Written by Ajay Chahal, RPh., PharmD

Health Canada quietly released a comprehensive document in January 2026 titled Information on the Use of Cannabis for Medical Purposes. On the surface, this looks like progress: clear explanations of cannabinoids, drug interactions, contraindications, dosing principles, routes of administration, side effects, and red-flag scenarios. Dig a little deeper, though, and something uncomfortable becomes obvious.

This document, written explicitly for patients, contains more clinically relevant cannabis information than most Canadian healthcare professionals (HCPs) ever receive in their formal training.

That should alarm everyone.

The guide walks patients through concepts like dose titration, THC vs CBD risk profiles, pharmacokinetics across different routes of administration, interactions with antidepressants, antipsychotics, anticoagulants, immunosuppressants, and even grapefruit juice. It flags risks around pregnancy, psychosis, cardiovascular disease, and polypharmacy. It openly acknowledges that cannabis can cause serious adverse effects, including dependence, hyperemesis, and psychiatric destabilization. 

This is not “wellness blog” material. This is applied pharmacotherapy.

Yet in real clinical settings across Canada, patients routinely hear:

• “There isn’t enough evidence.”
• “I don’t know enough about cannabis.”
• “Talk to the dispensary.”
• “Just don’t use it.”

That gap between what patients are being told to know and what clinicians actually know is no longer benign. It’s dangerous.

A Systemic Failure, Not an Individual One

This is not about blaming physicians, nurses, or pharmacists. The problem is structural.

Cannabis remains almost entirely absent from medical, nursing, and pharmacy curricula. Most HCPs graduate having never learned:

• How THC and CBD are metabolized
• How to counsel on starting doses or titration
• How to manage cannabis–drug interactions
• How to identify when cannabis is helping versus harming

Meanwhile, millions of Canadians are already using cannabis for pain, sleep, anxiety, chemotherapy side effects, neurological conditions, and palliative care. This is often without guidance, or worse, in contradiction to their existing medications.

Health Canada’s response appears to have been: educate the patient and hope for the best.

That is not patient-centred care. That is institutional abdication.

The Absurdity We’re Now Living In

We’ve reached a point where:

• Patients are expected to understand cannabinoid dosing.
• Clinicians are expected to “monitor” cannabis therapy.
• No one is formally trained or paid to do this work.

It’s upside-down healthcare.

Even more absurd: pharmacists, arguably the most qualified professionals to manage cannabis as a medication, are structurally excluded from doing so. There is no broad provincial or federal reimbursement model for cannabis education. Services that do exist often operate in regulatory grey zones and face marketing restrictions that don’t apply to virtually any other therapeutic area.

What Needs to Change (Immediately)

If Canada is serious about safe, evidence-informed cannabis use, three things must happen.

First, cannabis education must be mandatory in healthcare training. Not electives. Not optional CE. Core curriculum. Cannabinoids interact with the same CYP pathways, receptors, and risk frameworks as other medications. Treat them accordingly.

Second, specialized cannabis education services must be allowed to operate openly and at scale. Organizations that focus exclusively on cannabis, like Apothecare, exist because the system created a vacuum. Blocking these services from reaching patients and clinicians doesn’t protect the public; it abandons them.

Third, there must be a public reimbursement model for cannabis education. If pharmacists are expected to counsel on dosing, interactions, and monitoring, as Health Canada itself suggests, then that work must be funded. Patients should not have to pay out of pocket to receive basic medication-level guidance.

Fourth, regulators must confront the fiction that “recreational advice” isn’t medical advice. In reality, budtenders on the retail cannabis side routinely step into a clinical role, effectively acting as pharmacists. They recommend products for sleep, pain, anxiety, or cancer-related symptoms using disclaimers like “this worked for someone I know.” The Cannabis Act explicitly forbids this, yet enforcement is effectively absent. The result is a dangerous false sense of safety for patients, who may assume medical appropriateness where none exists. There is no screening for drug interactions, contraindications, or high-risk populations, which poses real dangers for patients on chemotherapy, blood thinners, or anti-epileptic medications. Regulators such as the AGCO must prioritize enforcing this boundary. Allowing untrained retail staff to provide quasi-medical guidance is not harm reduction; it is regulatory neglect with potentially catastrophic consequences.

The Bottom Line

Health Canada has unintentionally exposed the problem by publishing it in plain sight. The information is there. The need is undeniable. The expertise exists.

What’s missing is the will to treat cannabis like what it already is: a widely used, pharmacologically active substance that deserves competent, compensated, professional oversight.

Until that happens, Canada will continue pretending this is about stigma or evidence gaps, when in reality it’s about something simpler and far more dangerous.

We built a system where patients know more than their providers. And then we called that “healthcare.”

That’s not progress. That’s negligence.