EXPLOSION IN CLAIMS OF SEVERE ARTHRITIS

Now 40 Per Cent of Applications for Marijuana Treatment Seen by Health
Canada, a Jump of 2,400 Per Cent From 2008 to 2010

The federal government has seen a staggering increase in the number of
requests for medical marijuana authorizations from applicants claiming
they have severe arthritis to legally obtain the drug.

Applications to Health Canada based on severe arthritis claims jumped
2,400 per cent between 2008 and 2010, far outstripping the number of
claims for cancer, HIV/AIDS and other serious diseases, an Ottawa
Citizen analysis has found.

The spike in arthritis claims was part of an overall rise in
applications over the past three years, as more private clinics
specializing in marijuana began referring patients to pot-friendly
doctors willing to sign their forms.

Arthritis was listed as the reason for 40 per cent of all applications
under the Marihuana Medical Access Regulations received so far in 2011.

Severe arthritis is one of the Category 1 illnesses that require
patients to obtain the signature of just a single doctor under Health
Canada rules. Cancer, multiple sclerosis, HIV/AIDS infections and
spinal cord injuries and disease and are also listed in Category 1,
but often have more obvious visible symptoms than arthritis.

Patients with other Category 2 illnesses such as hepatitis, glaucoma
or ulcerative colitis must go through the additional step of getting a
specialist to sign their applications, a process that can take many
months and does not always succeed.

"I think a lot of people are applying under arthritis even if they may
have a different condition," says Scott Gilbert, who runs the Hamilton
Medical Marijuana Centre. "They are going with whatever is the easier
one to get approved on."

Although a patient might otherwise qualify for authorization based on
a Category 2 illness such as fibromyalgia or Crohn's disease, a savvy
doctor familiar with the medical marijuana program might ask if the
patient also has arthritis, too.

Health Canada is conducting a review and plans to overhaul the way the
program works, in part by transferring more authority to doctors. The
department says it is required to approve applications that have been
signed by a doctor and meet the conditions of the program. It has
noticed the sharp increase in marijuana applications but doesn't know
why, exactly, the numbers are rising so sharply.

"Increasing awareness of the program among patient groups and treating
physicians is likely a key contributing factor," said Health Canada
spokesman Gary Holub.

The department is also aware of the increase in arthritis claims, Holub said.

"The risk of abuse exists within the current system. That's why
changes are being proposed that will balance the legitimate needs of
patients, while reducing the risk of abuse."

Patients often complain that the refusal of doctors to approve their
applications is the greatest obstacle to entering the program. But the
surging number of applications suggest they are finding other ways to
get approved.

Many privately run clinics are sprouting up across the country, with
in-house physicians to sign the 33-page Health Canada application form
or provide referrals to doctors who are willing.

The Do No Harm Clinic in Kelowna, B.C., for example, has helped
process applications for more than 500 patients over the past two
years. It serves patients who have been unable to find a doctor to
sign their forms and will provide a physician to consult with patients
anywhere in the country over the Internet.

A doctor who works at the clinic agreed to speak to the Citizen about
his practice on the condition he not be named, as he does not want to
be deluged with requests from potential patients.

"Medical marijuana is not a prescription," he said. "I don't have to
touch the patient to see they have cancer."

But he said he will not list severe arthritis or other illness on the
application unless the patient can produce documentation of the
disease provided by a specialist.

"We would make sure you've seen a specialist," he said.

He acknowledged, however, that some other Canadian marijuana clinics
are moving to what he calls the California model, where a patient
walks in off the street and gets a doctor to sign the forms on the spot.

"That kind of thing goes on," he says, but he notes patients can do
the same thing if they present with back pain to get a prescription
for Oxycodone, a powerful and addictive pharmaceutical painkiller.

The doctor volunteers his services, but the clinic charges $400 to
help patients complete the Health Canada application form.

Gilbert's clinic in Hamilton works a bit differently, prescreening
patients with cancer, HIV and other conditions and, where suitable,
sending them to doctors in the community known to be comfortable
prescribing marijuana.

An increasing number of private clinics and services are working
within the system to arrange approval under Health Canada's rules -
some charging processing fees.

For $450 plus tax, the Medical Cannabis Resource Centre in downtown
Vancouver will hook a patient up with a doctor on Skype to confirm
identity. Like the Do No Harm Clinic, the centre still requires a
statement of diagnosis of a pre-existing condition from another doctor.

These clinics are trying to work around the problems in Health
Canada's rules to get marijuana to patients who need it, says Rielle
Capler of the Canadian Association of Medical Cannabis Dispensaries.

"Whether they're entrepreneurs or well-meaning physicians, they're
stepping in to fill these gaps," she said.

Capler says she's concerned about clinics asking large fees from
patients who are often too sick to work and living on fixed incomes.

"There are some that have been charging $500. But this is what it has come to."

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HOW CANADA'S MEDICAL MARIJUANA SYSTEM WORKS

Since 2001, Canada has allowed patients with serious illnesses to
apply for authorization to possess and, in some cases, grow marijuana.
The rules are called the Marihuana Medical Access Regulations (MMAR).

Who can apply?

Under the MMAR, people who are classified as Category 1 can apply to
relieve symptoms of these diseases:

- --Cancer

- --Multiple sclerosis

- --HIV/AIDS infection

- --Spinal cord injury or disease

- --Severe form of arthritis

- --Seizures caused by epilepsy

Category 1 patients need their doctor to fill out a form recommending
their treatment with medical marijuana. Then their application must be
approved.

Category 2 patients have one or more debilitating symptoms of another
illness not covered in Category 1. They require a specialist to attest
that conventional treatments have failed or are not appropriate to
relieve their symptoms.

Types of authorizations

- - - A patient can be author-ized to possess marijuana produced for
Health Canada by Prairie Plant Systems. The typical amount allowed
varies from between one and five grams. It is sold for $5 plus taxes
per gram.

- - - A patient can be authorized to possess marijuana they have grown
themselves. They can purchase a package of 30 seeds for $20 plus taxes.

- - - A patient can be authorized to possess marijuana grown by a person
they designate as their producer. A designated grower can produce
marijuana for a maximum of two patients.

Proposed changes

Health Canada has been consulting over proposed changes to the MMAR.
The new regulations have not been finalized and it is unclear when
these changes would come into force. Also unclear is whether patients
already authorized under MMAR would be allowed to continue to operate
under the old regulations. The changes would:

- - - Eliminate the categories of conditions or symptoms

- - - Eliminate the require-ment to have Health Canada approve the
applications. Doctors alone would determine who gets medical marijuana.

- - - End the provisions that allow patients to grow their own marijuana
or designate a grower. Instead, Health Canada would license approved
commercial suppliers.

Ottawa Citizen