THC and CBD

FAQ - Canadian Cannabis Regulations for Health Professionals

How can my patients access legal cannabis?

Currently there are 4 ways in which cannabis can be legally accessed in Canada

  • A physician can register a patient with a licenced producer (standard or micro cultivator or processor with a license for medical sales) and, once approved, the patient can order products online from that producer. A list of authorized producers can be found at https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/industry-licensees-applicants/licensed-cultivators-processors-sellers.html . Each producer has their own registration system and forms.
  • Adults can purchase cannabis through the recreational cannabis system. This system is province specific and can be online or through physical cannabis stores. Not all stores currently selling cannabis are licensed to do so.
  • A physician can register a patient to produce their own medicinal cannabis or designate someone else to grow it for them. Details of this program can be found at https://www.canada.ca/en/health-canada/services/registering-produce-cannabis-own-medical-purposes.html . You may also need to register for an exemption to possess or carry more than 30g of cannabis at a time.
  • Adults can grow up to 4 plants per household for recreational purposes. This right cannot be transferred to a different person. There are many restrictions on how and where this can be done including a limit on the number of residences a person can grow at, visibility to the public, registration of plants etc.

What is the difference between medical and recreational cannabis?

Although there is usually no difference in the cannabis itself, product availability and pricing may vary. The majority of insurance providers will only reimburse cannabis if it is purchased through the medical program.

How do I prescribe a specific product or dose?

Unfortunately, there is currently no way to prescribe cannabis like a prescription. The medical system is for an authorization to purchase and not for a specific product or dose, although restrictions to CBD only are sometimes possible. Recommendations can be made directly to the patient but will not appear on the product when it is delivered.

How do I convert a dose in mg of active ingredient to g/day?

Medical authorizations require a maximum number of g/day to be specified. Although this is simple when looking at flower products, a conversion must be done if the patient is using an oral or topical product. There is no standard for this conversion and each producer may have a different equivalence for their products.

What products are currently legal?

Until October 17, 2019, cannabis flower, seeds and extracted oils up to a maximum concentration of 30mg/ml THC/CBD are allowed. After this date, approvals for more concentrated products, tinctures, vaporizer products, topicals and edibles will be processed by Health Canada. These products will likely be available by December 2019.

How do I tell if a product is legal?

A product is likely from a legal source if: 

  • It comes from a producer registered with Health Canada
  • It comes in plain, child-proof packaging 
  • It displays the THC warning symbol and one of the standard warning messages
  • It is sold at a licensed cannabis retail store or online from the BC liquor distribution branch

A product is likely from an illegal source if: 

  • It is an edible, vaporizer or topical cream sold before December 2019
  • It is available online through any website other than the provincial retailer
  • The product makes health claims of any kind including stating a medical condition or dose
  • It is in metallic, non-child proof packaging
  • It displays a cannabis leaf on the packaging other than the red THC warning symbol
  • It is an extract stronger than 30mg/ml prior to December 2019
  • It is sold at a farmer’s market or other ‘pop up’ location
  • Products are available to test prior to buying

What about pet products?

There are currently no legal means to produce pet products containing CBD or THC in Canada.

Why is it important to buy from a legal source?

From a medical perspective, the most important answer to this question is safety. Licensed cannabis producers are required to undergo strict testing of both their facility and products. This testing includes ensuring that the product is free of bacterial and fungal contamination, pesticides, heavy metals and residual solvents. This is especially important as cannabis and hemp are bio accumulators meaning that they tend to absorb toxic substances including pesticides and heavy metals from their environment. Cannabis and hemp extracts in particular can have higher levels of pesticides due to the concentrating effects of the extraction process. 

How is CBD regulated?

THC and CBD are regulated the same way and no exemptions for unlicensed sale of CBD products exist. Illegal CBD products are especially prevalent today, with many people believing that CBD is not regulated due to its lack of intoxicating effects. Unregulated products may contain little to no CBD or contain ingredients not listed on the label. Customers should also be aware that hemp seed oil is not the same as CBD oil or extract and, though it may have benefits of its own, it cannot be used interchangeably.  

Can cannabis be administered in a hospital or long-term care facility?

Regulation on the administration of cannabis products varies from province to province and between health authorities. In general, smoking of any kind is not allowed in hospitals or in long term care facilities. Oral products may be allowed in some facilities but may need to be identified and labeled by the pharmacy or may need to be administered by the patient or patient’s family. Please check with your health authority for details.

Can my patients travel with their cannabis products?

It is illegal to cross a Canadian border with a cannabis product (THC or CBD) and penalties can be severe.

Can my patients drive after taking cannabis?

It is illegal to drive while impaired by cannabis or any other drug.

Where can I find more information?

The Government of Canada has information on the use of cannabis, health effects and legislation.

https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis.html

*Information presented is intended as a guideline only. As always, please use your professional judgement. 

             Written by: Sarah Roberts, RPh (CSO)