Health Canada market data for the past few years shows that British Columbians and Quebecers appear to prefer the black market over Canada’s legal medical cannabis system.
Despite being the second and third largest provinces in Canada, with over 8 million and 4.7 million people respectively, shipments to registered patients in Quebec and British Columbia are some of the lowest in the country.
Patients registered in Quebec only received 2,457 shipments in August. BC, only 2,534. The same month saw 34,757 shipments to registered clients in Ontario and 12,986 in Alberta. Previous data shows similar figures in the past.
Looking at the numbers cumulatively, Ontario received 177,752 shipments from January to August of this year, and Alberta received 60,726. BC received 17,080, and Quebec received 13,819 in the same time frame. For comparison, New Brunswick, with a population of only ~700,000 saw more than Quebec, with 16,825 from January to August 2016.
Ontario is the most populated province with nearly 14 million people. Quebec is the second largest with over 8 million. Alberta is fourth with about 4.2 million people.
There are two very different reasons for this. While Quebec is limited by a strict provincial rule preventing doctors from prescribing cannabis unless through a research project like the Quebec Cannabis Registry, British Columbia has a deeply embedded cannabis and dispensary culture that is already familiar with the ease and selection of retail dispensary outlets.
When Canada’s Marijuana for Medical Purposes Regulations (MMPR) were first laid out, Quebec’s College of Physicians issued new rules preventing doctors in Quebec from prescribing cannabis outside of a ‘research framework’. This has significantly limited the amount of doctors even allowed to prescribe cannabis in the province.
Not all doctors have been keen to sign up through such framework, nor are all who apply accepted by the system. As of June of this year, only 23 physicians were approved to authorize the use of cannabis for medical purposes, out of 160 who have applied, with the registry tracking over 500 patients.
The goal of the program is to have at least 3,000 patients. No timeline has been given for that number. Even at this level of participation, this would still put Quebec well under the rates of usage per capita seen in other provinces. And with only 500 patients in over a year of the Quebec Cannabis Registry being open, patients may be waiting for years for legal access.
At least one licensed producer, Tweed, is so interested in making inroads in Quebec that they recently brought on Adam Greenblatt as their Head of Quebec Engagement. Previous to working with Tweed, Greenblatt was the co-founder of Sante Cannabis, Montreal's first cannabinoid clinic and medical marijuana resource centre, helping patients access Canada’s legal medical system (at the time, the MMPR). Greenblatt estimates that 70% of MM/ACMPR clients in Quebec have come through Sante Cannabis.
“The Quebec Cannabis Registry needs more doctors. Only just recently did they get approval to expand that into public institutions like hospitals and long term care facilities, which is expected to bring another 160-ish doctors into the study.
“With the need for more physicians also comes the need for more clinics. There has yet to be a clinic with real credibility and any media savvy to establish itself in Quebec after Santé Cannabis, despite some lacklustre attempts. But we need a lot more of them.”
This doesn't mean Quebecers aren't using cannabis, though. A recent poll showed Quebecers were significantly more likely to grow their own. In response to the question "Where do you currently obtain the marijuana you consume?", Quebecers were several times more likely than the rest of the country to say they grew their own, while 'dispensary' and 'friend' were more or less on the national average.
British Columbia, however, is not as burdened by their college of physicians. Although still relatively limiting, the BC College of Surgeons and Physicians doesn’t restrict doctors from prescribing cannabis. The issue in BC is more to do with such a deeply rooted black market cannabis industry, from growers producing a multi-billion dollar annual crop, to the numerous dispensaries across the province. Some dispensaries are even being licensed by their respective municipalities.
“It’s really two completely different scenarios, BC and Quebec,” says says Jordan Sinclair, the Director of Communications at Tweed Inc. “The Quebec side of things does seem to be a little bit more structural. It seems to be driven by the fact that your prescription needs to be part of a research protocol to be able to have it prescribed by a doctor. There really is just not as many options to get a prescription in Quebec compared to Ontario.”
As for BC, Sinclair says a long-standing tradition of dispensaries and societal acceptance of cannabis in general obviously leads to people choosing existing modes of retail, rather than the government’s system.
“The dispensary system is very, very deeply ingrained in BC culture, certainly in Vancouver culture, and it just feels that it’s so much more a part of the ecosystem out there than it does anywhere else, that I don’t know if people are as compelled to go to a doctor when they can just go to a location that’s in their neighbourhood.”
“Many of the people I work with are there because of the selection. I’m not talking about flowers. Flowers seem to not be the biggest hurdle. It’s more about the processed products: capsules, topicals, CBD products, oils, tinctures etc." Andrea Dobbs, Co-founder of the Village Dispensary in Vancouver
Andrea Dobbs, Co-owner of The Village dispensary in Vancouver, agrees that ease of access and the immediacy of brick and mortar retail is simply more appealing for many of her clients. Dobbs has been running the Village with her husband Jeremy since mid 2015 and have seen a steady increase in interest over that time.
“In Vancouver, we have this history,” says Dobbs. “So it makes more sense for people in BC to walk down the street to a shop, it feels a bit more normal. We’re used to it.
“From my perspective, and the people I interact with (through The Village), the main concern about working through an LP is a lack of human contact. They want to talk to someone in person, they want to see the product. I know they (LP’s) have been very limited by the government in the way they can serve people, as well as the way they can produce.”
What LPs can and can’t sell is a major factor, too, says Dobbs. While LP’s can currently only sell dried flowers and about a dozen are allowed to sell a very limited supply of cannabis oils, patients can easily turn to a local dispensary for other products like capsules, topicals, tinctures and more. Dispensaries in Canada are, on average, slightly more expensive than their legal and illegal online counterparts, but the variety of products available inside, and the ability to visit a physical store, can make the choice obvious for many patients.
“Many of the people I work with are there (at The Village) because of the selection. I’m not talking about flowers. Flowers seem to not be the biggest hurdle. It’s more about the processed products: capsules, topicals, CBD products, oils, tinctures etc.
“Then there’s the issue that someone my age, I haven’t really gotten into the online shopping thing. I might buy books online, but I don’t buy shoes online because I want to try them on, I won’t buy food online because I want to see it, touch it. So there’s that hurdle, potentially, especially for a particular age range.” (Note, Andrea says she turned 50 this year)
However, that doesn’t mean it’s an either/or for patients, says Dobbs. While she clearly sees the benefits of her own business, she also points out that the government’s legal access program serves a useful purpose, as well.
“I have directed a number of people to licensed producers, because I know that what they’re looking for, (the MMPR/ACMPR) is more suitable from a licensed producer. If you are somebody who is chronically ill, with something that threatens your survival, you may need to look at someone who has a standardized product, that they know is always the same, every single time and doesn’t have any wait times between deliveries, etc. So I’ve definitely moved people in that direction, because I thought it was better for their health.
“I think that we serve very different purposes, generally speaking. And I wish that we had something that was more directed towards life threatening ailments, vs therapeutic, vs your enjoyment.”
It’s hard to see what could shift these dynamics in British Columbia and Quebec. While Quebec doctors are slowly accepting the Quebec Cannabis Registry, it will take a long time to see the same kind of per-capita client registration in Quebec as its neighbour Ontario. And with British Columbia having such a long standing, deeply rooted and largely tolerated culture of cannabis, it’s hard to see any radical shifts occurring without changes to how medical cannabis is legally sold in Canada.
Bringing some kind of brick and mortar retail model into the existing regulatory regime is one possibility. The inclusion of pharmacies into the ACMPR is a very real possibility in the future and many may be content to buy their medical cannabis there. But without the inclusion of the retail model British Columbians are already familiar with, its hard to see the potential for a shift toward participation in the legal system, even through something like a traditional pharmacy.
As long as it’s easier and more familiar to visit a dispensary than to visit a doctor's office (if you’re lucky enough to have or find one who is receptive) and then to register with a producer and manage all your orders online, people will be ‘voting with their feet’, as has become the phrase.