages of AIDS is being penalized for medical treatment that many doctors would recommend if they could. Experiments have shown—and a significant number of health care professionals have recognized it publicly—that the use of cannabis has beneficial effects in the case of at least four serious diseases. First, by lowering eye pressure, it controls glaucoma. Second, it reduces spasms in victims of MS. Third, it reduces nausea and suffering of those with cancer. Finally, it helps those with AIDS fight depression and regain the appetite they need to survive. It is also felt that marijuana can help those suffering from certain diseases such as migraines and emphysema. The other factor working considerably in favour of the use of marijuana for medical purposes is that it produces no side effects, as too often occur with other treatments and which can be of such intensity as to discourage those who are ill from taking their medication, despite their suffering. The Deputy Speaker: I am sorry to interrupt the hon. member, but the time provided for the consideration of Private Members' Business has now expired. The order is dropped to the bottom of the order of precedence on the Order Paper. 1830 Mr. Bernard Bigras: Mr. Speaker, I would ask the unanimous consent of the House in order for the Hon. member for Shefford to finish her speech. The Deputy Speaker: Does the hon. member have the unanimous consent of the House to continue? Some hon. members: Agreed. Some hon. members: No. The Deputy Speaker: The hon. member for Shefford will have six minutes to complete her speech the next time the motion is debated in the House. [End of excerpt relating to medicinal marijuana] Return to Canadian Foundation for Drug Policy home page Return to other materials on medicinal marijuana (debates, news reports, research materials)

Return to other materials on medicinal marijuana (debates, news reports, research materials)

Excerpts from April 14, 1999 House of Commons Debates on Medicinal Marijuana (to see full transcript of the day's Debates, click here)

EDITED HANSARD • NUMBER 207

CONTENTS

Wednesday, April 14, 1999
. . .

PRIVATE MEMBERS' BUSINESS

[English]

LEGALIZATION OF MARIJUANA FOR HEALTH AND MEDICAL PURPOSES

The House resumed from March 4 consideration of the motion and the amendment.

Mrs. Sue Barnes (London West, Lib.): Mr. Speaker, there is a growing body of evidence, most of it still anecdotal, that
strongly suggests that marijuana has unique therapeutic properties in the treatment of several life and sense threatening diseases.
For example, some people with multiple sclerosis believe that smoking marijuana helps them to control their spasticity. In
certain instances the use of marijuana has helped to reduce nausea and stimulate the appetite of those living with HIV and
AIDS.

Last year the board of directors of the Canadian AIDS Society passed a position statement on the medicinal use of smokable
marijuana stating that people living with HIV-AIDS and their physicians should have access to marijuana for medicinal
purposes in the treatment of these conditions.

1730

There are indications that smoking marijuana can likewise reduce nausea and vomiting brought on by chemotherapy, principally
among cancer patients. This is not simply a matter of comfort, as some cancer patients have had to cease treatment because the
constant vomiting can make it impossible to continue taking the therapeutic drugs they need. Many chemotherapy patients
complain that other anti-nausea drugs are ineffective and in some cases produce unwelcome side effects.

Marijuana is reputed to be helpful in the treatment of glaucoma through the reduction of intraocular pressure caused by fluid
accumulation.

Other medical conditions or situations for which marijuana is reputed to have some effectiveness include an anti-convulsant
action which may have an application in the treatment of epilepsy, and an analgesic action for pain relief. Marijuana cannot be
said to cure any of these conditions but the potential exists with rational, medically supervised use to help alleviate pain and
suffering. One recent report would term this belief based medicine. In Canada we strive for evidence based medicine.

The therapeutics products program, the regulator in Health Canada, has in place an expert advisory committee that since last
year has been examining a number of issues relating to the medical uses of marijuana.

I am delighted that Canada will be among those jurisdictions to gather evidence in a safe and controlled manner so that our
body of evidence can be evaluated along with that being done elsewhere.

In the U.K., GW Pharmaceuticals has been granted licences by the British Government to cultivate cannabis plants and to store
and dispense the cannabis preparations for research. Initially it will develop standardized extracts of cannabis plants grown
under controlled conditions. Research will also be concentrated on the best way to give the drug to patients and on which
conditions it can safely treat.

They intend to proceed to clinical trials with a smokeless whole plant extract while also supplying marijuana to other
investigators interested in medical research and pharmaceutical development.

Earlier this year the International Narcotics Control Board, which is responsible for the implementation of United Nations drug
conventions, released its annual report for 1998. In the report the board called for unbiased research into the possible medical
benefits of marijuana.

If the medical usefulness of marijuana is established, which I believe it will be, it would remain a drug no different from any other
narcotic drugs. It would still be subject to licensing and other control measures according to international treaties, just like
morphine and opiates.

Last month the American Institute of Medicine issued its report entitled “Marijuana and Medicine: Assessing the Science Base”.
It declared that the medical use of marijuana may be one of the most effective treatments available for people with serious
diseases such as AIDS and cancer.

This study, the product of more than 18 months of research, highlights continued concerns about marijuana but says it clearly
controls some forms of pain, was not particularly addictive, and did not appear to be a gateway to harder drugs. The report
also states that new research on the medical uses of marijuana should try to develop a non-smoked rapid onset delivery system
to simulate the action of smoking marijuana.

To assist desperately ill patients who may not want to wait for a safe alternative to be developed, the report suggests doctors
be allowed to launch clinical trials of marijuana, telling each test subject the benefits and risks of smoking it, including the
negative impact of the smoke itself.

At the present moment a licit supply of medical research quality marijuana for clinical trials in Canada is potentially available and
obtainable from the American National Institute on Drug Abuse. GW Pharmaceuticals may also be interested in performing
some clinical trials with its developed alternate delivery systems outside its jurisdiction of Britain.

In Canada no scientific evidence that smoked marijuana has medicinal benefit has been submitted to the therapeutic products
program. I believe very soon there will be a need for researchers to come forward and present proposals to study the benefits
of the medicinal use of marijuana.

Under the Controlled Drug and Substances Act there is sufficient latitude to distribute marijuana without having to now change
the law.

Under the CDSA the Minister of Health can enact regulations to authorize the possession, import, export and production of
cannabis for medical purposes. Section 56 of the act states the following:

The Minister may, on such terms and conditions as the Minister deems necessary, exempt any person or class of persons
or any controlled substance or precursor or any class thereof from the application of all or any of the provisions of this
act or the regulations if, in the opinion of the Minister, the exemption is necessary for a medical or scientific purpose or is
otherwise in the public interest.

1735

Under the regulations of the CDSA, the minister also has the authority to authorize research on controlled substances. Together
with others, specifically those in our social policy caucus at the time, I worked on the rework of the relevant bill in the 35th
parliament. Hansard debates recorded this.

In the summer of 1997 I commissioned the Library of Parliament to prepare a report regarding the use of the new CDSA act
and medicinal marijuana. This report was delivered to me in September 1997, at which time I provided it to our Minister of
Justice and our Minister of Health.

I have pushed this matter very hard inside my government and since that time with these departments. I, with others, understand
that even now there will not be overnight change; but let us not underestimate the progress made. The answer to my question to
the Minister of Health on March 3 was a significant embarkment on a new policy direction for Canada.

There are drugs that contain THC, the active ingredient in cannabis, which have received therapeutic drug approval by Health
Canada. These drugs went through the drug submission process, received a notice of compliance and then were granted drug
identification numbers. The drugs can be sold legally in Canada pursuant to a prescription by a practitioner. Since the active
ingredient in cannabis is already available for medicinal purposes in Canada, expanding its use may seem to be an appropriate
development once we have the supportive research in hand.

At the present time in Canada there are two approved drugs that contain the active ingredients derived from the marijuana
plants in pill form: Marinol and Cesamet. For many patients these synthetic versions of marijuana's active ingredients are
expensive, unpalatable, and if they are trying to control nausea to be able to take oral medications they are ineffective
oftentimes.

Smoking marijuana meanwhile appears to provide immediate relief of nausea and a stimulation of the appetite, allowing people
to hold down both their pills and some food. There may be better mediums, for example inhalers, that reduce the negative side
effects associated with smoking marijuana. These are still under development.

Currently some people who suffer from these diseases discussed above, for whom the legal medical options have proven
ineffective or painful, have made choices. Some have obtained marijuana illegally in Canada and therefore risk suffering
consequences such as arrest, fines, court costs, property forfeiture, incarceration, probation and criminal records.

Once evidence has been gathered the federal government will need to establish quickly an approach that would provide
medical quality, licit marijuana so that people suffering from disease do not have to take further risks with their health by buying
potentially impure, contaminated or chemically adulterated marijuana as is the case currently in Canada.

The concept of legalizing marijuana for medical purposes has been debated on and off in Canada for a number of years. I stress
today that it is not the so-called legalization of a controlled substance that is the real issue. It is the legal access through the
CDSA, which could be dealt with easily. In a recent court case in my riding, Regina v Clay and Prentice, Ontario Court Justice
John McCart stated:

Parliament may wish to take a serious look at easing the restrictions that apply to the use of marijuana for the medical
uses as outlined above as well as for alleviating some of the symptoms associated with multiple sclerosis, such as pain
and muscle spasm. There appears to be no merit to the wide-spread claim that marijuana has no therapeutic value
whatsoever.

It is a welcome step what we are doing. We need solid research efforts to commence soon. We also need to help set up a
system so that those on trials are not open to criminal harassment. It is a matter of compassion. It is not fair to these people
who have to fight both their disease and the law at the same time.

I applaud members on all sides of the House who have worked on this matter over the years. I think it is very important to
recognize them. I also think it is important to recognize the Minister of Health who has taken this step forward at this time.

I want to also thank my constituents and those across Canada who have brought the poignancy and the tragedy of this issue to
my attention. I am proud to be part of our government as we move forward on this issue.

1740

[Translation]

Mrs. Pauline Picard (Drummond, BQ): Mr. Speaker, I am pleased to take part in today's debate on the use of marijuana
for health purposes.

This is a health debate, a justice debate, based on the values of fairness, mutual aid and compassion that we all share as a
society.

Unfortunately, the motion, as amended by the Parliamentary Secretary to the Minister of Health, no longer mentions the
legalization of marijuana, which is a matter of concern. It now talks about the “possible legal medical use of marijuana”. In our
view, this is a step backwards since the government has asserted many times that it was open to the idea and eager to look into
it further.

In fact, more than a year ago, my colleague from Rosemont asked the Minister of Health to set up a parliamentary committee to
consider the issue. The minister replied that the question was under consideration, that some people were already studying the
matter. He said, and I quote: “The issue is under consideration by my department and by the Department of Justice. Along with
my colleague, we are reviewing all the aspects of the issue. We hope to present our policy in the coming months”.

Thirteen months after this statement, we are still waiting for some answers and for some concrete measures by the minister or
his colleague, the Minister of Justice, who, a year ago, had already started to review all the aspects of this important issue.

In our view, at the present time the government is holding hostage thousands of people who are suffering and waiting for a sign
of hope while risking six months in jail and a $1,000 fine in order to buy marijuana on the black market.

Currently, this debate is about medical issues. But it is also a matter of compassion. More often than not people with
HIV/AIDS or other diseases suffer from extreme nausea and are unable to eat. This is a problem, since some of the drugs
prescribed to them must be taken with food.

If the patient is successful in taking his medication in spite of the nausea and lack of appetite, he might be affected by side
effects: more nausea or even total intolerance to the drug itself.

For some, the solution to these problems has been to smoke or inhale marijuana. It eases nausea and stimulates the appetite.
Currently these men and women must break the law to get relief. This is intolerable in a country boasting one of the best health
care systems in the world.

Nobody doubts the therapeutic effectiveness of THC, the main active ingredient in marijuana. As a matter of fact, for a number
of years already physicians have been prescribing Marinol pills containing synthetic THC. This drug is available in drugstores.
However even Marinol is not as effective as inhaled marijuana.

Many physicians are asking to be allowed to prescribe THC, arguing they are in the best position to determine in which form
marijuana will be the best able to help their patients.

The positive effects of THC have been know for a long time, but, strangely enough, it is only recently that medical authorities
have started to examine seriously through clinical research these effects and potential medical applications.

Last March, the American medical institute published a report that found, once again, that marijuana has an excellent medical
potential.

In November of 1998, the British science and technology committee of the House of Lords took a strong stand in favour of the
legalization of marijuana for therapeutic uses. The chairman of the committee stated “We have enough evidence to be
convinced that physicians should be allowed to prescribe marijuana to ease the suffering of the sick or the symptoms of multiple
sclerosis, criminal code notwithstanding”.

1745

Recent research has confirmed earlier reports, including those of the World Health Organization, which are more and more
dispelling myths about the therapeutic value of marijuana.

Since the beginning of his campaign, my colleague from Rosemont has gathered a great deal of support, and more support
keeps coming in. The Canadian AIDS Society, the Quebec chapter of the Canadian Hemophilia Society and the Coalition des
organismes communautaires québécois de lutte contre le sida support motion M-381 without any reservation.

Not too long ago, the National Pensioners and Senior Citizens Federation urged the health minister to act quickly on this issue.
The Canadian Medical Association has been defending the decriminalization of simple possession of marijuana since 1981 and
deplores the lack of any systematic scientific research on the issue.

Support for decriminalization of marijuana for therapeutic purposes does not come just from the medical associations or social
groups; according to a survey carried out last month, close to 80% of the population are in favour of this major change.

Health Canada has had a program since 1966 whereby certain patients may receive unauthorised drugs so that they do not
have to suffer needlessly while awaiting authorisation of a product that could help them. Jean-Charles Parizeau and James
Wakeford, among others, have applied to obtain marijuana The government has not, however, given any concrete response as
yet.

This is a problematic situation, because a recent Ontario Court decision on the Wakeford case almost found the Narcotics Act
unconstitutional, since it has the effect of depriving certain individuals of the only effective treatment to alleviate their condition. It
did not do so for just one reason: there is a way to obtain marijuana and other drugs, such as morphine and other unauthorized
drugs, under the current legislation, via the special access program.

This means that, if the government persists in refusing to respond to requests, or refuses access to marijuana through the special
access program, part of the Narcotics Act will become unconstitutional, not by law but by fact.

Mr. Parizeau and Mr. Wakeford, and others in their position, would have two choices available to them. First, to play the good
citizen, to suffer and to die in the near future, or second to improve their condition and their quality of life by an illegal act. This
is the impossible choice this government offers to those in needs. It is unacceptable.

In conclusion, the government must stop holding sick people hostage, stop waffling, stop letting the courts decide for it.

I would therefore like to propose an amendment to the amendment of Motion M-381. If the government is sincere in its desire
to settle this important question, it will acknowledge that the change is well-founded.

I move:

That the amendment be amended by deleting the words “concerning the possible legal” and substituting the following:

“to legalize the”

Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): Mr. Speaker, I am pleased to rise today to speak to Motion M-381 as
well as to the amendment put forward by the Parliamentary Secretary to the Minister of Health.

First, I will take a few moments to give the history of Cannabis sativa and to talk about the various reports and commissions
on this issue, and I will then explain why I strongly support the motion and the amendment to legalize the use of marijuana for
health and medical purposes.

To better understand the issue, I did some research and I consulted the Le Dain report, among others.

Cannabis sativa is cultivated or grows wild in most countries in tropical or temperate zones, including Canada.

1750

This plant, which probably came originally from Asia, has been cultivated for a very long time. The street language has given
marijuana different names, including pot and grass in English. In India, medium quality marijuana is called bang and high quality
marijuana is called ganga. It is called kif in Marocco, dagga in South Africa and ganga in Jamaica.

Cannabis also produces an amber coloured resin which, in the almost pure state, is a drug called charas in India and hashish in
western and middle eastern countries.

As for the word marijuana, its etymology is not clear. Some sources say that it is the contraction of two first names that are
popular in Mexico, namely Maria and Juana. Other believe that this word comes from the Mexican word mariguano, which
means intoxicant, or the Panamanian word managuango, which has the same meaning.

Cannabis has many uses. Its stem provides strong textile fibres that are used in the manufacturing of wires and cables. They can
also be used to make blankets, clothes, flags and boat sails. The seeds contain a kind of oil similar to linseed oil that is used in
the manufacturing of soap and paint. In Canada, people used to grow cannabis to fight erosion and strong winds.

After this brief historical overview, I will know look at the medical use of that plant.

Our first description of cannabis comes from a medical treatise attributed to the Chinese emperor Chen-Nong, who lived
around 2700 B.C. In addition, archeological discoveries at a site in Egypt between 3,000 and 4,000 years old have revealed its
use. Herodotus, a Greek historian, mentions in his writings that inhaling the smoke from cannabis was a funeral purification rite
of the Scythians, a people speaking Iranian and living between the Danube and the Don starting in the 12th century B.C.

The oldest of the Veda, the sacred Hindu books, written in Sanskrit after 1800 B.C., indicates the properties of cannabis.

Similarly, the Avesta, the holy book of the Zoroastrians, who originated in Northern Persia, which dates from 600 B.C.,
mentions that the cannabis resin produces drunkenness. One of the Hindu god Siva's titles is lord of the bongs and even today,
the bong plays an important role in many Hindu religious practices, both symbolically and therapeutically.

In Europe, interest in the use of cannabis did not really develop socially and medicinally until 1798, or after the return of
Napoleon's expeditionary forces from Egypt.

In the 19th century, western medicine paid a lot of attention to cannabis because of the influence of two authors: Dr.
O'Shaughnessy, an English doctor who returned from India in 1843, and Moreau de Tours, a Frenchman who wrote
considerably on the medicinal use and the abuse of cannabis in 1848.

In Europe, cannabis only began to gather a following in 1844, when the Club des Hachichins, whose members included Balzac,
Hugo, Baudelaire and Gautier, was founded in Paris.

In Canada, the French apothecary, Louis Hébert, who arrived with Samuel de Champlain in 1606, was the first colonist to
cultivate marijuana in North America.

There have been many studies and commissions on the subject, the most exhaustive being the 3,281-page, seven-volume
Indian Hemp Drugs Commission report, published in India in 1894. It was followed by the Guardian committee report, named
after the mayor of New York, England's Baroness Wootton report, and our own Le Dain commission report.

One argument used against legalizing marijuana for medical purposes is that marijuana now exists in the form of a drug, THC or
tetrahydrocannabinol, marketed under the name Marinol.

The problem is that THC, like most drugs, is absorbed by the gastrointestinal tract slowly and irregularly and its speed of
absorption can be affected by the stomach's contents.

In addition, THC frequently has undesirable side effects, and patients stop taking it.

As for marijuana, which admittedly also has harmful side effects, its rapid absorption by the pulmonary route is a real benefit to
certain patients.

1755

Despite all that medicine has done to understand the human being and try to stave off death as long as possible, it seems that
compassion for human suffering sometimes falls short.

There is still a wide range of treatments, medical cocktails, for the seriously ill, of course. But what good are they if ingesting
them makes people sicker.

Earlier, its benefits for those with MS, glaucoma, epilepsy or cancer were mentioned. There is also the wasting, or loss of
muscle and fatty tissue seen in those with HIV and AIDS. In this particular situation, inhaling marijuana not only brings speedy
and significant relief, but also helps patients' physical and psychological recovery.

Demonstrating compassion towards the sick is also the role of politicians and that is why I support any legislative measure to
provide controlled access to the therapeutic and medical use of marijuana.

The Deputy Speaker: Before continuing, I want to point out that debate will now be on the amendment to the amendment
moved by the hon. member for Drummond.

[English]

Ms. Elinor Caplan: Mr. Speaker, I rise on a point of order. It seems to me that the subamendment changes the intent of the
motion and the amendment and I question whether it is in order.

The Deputy Speaker: In the opinion of the Chair, the subamendment does fall within the amendment that was proposed. It
simply clarifies the amendment. If the clarification is such that the House finds it objectionable, the House can reject it when
voting on the subamendment. However, I think the subamendment appears to be in order and I have accordingly put it to the
House.

[Translation]

Mr. Grant Hill (Macleod, Ref.): Mr. Speaker, I want to congratulate the hon. member for Rosemont for this motion on the
medical use of marijuana. This debate needs to be held.

[English]

In my view, cannabis for palliation has a place. There are instances of terminal cancer, AIDS, chemotherapy wasting, epilepsy
and glaucoma where it looks like cannabis has a positive effect. I especially believe that it has a place when there is no other
product that works.

We are debating the medical use of marijuana only. I think that good medical practice would say yes to the medical use of
marijuana if there were no other choice. As an example, heroin, which is considered to be an illicit drug in Canada, is available
to medical practitioners for this very purpose and if heroin, which is a potent illicit drug, is available, the argument would say,
why not the medical use of cannabis.

There are some difficulties with the medical use of marijuana. This is not a straightforward issue. Smoked marijuana is impure.
In fact it is a chemical cocktail.

1800

Many of the medications we use for palliation are in fact a cocktail, but we have some choice over their constituents. The
impurity of THC and the other constituents in marijuana is a problem. THC or cannibinoids are but one component of smoked
pot, which is the common expression for this medication.

There are some new studies that state that cannabis has some positive medical effects. The recent one which I would like to
quote from today is from the Institute of Medicine in the U.S. This was reported recently in The Washington Post. The
Institute of Medicine is an independent advisory body and the study did take some time. It was quite eagerly looked upon for
some help in this debate, a debate that is complex.

The basic conclusions of this study were that marijuana smoke can have an important effect on certain disease states. The study
states “While we see a future in the development of cannibinoid drugs, we see little future in smoked marijuana as a medicine”.
There we have the division. The cannibinoids in marijuana have a fairly positive future. This study suggested that smoked
marijuana might well not be the way to go.

As the study went on, there were very specific issues raised.

Pain relief is probably the biggest commercial marketplace for cannibinoids. It went on to say that for nausea and vomiting
caused by chemotherapy, cannibinoids are mildly effective but other preparations may be just as good. For the other things,
glaucoma, migraines, Parkinson's, Huntington's disease and whatnot, not nearly as impressive results were found.

If I can summarize this report, I would say that cannibinoids or THC in marijuana do have some positive benefits, especially in
the treatment of pain. That would suggest to me for pain relief in a palliative sense for serious illnesses such as cancer and
possibly AIDS this may well be a useful product.

One of the other big difficulties with the medical use of marijuana is the likelihood that recreational use will become more
difficult to control. That is not the case with other products, like heroin, which are chemically produced.

Marijuana of course can be grown and is fairly easily grown. It can be grown in a house under certain circumstances. It can
certainly be grown in the summer in Canada. That makes the control of recreational use more difficult. There are some who say
that recreational use should be allowed unfettered. That is not something I agree with at all.

I would like to suggest some potential solutions for the problems we have. On the one hand, it looks like cannibinoids may well
be useful for palliation. On the other hand, there are some difficulties with control of the recreational use.

The potential solutions would be, number one, to isolate these cannibinoids for specific use. There is some new research being
done along those lines.

We could also find alternate routes of administration. As my hon. colleague across the way mentioned, the oral route is not the
best route for this particular preparation. Gastric absorption is not perfect and patients have told me that. There are three other
potential routes.

There is a new waxy capsule that has been developed. This is from the University of Mississippi in the United States. Initial
research there looks very positive. It is absorbed quite rapidly. It is not the ideal way to administer for many people, but for
individuals in these tough circumstances I think that might be a fair alternate.

An oral or nasal spray of the very specific THC might also be possible. It has been suggested and in fact has been used in
research.

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A patch which is another mechanism of administration has also been looked at.

This would not be a controversy at all if it were not for the recreational use of marijuana. This would have been done long ago
under an enlightened medical system.

There are a host of individuals who use the medical use of marijuana as a gateway toward a larger use. As a practitioner, I had
the opportunity to treat patients for drug problems. I do not go down the road of softening marijuana use for recreational
purposes for one second. The reasons are legion but I do not have too much time so I will be narrow in this focus.

Some 5% to 15% of the youth using cannabis become habituated. I did not use the word addicted because that is not the
appropriate word for marijuana. Habituated is a more appropriate word. There are those who say not to bother with those
small numbers because many, many kids who use this preparation go on to become perfectly healthy. I grant that as absolutely
true.

I would ask those individuals to attend in any city in the country a drug rehab facility. Go to a NarAnon meeting and listen to the
youth and sometimes the adults who talk about the problems they have had with marijuana misuse. Ask about the school
attendance from youth who have been habituated to marijuana. Ask about the personality changes these youth undergo. Ask
about the problems they have undergone with the legal system, not just because of their marijuana use but because of fencing
and the other things that go along with the drug subculture.

The medical use of the specific components of marijuana have some merit. I am quite cautious about going down the road of
recreational use and in fact am vigorously opposed in that regard. Purifying and looking at THC in its purest form is ideal.
Smoked marijuana for those who have absolutely no other choice or those at the end of life could be approached.

This debate is one that is timely.

Ms. Libby Davies (Vancouver East, NDP): Mr. Speaker, I congratulate the member for Rosemont for bringing forward
private member's Motion No. M-381, to allow the legal medical use of marijuana.

This motion is a very good demonstration of what we can do as parliamentarians to examine an issue. In some ways this
institution of the House of Commons is sort of far behind public opinion, even where the medical community is. Certainly
people who are suffering from pain and diseases like AIDS or cancer are very eager to see this motion pass.

I congratulate the member for his diligence in bringing this issue to the House and seeking out support from other members. I
think that support is now quite strong. Many of my NDP colleagues are very supportive of this motion. Our health critic, the
member for Winnipeg North Centre, spoke on March 4 and outlined very well the medical evidence that already exists to
demonstrate that this motion should be approved in full rather than with the amendment put forward by the government.

There is lots of evidence before us to show that the medical profession has made it quite clear there are very good grounds and
information to show the medical use of marijuana is actually something beneficial. It helps people who are suffering from HIV,
AIDS, cancer, MS and other ailments. We have received communications from groups such as the Canadian AIDS Society. It
has very strongly outlined and advocated its support for this motion.

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There is no question there have been numerous studies. Also, very brave individuals in our society have taken on the justice
system, sometimes almost alone, to challenge the archaic laws when it comes to the medical use of marijuana. People like Jim
Wakeford, Terry Parker and others with a lot of expense and anxiety have had to take on the system to get this issue before
the courts and to challenge the sanity and the rationale of why this law still exists.

Numerous polls show us that even the Canadian public believes very strongly that the medical use of marijuana is something
that should be sanctioned and supported. It creates a very strange situation that we have public opinion, and we even have
judges making court rulings, we have health professionals, and the medical profession all telling us that this is the right thing to
do. The lack of political will and commitment to follow through is now the greatest obstacle we face.

I along with other members were very happy to see the Minister of Health make his announcement on March 3 that Health
Canada will study and develop a plan around clinical trials for the medical use of marijuana. I do think we have to question
whether or not this is simply a stalling tactic that is going to cause people more harm and more suffering as they wait for more
studies to be done.

We have to be very clear that the Minister of Health has the discretion and the power today. He had it last year and the year
before that but he has it today to approve applications on compassionate grounds for the medical use of marijuana. There are
applications before him.

The Vancouver Compassion Club is an organization in my riding with a membership of about 700 individuals. Marijuana is
actually dispensed for medical purposes. They have a lawyer who is signing people up to apply for an application for
exemption. They are even prepared to go to a legal challenge based on their constitutional rights to have this medical exemption
take place while the trials are taking place.

I encourage members of the House, particularly government members, to continue to put pressure on the health minister. It is a
useful and good thing to have these clinical trials go ahead as there are things that we need to learn. However, we have enough
information now to ask the minister to go ahead with the exemption so that people can get relief, help and support now without
having to become criminals if they seek help through places like the Vancouver Compassion Club or other organizations.

Why are we afraid of taking immediate action on this? Why is the government afraid of doing that? It is partly wound up in the
morals we have. We heard from the health critic of the Reform Party. It is all wound up with people's concerns about
recreational use. This is part of a debate which I think is very necessary on Canada's drug laws. We need to have progressive
reform in our drug laws.

I have been working on an issue that affects my riding very much. It deals with injection drug users, heroin addicts who are
literally dying on the streets. I have been advocating for heroin prescription trials as a way of medicalizing support and help to
actually prevent people from dying, to get support for those people who now are completely outside of the system.

The biggest barrier is not from the medical community, nor even from the public. It is from elected representatives, particularly
the government representatives who are afraid to take this issue on. It deals with the taboos around a drug policy.

I say very strongly that this is a place to begin in terms of drug reform policy. There is strong public support but we do have to
go further.

1815

We can make a very rational, articulate and well reasoned case why the motion should be approved. The Minister of Health
should be approving applications today for exemptions so that Canadians do not suffer any longer, so that they can get the relief
they need without having to go to all kinds of difficult means and being made to feel like they are being marginalized and
stigmatized by having to get medical marijuana illegally. That is a shame. It is something that does not need to exist if we had the
political will and the leadership.

I thank members of the House who support the motion. We must continue this work. There is a lot at stake here. This is an
important debate. We must put pressure on the health minister to provide those exemptions.

We must make it very clear that we do not want to wait another two or three years for the trials to be conducted. We do not
want to wait for another study or another plan. We want help and relief to be provided now while those trials are going on.
That is what we must urge the government to do in the interest of compassion and of providing people with real help and
assistance.

[Translation]

Mrs. Christiane Gagnon (Québec, BQ): Mr. Speaker, I am pleased to speak today on an issue that is important for the
well-being of some sick people.

Legalizing the use of marijuana for health purposes is an urgent necessity for many sick persons, and the government's
reluctance to set up an concrete plan of action is unacceptable to the many sick people who must act like criminals, even though
they are using a drug prescribed by a doctor.

This debate is a first in the history of the House of Commons. At last, thanks to the motion of my colleague, the hon. member
for Rosemont, we have a unique opportunity, as representatives of our fellow citizens, to discuss the legalization of marijuana
for medical purposes.

But the issue is not a new one. In this regard, we lag far behind our civil society. We want to catch up by making sure that
Motion M-381 gets the support of a majority of members from all sides, when we vote on it here, in this House.

Let me explain why this is such an important issue. First, the Ontario court has already found part of the Narcotic Control Act
to be unconstitutional, including the provisions on the use of marijuana for health purposes.

As legislators, we have a duty to make a decision before the current legal vacuum forces judges to make that decision for us.
Judges are not elected and should not be forced to make the final decision in a debate involving all of society because we
hesitate to play our role as legislators.

This is also a matter of compassion towards those who suffer from nausea, vomiting and other symptoms that often accompany
chronic illnesses or are side effects of their treatments. Thousands of patients affected by cancer, AIDS, multiple sclerosis,
epilepsy and other illnesses reported considerable relief from smoking marijuana.

The effects are so positive that many patients and their families are ready to risk jail sentences to buy their drug on the black
market.

It is always shocking, especially for parents, to see relatives suffering when there is no efficient drug to alleviate pain. For all
those who suffer, it is unacceptable that someone having to live with a chronic disease should risk six months in jail and a
$1,000 fine for using a drug recommended by a doctor. In several cases, marijuana is the only drug that can effectively reduce
some symptoms associated with an illness.

Above all, it is unacceptable to make a criminal out of a person who uses for medical purposes a product whose therapeutic
virtues are well established.

In fact, practitioners have been prescribing Marinol pills for years. This drug is known to contain tetrahydrocannabinol, or
THC—that is a lot simpler to pronounce—which is the main active ingredient of marijuana. Indeed, no one will deny the
therapeutic value of THC, which is prescribed to relieve terminally ill patients from nausea and to stimulate their appetite.

1820

However, this synthetic pill is not a valid alternative to inhaled THC. According to the famous American medical magazine, the
New England Journal of Medicine of January 30, 1997, inhalation is the only way to increase rapidly the level of THC in blood.
Hence, inhalation of THC considerably improves the therapeutic efficiency of this substance.

Besides, numerous patients who would use marijuana for therapeutic purposes already have to swallow every day an
astronomical number of pills. This can cause vomiting and patients are therefore forced to swallow again the medication they
have rejected. This is totally inhuman. It is obvious that in such cases, it would be better to administer THC by the pulmonary
route rather than by the digestive route.

I will now answer a question that many people ask about therapeutic inhalation of marijuana. Are the side effects of this
practice acceptable?

The inhalation of marijuana has well-known side effects. One only has to think about the damages caused to the lungs by
inhalation of noxious smoke or about certain psychotic effects. We must understand that many medications, and not only
marijuana, have side effects.

Think, for example, of the undesirable and serious side effects of chemotherapy or AZT treatments. Let us consider, as well,
the precautions that must be taken by those who use, for therapeutic purposes, by-products of morphine and cocaine. Even in
the case of a simple Sudafed tablet, it is recommended not to drive a motor vehicle because of side effects. Indeed, this
restriction would probably also apply to those who take marijuana for therapeutic purposes.

We must bear in mind, however, that the side effects of marijuana are considered less harmful than those of at least two
products that are widely used. As a matter of fact, a report produced by a group of French and foreign experts, and entitled
Problèmes posés par la dangerosité des drogues, came to the conclusion that the use of marijuana is less hazardous than the
use of alcohol or tobacco. These conclusions are consistent with the results of a similar study conducted on behalf of the UN
World Health Organization.

The side effects of a drug cannot be dissociated from its benefits.

For many patients the various benefits of marijuana far outweigh the side effects known to be less serious than those of alcohol
or nicotine. It is in this context that the British Medical Association publicly asked the police and the courts to tolerate the
therapeutic use of marijuana.

In its report, the association says that some patients are condemned to using an illegal drug to relieve symptoms no existing
medication can control and that there is compelling evidence that marijuana can help in some circumstances.

The British government responded to this request by allowing a pharmaceutical company to grow and supply cannabis for
medical research, which led the Royal Pharmaceutical Society of Great Britain to say she is confident prescriptions will be
allowed within the next three years.

In the U.S., 28 states already have laws on the therapeutic use of marijuana. During the 1998 elections, six other states held a
referendum on the issue. In all six cases, measures favouring the therapeutic use of marijuana got the majority of the popular
vote.

In Canada and Quebec, physicians are mobilizing to make the medical benefits of marijuana better known. They point out that
marijuana relieves nausea and stimulates the appetite, which can help save the life of patients suffering from anemia because of
chemotherapy or AIDS treatments.

A cross-Canada poll has shown wide support, 83%, for the legalization of marijuana for therapeutic uses. The Globe and Mail
commissioned that Angus Reid poll on November 4, 1997.

1825

On the political front, the Progressive Conservative Party, the NDP and the Bloc are in favour of legalization of marijuana for
therapeutic uses, and individual members of the Liberal Party and the Reform Party are also in favour.

As far as the federal government is concerned, the health and justice ministers stated in the House in March 1998 that this
important issue was under consideration in their departments.

There is no place here for petty politics, for this question is too important for thousands of patients.

Nine months have gone by, and the federal government has still not come up with a policy, and the ministers have not yet given
a date for one. This is cause for concern, because people are suffering. I urge all legislators to support this motion so that
people affected by diseases like AIDS or multiple sclerosis who do not have any suitable drug available to them can at last be
relieved of their pain.

I ask for a unanimous vote on this motion.

Ms. Diane St-Jacques (Shefford, PC): Mr. Speaker, first of all, I want to commend the hon. member for Rosemont for
putting this private members' motion before the House and for the key role he has played these last few weeks in urging the
federal government to take concrete measures to support the use of marijuana for therapeutic and medical purposes.

I also want to congratulate all those who, in their own way, have constantly put pressure on the elected representatives so that
this debate could be held and concrete measures could be implemented to help the people who need to use marijuana for
medical purposes, who need to find some relief from pain and suffering or to deal with the symptoms of chronic or terminal
illnesses.

Of course, I am glad to join all those who have worked together to urge the federal government to have the political courage
and the leadership to recognize the medicinal value of marijuana by immediately implementing measures to legalize the use of
marijuana for therapeutic purposes.

As my colleague from New Brunswick Southwest said, this issue must be addressed from a compassionate point of view. We
must keep an open mind and show compassion throughout this debate.

We have to keep in mind that for the sick who need marijuana for therapeutic purposes, every day they suffer is one day too
many. Do not think I am talking in abstractions. I know what I am talking about, because my mother died of cancer after many
long years of suffering. I will never forget how useless I felt as I watched her suffer and I wish I had known the therapeutic
effects of marijuana at the time.

However, it was unfortunately only a few years later that I learned about its therapeutic use, and I support the actions of those
fighting for its medical use.

I will tell you that this decision was very easy when I learned that the leaders of this campaign were those who were themselves
sick and had to obtain marijuana illegally at the risk of being arrested.

I think it is totally unacceptable that someone who is chronically ill or in the final stages of AIDS is being penalized for medical
treatment that many doctors would recommend if they could.

Experiments have shown—and a significant number of health care professionals have recognized it publicly—that the use of
cannabis has beneficial effects in the case of at least four serious diseases. First, by lowering eye pressure, it controls glaucoma.
Second, it reduces spasms in victims of MS. Third, it reduces nausea and suffering of those with cancer. Finally, it helps those
with AIDS fight depression and regain the appetite they need to survive.

It is also felt that marijuana can help those suffering from certain diseases such as migraines and emphysema.

The other factor working considerably in favour of the use of marijuana for medical purposes is that it produces no side effects,
as too often occur with other treatments and which can be of such intensity as to discourage those who are ill from taking their
medication, despite their suffering.

The Deputy Speaker: I am sorry to interrupt the hon. member, but the time provided for the consideration of Private
Members' Business has now expired. The order is dropped to the bottom of the order of precedence on the Order Paper.

1830

Mr. Bernard Bigras: Mr. Speaker, I would ask the unanimous consent of the House in order for the Hon. member for
Shefford to finish her speech.

The Deputy Speaker: Does the hon. member have the unanimous consent of the House to continue?

Some hon. members: Agreed.

Some hon. members: No.

The Deputy Speaker: The hon. member for Shefford will have six minutes to complete her speech the next time the motion is
debated in the House.

[End of excerpt relating to medicinal marijuana]

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