Chronic relief

Manitoba’s budding medical marijuana industry

Manitobans currently spend between $300 and $500 million on marijuana annually, and that number is growing.

Your across-the-hall neighbour or pizza guy with his baggy of shake may contribute to that total, but recreational marijuana is only a small piece of the puzzle. Medical marijuana is one of the province’s and country’s fastest growing industries, and in Winnipeg, it comes from a manufacturing plant that is as regulated as a pharmaceutical company that produces OxyContin. 

Since receiving their license in 2014, Winnipeg’s Delta 9 Bio-Tech has supplied patients across Canada with government-grade medical marijuana and is currently Winnipeg’s only licensed producer. Vice president and co-founder John Arbuthnot has found himself in the right place at the right time.

“This is an opportunity for a growth industry the likes of which Canada has not seen since the dot-com era,” Arbuthnot says. “You really haven’t seen an opportunity for this many new companies, this influx of investment capital and ultimately the investment return on an industry that is being sprung from nothing.”

John Arbuthnot, president and co-founder of Delta 9 Bio-Tech, sees medical marijuana as an opportunity for growth.

Delta 9 currently produces $1.5 million of product per year, an amount that will go up to $3.2 million by the end of 2016 and $150 million by 2020, Arbuthnot says. Not only are they seeing more patients, but he says they are also preparing to supply a soon-to-be legalized recreational market. 

“We would look at both,” he says. “The production elements would be very similar.”

Delta 9’s production is carefully monitored by Health Canada to ensure safety and quality up to the same standards as other medicines and narcotics. Unlike pills, however, plants pose a unique set of challenges when it comes to standardization.

“We’re looking to emphasize the production of the medicinally active cannabinoids. To achieve that, we’re looking to maximize the amount of resin production,” Arbuthnot said.

While marijuana has been used throughout history for pain relief and to treat a variety of ailments, it was only approximately 30 years ago that medical marijuana received some backing from science. Our bodies have cannabinoid receptors – CB1 and CB2 – which are part of the endocannabinoid system and are present in the nervous system, connective tissues, glands, organs and immune system. 

What do they do? Our endocannabinoid system keeps everything balanced, despite external changes, through a process known as homeostasis. Depending on the patient, cannabis will go to work in different ways, and it’s prescribed for a variety of different reasons.

Carefully tending to the plants requires protective equipment so as not to contaminate the product, which could cause big problems for recipients who are immune-compromised.

RX Connection

This summer, MCRCI (Medicinal Cannabis Resource Centre Inc.) opened its first centre in Winnipeg. The national company is based in Vancouver and has opened locations throughout Canada to connect marijuana patients to knowledgeable doctors. President and CEO Terry Roycroft says the number of patients is growing exponentially.

“For the last year, every quarter they would see about a 50 per cent increase in the amount of patients signing up,” Roycroft said of the country overall. “In the last quarter, it jumped to 120 per cent, meaning over 8,000 patients signed up in the last month.”

MCRCI patients can come into the clinic and connect with doctors from throughout Canada via a telehealth conference. After receiving a prescription, they will work with a patient care specialist, who walks them through the different consumption options and purchasing from a licensed producer, like Delta 9. 

According to Roycroft, many patients are using marijuana for the first time. Older adults are directed to the clinic by their kids, who see an alternative to the endless parade of pill bottles for a variety of health issues. 

Yet some stigma still exists around using pot to help with issues like arthritis. If people have only heard about marijuana grouped together with drugs like cocaine, heroin and ketamine, they may see more harm than good.

But for those who don’t want to get high or smoke a joint to get their medicine, there are plenty of options.

“We see the future of medical marijuana becoming more medical,” Arbuthnot says. “Long term, I don’t see it as the dried flower. I think medical marijuana will naturally move toward pills and creams and oils and sublingual sprays and a patch … all those things that pharmacists and doctors are more used to seeing in their clinical practice.”

All of these products deliver a very specific mix of THC (tetrahydrocannabinol) and CBD (cannabidiol), which can lower or totally remove the “high” feeling from marijuana while keeping the positive effects.

What are patients coming in for? Roycroft says the number one concern is chronic pain. Following that, it’s sleep issues and stress.

“They’re all interrelated,” Roycroft says. “If you have pain, you can’t sleep, and if you can’t sleep, you’ll feel the effects of stress.”

The list goes on to include patients with muscle spasms, PTSD, anxiety, depression, glaucoma, cancer and autoimmune deficiency diseases. Patients in palliative care are sometimes prescribed marijuana to increase a sense of well-being and peace. 

“People tell us, ‘This is fantastic. It saved my life,’” Roycroft says. He adds that legalization is imminent, but for those looking to use it for medical purposes, going through a doctor is still the better, and cheaper, route. 

Arbuthnot predicts that marijuana production will eventually move towards emulating more traditionally medical products, such as pills and creams.

Myths and taxes

When it comes to cost of medication, Arbuthnot is hoping to see marijuana treated in the same way other prescriptions are.

“Currently only about six to seven per cent of our patients have their medicine covered under insurance – an incredibly small number,” he says. 

“That being said, a lot of insurers are starting to come on board with medicinal marijuana, because they’re realizing that, in many instances, when a patient starts taking medical marijuana, they will stop taking some other drugs, usually more expensive narcotic drugs, so there can be a lot of replacement that’s to the benefit of the insurance company.”

Buying from a licensed producer will cost patients between $4 and $9 per gram, but as of Aug. 24, patients also have the option to grow marijuana at home. For those who require high doses or are low-income, growing at home represents a much more affordable option at $1 to $2 per gram. It depends on what you need, Arbuthnot says.

“There’s the cost savings, plus there’s the effects of, ‘I’m tending to my own garden and growing my own medicine,’” Arbuthnot says. “Here, we can guarantee with product testing what we’re selling … we sterilize our product to make sure there is no mould or mildew, and for patients who are immunocompromised, that becomes the most important factor.” 

He compares it to making your own wine. It can take many rounds before you get a quality product and up to six months before the first batch is ready for use.

Plant production is closely monitored by Health Canada.

“Anyone can grow marijuana,” Roycroft says. “It takes special skill to grow good marijuana.”

He, however, sees the new legislation as a positive step forward for the medical marijuana industry, like many of the changes that have taken place recently. It’s easier than ever for patients to get access to what they need. 

One of the decisions patients may have to make is whether to purchase indica or sativa, which may be generally talked about as having varying effects: Sativa provides an energetic head high, while indica will find you stuck on the couch with a deep body high. However, Arbuthnot says there’s little evidence to support those claims.

“The difference is where the plant dates back to,” he says. “Sativa is the more spindly thin-leaf variety that would grow more naturally in the rainforest … where the indica variety, the shorter, squat plants with the fat leaves, are more predisposed to mountainous regions.

“So now does that extend to the medicinal value?… Really, there’s very little evidence to corroborate any of that. We see high and low potency in both … the jury is still out on whether there is a difference.”

Published in Volume 71, Number 5 of The Uniter (October 6, 2016)

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