Health Canada cracks down on authorizations for high amounts of cannabis amid risk of illicit diversion

Health Canada says it’s concerned over high levels of cannabis being authorized by clinicians for medicinal purposes and is cracking down on abuse of the system leading to diversion into the illicit market.In a message that was sent to the physician regulatory colleges across Canada on Nov. 7, the agency said it is concerned over “high daily amounts being authorized by some healthcare practitioners in some jurisdictions.” “The department is concerned that high daily authorized amounts are, in a few instances, leading to abuse of the access to cannabis for medical purposes framework and are undermining the integrity of the system,” Health Canada said.“Treatment options remain a decision best made in consultation between a patient and their healthcare practitioner. However, daily authorized amounts which are well above what is recommended based on guidance and evidence may pose risks to public health and safety, including the risk of cannabis being diverted to the illicit market,” the agency added.Moving forward, Health Canada says physicians and other healthcare practitioners who authorize significant amounts of medical cannabis may now be required to provide a medical rationale for their prescription.After the Health Canada notice was sent to the colleges, the College of Physicians and Surgeons of Manitoba told its registrants they should be prepared to provide information such as peer-reviewed data if they authorize high amounts of cannabis.“Gathering this evidence will help Health Canada assess potential risks to public health and safety. It will also inform new or renewal applications when individuals seek to be registered to produce cannabis for their own medical purposes. If registrants do not respond to Health Canada or cannot provide information to substantiate the amount authorized, the application may be refused,” the college in Manitoba said.Health Canada says according to the available data, most patients who use cannabis for medical purposes only need between one to three grams of dried cannabis per day.These actions come after the legislative review of the Cannabis Act from the independent expert panel, which released its final report in March 2024. In the report, the panel expressed concerns about abuse of the personal and designated production program, which allows patients who have a medical authorization for cannabis to grow their own.Canadians without medical authorization are currently only permitted to grow four cannabis plants in their home. However, obtaining medical authorization allows for patients to exceed this four-plant limit, so long as the number of plants aligned with their medical authorization (typically five plants per gram for indoor growing and two plants per gram for outdoor growing). The review found that some of the cannabis grown by individuals with medical authorizations have ended up on the illicit market and said Health Canada should refuse and revoke applications that pose a risk to public health or safety. The task for also called for regulatory colleges to investigate and sanction healthcare professionals “with problematic authorization practices.”“Law enforcement, municipalities and patients have all raised concerns about abuse of the personal and designated production program, particularly when individuals have authorizations for large plant counts. They indicated that this abuse is a significant contributor to the supply of illicit cannabis in Canada,” the expert panel wrote, adding the extent of the abuse of the program is “unclear as the evidence is not comprehensive.”After the Cannabis Act came into effect in October 2018, Health Canada began collecting data on the number of healthcare practitioners associated with authorizations of high doses for medical purposes. The number of healthcare practitioners associated with authorizations of 25 grams or more of cannabis per day increased from 366 at the start to nearly 500 in 2020. However, this number has steadily gone down to 233 as of March 2024 (the most recently available data).Similarly, there were 27 practitioners in October 2018 associated with authorizations of 100 grams or more per day, increasing to 57 in November 2020 before falling to 10 in March 2024.Of the practitioners who have authorized 25 grams or more, 78% are from British Columbia and Ontario. B.C., in particular, has seen a slight uptick in recent months, from 70 in August 2023 to 80 in March 2024.

Health Canada cracks down on authorizations for high amounts of cannabis amid risk of illicit diversion

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