Public-health specialists worried that Shoppers Drug Mart will sell pot

theglobeandmail.com
Feb. 24, 2016
By Carly Weeks

Leading public-health and addiction specialists are condemning plans by Canada’s largest drugstore chain to investigate the idea of selling marijuana, calling it a profit-motivated move that would have devastating effects.

The Globe and Mail reported on Tuesday that Shoppers Drug Mart is exploring the possibility of selling marijuana in its stores. According to people involved in the discussions, the company has held meetings with licensed medical-marijuana producers. It also has not ruled out a move into selling marijuana for recreational purposes. Currently, pharmacies are not permitted to sell medical marijuana, but the federal government has promised to legalize the drug, which could open the market.

“This is corporate greed,” said Meldon Kahan, medical director of the substance use service at Toronto’s Women’s College Hospital. He said it would be “destructive and dishonest” if Shoppers and other health-care facilities were to present their plans as a medical service.

Dr. Kahan compared the sale of marijuana in drugstores to the Prohibition era, when pharmacists could fill prescriptions for alcohol. There is little convincing scientific evidence that either substance can treat medical conditions, and pharmacies are not the appropriate venue for the sale, he said.

Ian Culbert, executive director of the Canadian Public Health Association, said there is “insufficient evidence to call [cannabis] medicine,” and warns opening the market to pharmacies could lead to increased use and serious side-effects.

“This is not a health product and don’t try to peddle it as a health product,” he said. “It’s the wrong direction.”

Rebecca Jesseman, policy director of the Canadian Centre on Substance Abuse, said the organization is concerned allowing marijuana in drugstores would convey that it is safe and effective when the evidence is far from clear.

“We know that cannabis has risks and harms associated with use. If we were to put it in a pharmaceutical context, does that give an illusion of safety?”

She added that 50 years ago, pharmacies used to profit from the sale of tobacco and marketed cigarettes heavily. If marijuana moved into drugstores without strict government oversight, it could harm public health, she said.

Benedikt Fischer, a senior scientist at Toronto’s Centre for Addiction and Mental Health, said pharmacies may be the right place to dispense marijuana. But the bigger focus should be on ensuring whatever system is adopted gives priority to public health, not a company’s bottom line.

In a statement, the Canadian Pharmacists Association said it is “concerned about the health effects of marijuana and cautions the government to act first with the health of Canadians in mind.” The organization is rewriting its policy on pharmacist dispensing of medical marijuana.

In a 2013 submission to the federal government, the association emphasized the concern over the possibility of having pharmacists dispense medical marijuana given the lack of evidence supporting its safety and efficacy.

The federal government has not approved marijuana as a medicine, but doctors are allowed to prescribe it. Although it has many proponents, the scientific literature is not conclusive.

An analysis of studies on cannabinoids - active chemical ingredients in marijuana - published in the Journal of the American Medical Association last year found some evidence they help chronic pain. But evidence was poor for whether cannabinoids helped other conditions, such as nausea from chemotherapy. The studies compared cannabinoids to a placebo, rather than a medical treatment. So the evidence does not give an accurate picture of how well cannabinoids work when stacked against existing medical treatments, Dr. Kahan said. At the same time, use of cannabinoids was linked to a higher risk of problems like vomiting, confusion and hallucinations. Some research suggests cannabis is linked to psychosis.

Many questions are still unanswered about medical cannabis, in part because tight restrictions make research difficult.

Mark Ware, a pain specialist who studies medical cannabis, said drugstores could be a viable option because pharmacists could counsel patients about drug safety and interactions with other medications.

Shoppers spokeswoman Lana Gogas said in an e-mail the company’s efforts are “directed at the safe dispensing of medical marijuana.” Ms. Gogas did not respond when asked several times if the company would rule out sale of marijuana for recreational purposes.