It’s not surprising to see prescription cannabis consumption decline with the emergence of recreational cannabis. A recent report from Health Canada showed that monthly sales of medical cannabis have fallen by 25% from October 2018 to June 2019.  Clearly consumers don’t want to jump through hoops to source their cannabis via prescription, when it’s easily accessible on the recreational market. 

To get an idea of why people are using recreationally sourced cannabis for medical purposes, it’s important to know how medical cannabis is accessed. Here’s is a brief summary of how to access medical cannabis:

1. You must find a doctor willing to prescribe cannabis. Many doctors will require frequent follow ups for them to feel comfortable enough to provide regular prescriptions. Keep this in mind when finding a doctor. 
2. Once the doctor has given you a prescription you must decide who will be your designated cannabis supplier.  The prescription is only valid for 1 supplier.
3. You must sign up with your chosen cannabis supplier and submit your prescription.
4. You can now order online cannabis from that supplier, limited by the quantity designated on the prescription.  You can only select strains or products that your supplier has in stock. 
5. Once you’ve placed your order, it will be mailed out to you over the next few days.
6. When your prescription runs out, you must see your doctor to get another one.

As you can see, this process can be frustratingly tedious, slow and confusing. 

What could save the medical cannabis market from being taken over by the recreational market? The answer is insurance.  Insurance providers are moving slowly to provide coverage for cannabis. This is a huge enticement for patients to stay in the medical market since cannabis use can be expensive. 

However, insurance companies are hesitant to provide coverage for cannabis because the plant lacks a Drug Identification Number (DIN). This is a number provided by Health Canada for prescription medications. The DIN signifies that the medication has been vetted by Health Canada to be relatively safe, effective and has a rigorous manufacturing process that consistently creates the same molecule.

In contrast, cannabis is grown and not synthesized; therefore, research studies cannot reliably show effectiveness of cannabis because there are thousands of strains. If a research study proves one cannabis strain to be effective for treating a medical condition, it does not mean all strains are effective. This limitation also applies to showing the safety of cannabis; there may be safety differences among the multitude of strains. Lastly, and most importantly, is the variability of cannabis within the same strain.  One strain of cannabis can have significant differences in its THC and CBD concentrations based on the environment that it is grown in. Changes in temperature, soil composition, humidity, altitude, etc. can alter how much THC or CBD is in the plant.  Health Canada won’t be able to provide a DIN number for this reason, because the plant will constantly have variable and inconsistent amounts of THC and CBD.  It is unlikely Cannabis will be given a DIN number anytime soon, which means insurance providers will have to develop new policies for cannabis coverage. This will take time and give reason for many insurance providers to opt out of coverage.  Long story short, without insurance coverage, many patients will use recreationally sourced cannabis for their medical needs.