Features

Good, bad, and ugly in the Cannabis Act review final report

Published on March 22, 2024 by David Wylie

Photo: David Wylie/the oz.

The newly released final report from the legislative review of the Cannabis Act does a good job pointing out some of the flaws stemming from how Canada has rolled out legalization.

Lack of research, little support for medical patients, a financially challenged cannabis industry that’s becoming less diverse, and barriers for Indigenous communities are among the issues cited.

The expert panel has made 54 recommendations and 11 observations to help rectify what they see as the key issues facing cannabis in Canada—particularly (and unsurprisingly) around health and safety.

The Good, The Bad & The Ugly

We read through the recommendations and observations and sorted the ones that stood out into three categories.

The Good

• Window to the weed: Allow a little clear area in dried flower packaging so consumers can get a sneak peek at their pot; also recommendations allowing for QR codes and recycling and organic logos.
• Greater diversity: Recognize the need for Indigenous government-to-government partnerships that create tailor-made legal frameworks for cannabis, as well as re-examining the approach to regulatory fees and grants for “equity-deserving” groups.
• Economic allowances: Look at amending federal regulations to allow for direct delivery, reviewing the excise tax model, and reviewing regulations around industrial hemp.
• Improving patient access: Permit pharmacies to distribute cannabis products to medical patients and rapid advancement of a pathway for cannabis health products containing CBD.
• Knowledge is power: More research on the therapeutic use of cannabis in Canada, and Health Canada should support a transparent process to identify the specific potential therapeutic applications of cannabis that would benefit most from additional study.

The Bad

• Vanilla packaging: Advising Health Canada to maintain plain packaging and labelling requirements, including overly strict limits on colours and branding.
• Doctor freeze: Risking a chilling effect on prescriptions by going after health care professionals authorizing high daily cannabis amounts.

The Ugly

• Keeping low limits: Recommending keeping the current 10mg THC limit on edibles, which is costly for customers and being undermined by LPs exploiting loopholes anyway.
• Tax on tax on tax: Suggesting Health Canada charge more tax on high-potency cannabis products to disincentivize their consumption—and if that doesn’t work, implement additional regulations.

Published in March, the report was authored by an expert panel appointed by the Minister of Health and the Minister of Mental Health and Addictions. It’s independent of the federal government. Their advice—which generally involves targeted changes to policies and regulations, as well as bolstering support for research, surveillance and enforcement—aimed at the federal government. Though they say they have made some observations that could apply to provinces, municipalities, law enforcement, and health care providers.

Notably, the panel expresses concern over high-potency products that are popular in the legal market, an issue propagated by provincial governments that control supply and choose to push high-THC flower while carrying few low-THC options.

“If the current trend toward higher-potency cannabis cannot be halted or reversed, then Health Canada should be ready to restrict or prohibit certain products to protect Canadians from the associated harms. To be effective, such regulatory measures should be accompanied by strategies to prevent the illicit market from taking over this market segment,” says the report.

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Another recommendation, this one around strict marketing limitations, is that Health Canada should maintain plain packaging and labelling requirements, including “restrictions on characteristics that are appealing to youth, child-resistant packaging and limits on the use of logos, colours and branding, that are aimed at protecting children and youth, and prohibitions on promotions that imply wellness or lifestyle enhancement.”

However, there are some common sense changes proposed. They include considering allowing a transparent area on dried flower packaging so consumers can get a look at what they’re buying. The panel also recommends simplifying product labels to make it easier to understand the THC levels, allow for the display of certain symbols that convey useful information to the consumer (for example, symbols related to organic certification or recycling). And, they recommend allowing the use of QR codes on product labels to convey factual information to consumers, within the constraints of what is currently permitted on labels or in cannabis promotions.

Key quotes from the final report

Indigenous support

“We call for amendments to the Cannabis Act, facilitating a collaborative process with Indigenous communities that would allow those who wish to exert more control over cannabis-related activities in their territories to enter into nation-to-nation agreements with the Government of Canada based on agreed-upon minimum standards to protect public health and public safety. We also recommend that Health Canada, as well as provinces and territories, take steps to improve their licensing processes to better support Indigenous applicants who wish to participate in the legal cannabis market.”

Industry

“Industry representatives raised urgent concerns about their financial viability in the highly competitive market that exists today. These concerns are well-founded; however, any efforts to support the industry must be consistent with the public health and public safety objectives of the Act and not aim to increase the amount of cannabis consumed or the number of Canadians who use cannabis.

“The Government of Canada should support continued displacement of the illicit market, while maintaining measures that protect public health and public safety. Continued monitoring of the legal share of the total market, relying on a combination of information sources that are sensitive to emerging trends, will be important to guide policymaking and priority-setting across all levels of government.

“Health Canada should reduce the financial and administrative burden it places on participants in the legal industry. We recommend Health Canada accelerate its work to reduce unnecessary regulatory burden, informed by the experience gained over the last five years. It appears there is room to revise certain regulatory requirements without compromising public health or public safety. Industry players have repeatedly called on the Government of Canada to reform the excise tax regime, particularly for dried cannabis where price decreases have substantially increased the tax burden for industry. We recognize that Finance Canada has committed to monitoring this issue, but we see an opportunity to update tax policy to reflect the current reality and to encourage positive changes in cannabis use behaviour by developing a progressive excise tax regime. This would involve higher-potency products being subject to more tax than lower-potency products.”

Diversity

“At the outset of legalization, there was a missed opportunity to address the harms of prohibition. The Government of Canada has a role to play in encouraging the participation of marginalized and racialized groups in the industry, and to support inclusivity and remove barriers to success. Health Canada and its partners should take a comprehensive approach that looks beyond the issuance of a licence, to include pre- and post-licensing supports, and take a broad view of diversity so that policies and programs consider how to support the inclusion of smaller-sized businesses across the country. We would like to see substantial improvements in the state of knowledge about the differential impacts of legalization on equity-deserving groups, as well as measures taken to address identified issues.”

10mg THC limit

“One of the issues we heard most about was the amount of THC permitted in edible cannabis products. While industry stakeholders favoured increasing the limit to encourage consumers to shift to the legal market, public health stakeholders opposed this, citing concerns about the potential impact on child poisonings, cannabis-related emergency room visits and mental health impacts. Given these concerns, we believe Health Canada should maintain the current limit of 10 milligrams of THC per package in edible cannabis products and continue to develop the knowledge base in this area to determine whether there are conditions under which the limit could be raised without unduly impacting public health.”

Medical access

“The legalization of cannabis has had a profound impact on how Canadians access cannabis. However, patients, health care professionals, medical regulatory bodies, municipalities and law enforcement have all voiced concerns about how the system of access to cannabis for medical purposes is working. Many patients are concerned that they do not have reasonable access to cannabis for medical purposes from licensed sellers, while health care professionals and medical regulatory bodies continue to have concerns about the lack of evidence to guide clinical decisions.

“Municipalities and law enforcement have serious concerns about the abuse of the personal and designated production program, and how cannabis is diverted from this program into the illicit market. We heard that some health care professionals authorizing cannabis for medical purposes accept financial incentives from industry, a practice that would be considered unacceptable in the context of prescription medications. We see a need to maintain a distinct medical access program, with improvements, to better support patients and to better address the problems caused by bad actors in the personal and designated production program.

“We appreciate that there are still significant gaps in the evidence base and recognize that cannabis is not a suitable treatment for all individuals and all health conditions, nor is its use risk-free. At the same time, there is a need to continue to support patients to access cannabis for medical purposes. Clinical guidance is required to increase the knowledge and understanding of health care professionals related to cannabis for medical purposes.

“In our view, an important improvement to the medical access regime would be the establishment of an in-person pharmacy access channel. We recognize that establishing a pharmacy access channel cannot happen overnight. It would require regulatory changes from Health Canada and consultation with interested provinces and territories and regulatory authorities for pharmacists. Pharmacy access would have benefits for patients by addressing concerns about delays with mail delivery and product shortages and would allow patients to consult with a pharmacist and discuss potential drug interactions or side effects.

“We recognize that Health Canada has made progress in reducing the number of registrations in the personal and designated production program, and the number of plants grown under these registrations. We encourage the department to continue to carefully scrutinize applications and to refuse or revoke those that pose risks to public health and public safety. Limiting the ability of multiple individuals to grow plants at the same site would also reduce the risks associated with this program.”

Research and surveillance

“Five years after the legalization of cannabis, many critical knowledge gaps remain. Priorities must be set to guide investments in research, helping to fill gaps in the evidence base and guide future policy decisions. We encourage this priority-setting to be done quickly, and for the necessary funding to be made available to support this research. In addition to research to fill knowledge gaps, there must be continued surveillance of cannabis-related behaviours and cannabis-related health effects.”