Gerald Major credits medical marijuana for helping him cut his opioid use down to a third of what he used previously. His spondylitis, an arthritis of the spine, causes serious and daily chronic pain that makes it difficult to sleep and function in the day. Medical cannabis, he says, isn’t a magical cure, but it helps. “It helps me with my mood more than anything, which helps me handle and process my pain differently,” he says.
More than 100,000 Canadians have prescriptions for medical cannabis, according to Health Canada data, but most pay for it out of pocket. They also pay sales tax on it, and the federal government is proposing that they be taxed even more. Last month, patients protested the federal government proposal that they pay the same 10 percent “sin tax” as recreational users when the drug becomes legal later this year.
Patients who use medical cannabis, like Major, argue that insurance coverage for medical cannabis should be expanded, and just like any prescription drug, it shouldn’t be taxed. But governments, employers and insurance providers worry about illegitimate use of the medical cannabis system.
How is cannabis covered now?
Medical cannabis is currently covered in extremely rare cases by government-funded and privately funded plans. But that might be changing. Last year, Loblaw Companies Limited and its subsidiary, Shoppers Drug Mart, announced the company would cover medical cannabis for up to $1,500 a year for approximately 45,000 of its employees, but only for symptoms related to multiple sclerosis and cancer. Also in 2017, the Ontario Public Service Employees Union began covering up to $3,000-a-year worth of medical cannabis for its employees, without stipulations on what it’s used for. The drug is only covered with a prescription from a doctor. Other unions and companies have since followed suit.
At other companies whose drug plans do not cover medical marijuana as described above, individual employees or claimants have challenged their companies, and the employers have agreed to cover medical marijuana for those individuals only, explains Joan Weir, director of health and disability policy with the Canadian Life and Health Insurance Association. For example, the Workers Insurance Safety Board in Ontario will cover medical cannabis on a case-by-case basis. “Most insurers will have employers who have said, ‘I want to cover medical cannabis for this person.’ There are exceptions on file,” says Weir.
Jonathan Zaid is one exceptional case. He is the founder of Canadians for Fair Access to Medical Marijuana, a patient advocacy non-profit organization that has received funding and grants from medical marijuana producers and clinics. The University of Waterloo student uses medical cannabis to treat his migraines and insomnia and a couple years ago, he challenged the fact that the drug wasn’t covered. His insurance had paid for dozens of other, more expensive prescriptions, none of which worked as well as medical cannabis. His student union, which administers the health insurance plan, eventually agreed with Zaid and the drug is now covered. But, Zaid says, most patients aren’t as fortunate. “It’s very common that patients are challenging their employers, but the success rate is not as high as we’d like it to be.”
Patients who can’t find coverage are on their own. Carole Reece, who suffers from spondylitis, chronic migraines and fibromyalgia, spends $300 a month on her medical cannabis, and she says she would spend more if she could afford it. Currently, she is vaporizing marijuana, but she would prefer to use the more costly gel capsules, which, she explains, “last longer and are easier to use.” She adds the drug has reduced her reliance on anti-inflammatory drugs. “Those are quite hard on my stomach,” she says.
According to Zaid, many people who use medical cannabis spend hundreds of dollars a month on the drug, and the number one reason people use medical cannabis is for chronic pain. He thinks insurance providers should “at least fund medical cannabis for non-cancer chronic pain in adults,” in addition to the more frequently funded cancer- and MS-related symptoms.
Why doesn’t health insurance cover cannabis?
Chris Kamel, director of the Rapid Response unit of the Canadian Agency for Drugs and Technologies in Health, says the evidence that cannabis effectively treats chronic pain is thin. He has headed several reviews of the health effects of the cannabis plant and synthetic forms—all at the request of health care decision makers, such as insurance companies. While some studies and reviews show therapeutic benefits for certain conditions like pain and post-traumatic stress disorder (PTSD), “we’re often looking at small studies or uncontrolled studies [studies without a placebo group],” Kamel says. “And largely the evidence is short-term, but we know people who use cannabis may use it for many years,” he says.
Research shows that cannabis has side effects, including short-term cognitive impairment, dependency, and psychotic symptoms. With most studies only following people for under a few months, it’s difficult to know whether the benefits outweigh the risks over the long term, Kamel explains.
“A number of patients are claiming they’ve really seen enormous benefits. We do not have the evidence to support that right now,” says Jason Busse, associate professor at McMaster and the co-director of the Michael G. DeGroote Chronic Pain Clinic.
Busse explains that decision makers can’t trust patient anecdotes, because patients may feel better due to the placebo factor, or they may have become dependent on cannabis. “You can become physically dependent on cannabis and feel withdrawal symptoms when you don’t take it, so you might continue to take it to treat withdrawal, thinking it’s helping you,” he says.
The demand for high-quality evidence before medical cannabis is funded puts users in a bind. “We do think that the federal government has a responsibility to fund medical cannabis research and we hope they’ll do that in the upcoming budget,” says Zaid.
Some have argued that cannabis should be covered as an alternative to opioids to treat chronic pain for some patients. For example, in a commentary in the Canadian Medical Association Journal, David Juurlink wrote, “many analgesics we might prescribe instead of cannabis are themselves not supported by robust evidence” and that “the direct toxic effects of cannabinoids are simply dwarfed by those of opioids and nonsteroidal anti-inflammatory drugs.”
Yet Dr. Esther Choo, an emergency medicine professor at Oregon Health State University, argues that we should learn from the opioid crisis and not make the same mistake of funding cannabis, without high-quality evidence that it’s helpful for chronic pain.
Zaid points out that many employers are concerned that if marijuana is covered for chronic pain and other common indications, people who enjoy cannabis recreationally will argue that they’re in pain to get a prescription for the drug, massively escalating costs. However, he says, “there are ways to mitigate those kinds of risks to ensure only people most in need who have legitimate conditions and proper documentation get covered.” For example, for many high-cost drugs, insurance companies require doctors to share detailed information about their patients’ conditions in order to receive approval for coverage, a process known as prior authorization.
Major thinks that there needs to be “accountability,” in that patients should be able to demonstrate a reduction in pain medications to have their medical cannabis covered. Otherwise he fears that patients will use cannabis on top of their other drugs without an improvement in their quality of life.
Why is medical cannabis taxed?
Late last year, Finance Minister Bill Morneau announced that medical and recreational cannabis would have the same excise tax applied, of 10 percent. The decision was in keeping with recommendations by Health Canada’s task force on the legalization of marijuana, which called for a single supply system for both medical and non-medical use. Bill Blair, parliamentary secretary to the Minister of Justice and lead on marijuana legalization told the media that the government is concerned that little or no taxation of medical marijuana could drive recreational users to inappropriately use the medical cannabis system.
But Paul Lewin, a Toronto-based criminal defence lawyer who focuses on the cannabis industry, thinks the concern that a tax rate differential will lead to abuse fails to appreciate the checks and balances of the medical system. “You need a doctor to sign off in order for it to be legal,” says Lewin. “Why are we casting doubt on doctors?”
Adam Greenblatt, an advocate for medical marijuana and the Québec Brand Manager at Canopy Growth Corporation, points out that other countries have tax rate differentials. Colorado taxes medical marijuana at 2.9 percent, and recreational marijuana at 15 percent, for instance.
Reece is concerned the excise tax will be an additional, unfair barrier, given that other drugs aren’t taxed. She points out medical marijuana users already pay sales taxes. “We should be treated fairly and as equitably as other patients who access other health products,” she says.
The comments section is closed.
“I was suffering from cancer for the last five years. In those times, I needed to take chemotherapy 20 times. I lost a lot of money for this, but the result was not hopeful. Last year, I started to take this medicine now I am feeling better than the previous. Now I need more oil, or the taxpayers can pay for a stem cell transplant, then I will need to pay $10,000 per month for the chemo drugs to keep me alive.
Let’s get this fixed now!!!”https://iccportcharlotte.com/
I am currently taken medical cannabis for pain and Rheumatoid arthritis. I cannot afford to pay total prescriptions and in the next couple OS months have to apply for bankruptcy. My drug plan does not and doesn’t appear to ever cover cannabis. I really do not know what to do next. I really can’t afford it any more after 4years. Could you please advise of where to go now and how to get medical marijuana din so that it will be covered.
Whether there are significant double-blind studies or not ( and I do believe there is more recent work showing efficacy for arthritis pain) is besides the point. If I have a medical sign off from my long-time primary care provider, something that is not easily come by, then it should be good enough to not tax this and only this kind of prescription pain relief
So what cage do we have to rattle to get this covered, any idea?
It’s medicine saved me from cancer, was given 32 months to live chemo did not work. Used Rick Simpson oil snd was cancer free in one month and in remission for 3 years.
Now I need more oil or the taxpayers can pay for a stem cell transplant, then I will need to pay $10,000 per month for the chemo drugs to keep me alive.
Let’s get this fixed now!!!
equality before the law, so if i have a medical condition, that does not require MM i dont pay taxes, but now i get diagnosed with another medical condition and now i have to pay tax on my MM. sounds discriminatory since certain conditions are more likely to need MM vs. others. sounds like certain medical conditions are treated way different than others whom dont need MM.
Lets not kid ourselves its just a government tax ploy
I only maintain my medical licence so that I can legally possess 120 grams of cannabis. LP products are not the highest quality. But they are usually the highest priced providers. Plus taxes? No way! The grey market still offers superior products, at a much lower cost than a LP would charge!
The argument that cannabis isn’t proven to help with PTSD symptoms is false. We know there is reduced production on endocannabinoids in patients that develop PTSD, and this is largely responsible for the hyperarousal symptoms of PTSD as endocannabinoids reduce the release of certain neurotransmitters, which are excitatory, such as GABA-A. Veteran’s affairs covers medicinal cannabis for veterans with PTSD. Several patients have come off drug cocktails and find improvement with cannabis, and many other patients have tried several drugs that have either made them worse or done nothing at all. The argument that giving cannabis and seeing improvement could be entirely due to the placebo effect is an awfully flimsy argument as that line of reason would invalidate nearly all psychiatric drugs. Benzodiazepines are highly addictive yet are often prescribed preferentially as anxiolytics… these drugs actually can drastically worsen PTSD symptoms as they are positive modulators of GABA-A, which means they increase the likelihood that the channels that release GABA-A are open which can contribute to a serious rebound effect once the drug is metabolized. Antidepressants are often considered the best drug for PTSD symptoms, but have been shown to work is approximately 50% of patients, at best. If you give a patient an antidepressant and their condition improves, did the drug work or is it just a placebo effect? The government does cover the marijuana pill (synthetic 1:1 ratio of THC:CBD and goes by nabilone or cesamet), but this is hard to use during the day as you can’t opt for just CBD in the day. Why would the government cover a synthetic agonist to our cannabinoid receptors but not the natural organic version? We know cannabis is not nearly as addictive as many prescription medications and the warnings on some psych and pain meds are grossly understated. People will get their hands on and abuse almost any chemical/plant they can, so again, this is a poor argument and speaks more to needing to improve addiction services than it does to making traumatized people and/or those in chronic pain or dealing with cancer to pay several hundred dollars a month. If some of these lawmakers/politicians could also familiarize themselves with the differences between THC & CBD, that would also be great. We have 2 types of cannabinoid receptors (CB1 & CB2) and THC works on one and CBD the other and the concentration of these receptors differs in different regions of the body with the receptors CBD targets having a high concentration throughout the body, particularly in the immune system (spleen), and THC receptors are concentrated in the CNS.
The government in general does not seem concerned with civilian trauma and addressing trauma through a variety of means, not just cannabis, could drastically improve addiction, suicide, abuse, and violent crime rates, along with decreasing unemployment and increasing overall productivity. The government needs to listen to patients and doctors who prescribe cannabis and follow patients. So many medications that have been proven to be highly addictive and come with dangerous side effects are practically handed out like candy… CBD could be a far safer alternative to give children and teens than benzos and prozaac. It’s already been proven how effective CBD can be for certain forms of childhood epilepsy. It would be interesting to see if giving patients high doses of CBD directly following traumatic experiences could lessen the likelihood of developing PTSD by decreasing the overall stress and subsequent hyperarousal responses, thereby lessening the overall aversive experience (imagine how amazing it would be to give someone who comes to the hospital to have a rape kit done a bottle of high quality CBD oil).
What about all these scares of abuse? Does that mean insurance companies don’t have fraud prevention measures to combat what they think is a “risk” to their business? Maybe they need another insurance option through the Government to have everyone feel “safe”. Medical users should not be the ones punished, I feel all kinds of laws are being broken in the name of greed off of the most vulnerable looking for a little relief. How many ways to feel the wraith of discrimination?
Thank you for sharing and spreading awareness! Cannabis is really indeed magical. As studies progress, it unfolds a lot of possible uses and applications in science and medicine. I hope this could be the future treatment of a lot of diseases. I hope that the insurance company will just look at it just like a standard medicine for mental condition and other condition.
Well if you will ask me regarding those statements I really suggest that they shouldn’t need to acquire taxes in using marijuana just for medicinal purposes it will be led to a bad situation.
I have worked all y life in Canada, Now I get my drugs as a senior for 4.11 each. Now I am in a great deal of pain, probably in need of surgical relief now. Although that is going to be a long time coming as after 6 months I have yet to get an appointment with a surgeon. I have problems with pain medications and the cannabis is a help. So why is this med not covered like the rest prescribed by my doctor. $4.11 against $80. Something is not right?
$1500 is the cost of a one month supply for me. Sure it is better than nothing but really there needs to be more affordable cannabis and insurance companies should cover it under the normal medication plans. Hopefully one day this will be the reality but I wont hold my breath.
This is one thing that the government should look at. Eye-opener post!
With the legalization of cannabis, I expect great change with medical cannabis regulation. Great article!
What kind of “Great Change” were you hoping for? Government is going Against the Will of the Ppl yet again & are Taxing Medical Cannabis & Refusing to cover the cost for Ppl on Odsp, however they cover a small amount for Veterans? They’ve Both got Disabilities but only Vets get coverage? Many Ppl Can’t Afford the High Cost of LP S–t & will be Forced to accept Prescription drugs for Free instead of using Cannabis, which can be More Helpful than RX Drugs! Taxing Medical Cannabis will help keep the black market going, as will Forcing Ppl to buy Pesticide Ridden & Irradiated pot! No Tax on Medical Cannabis! Turdo Must Go 2019!
This bothers me a lot that this is so expensive. I pay over $400 a month on stuff that literally ahs helped me off pills, it has helped me be able to walk without my medical knee braces for a few days at a time. This month because of Christmas and I have a big family, can’t afford medication so I will suffer which is sad as its medicine, and it helps but because it is not covered that is the reality of where this is with some I guarantee.
Can I still claim my medical cannabis on my taxes now that it’s legal ?
Yes as long as you buy LP Poison! It is covered on Taxes, but only as a Non Refundable Tax Credit, which means you probably Won’t get much back.
Dope for the dopes – it is unbelievable that this society is infatuated with drugs. We have problems after problems with tobacco, alcohol and opioids- now Trudeau makes another tier of dope legal – why for the tax revenue and votes. It is pathetic we now live in a drug culture promoted by the libtards and big business – just to make a buck. NO way anyone with any brains will take this crap– I hope they tax it 300% and give thes rest of us that do not use this crap a tax break.
Cannabis hasn’t killed a single person and only helps people. It’s not like we’re talking about fentanyl, that is what they put me on when I cannot afford cannabis. Oh and fentanyl is free for me, I actually pay a lot of money to not have to take it. Think about that for a second, I choose to pay a large portion from my meager disability income instead of taking the fully government covered fentanyl. THE GOVERNMENT GIVES ME NARCOTIC OPIODS LIKE FENTANYL AND MORPHINE FOR FREE BUT I HAVE TO PAY $1500 FOR A FULL PRESCRIPTION OF CANNABIS THAT COMPLETELY REPLACES THEM. The government needs to get their priorities straight.
Marie, I’ve gone through the Exact same situation as you with the Fentanyl! It costs over $800/mo for Fentanyl that leaves me stuck in bed & depressed as hell! Try buying from a reputable black market cannabis company, they offer a much Cleaner product with No Pesticides or Irradiation like LPs do! You should be able to buy it cheaper from black market & they Don’t Charge Tax! Our government has been given Petitions over this Tax on Medical Cannabis but CHOOSES to IGNORE them just like they Ignore Canadians in General everyday!
I wish I could give you a name of a great place to deal with, but can’t do it here… Ask around & you will find a decent dispensary to help you, just Stay Away from LP S–t, it Could make you very ill! Good Luck staying off Fentanyl, it’s a terrible drug & we are Forced to RETURN our “Used Patches” to Pharmacy in order to get repeats! No Other Drug is Required to be Returned & I don’t know about you but I Don’t Like Being Treated Like A Criminal Just To Get My Prescribed Meds! No Tax is Charged on Prescriptions & NONE Should Be Charged On Medical Cannabis!
Turdo MUST GO 2019!!!
Personally I find this whole legalization frustrating for people whom use cannabis for medical use rather than recreational. I have used cannabis oil and CBD for last 2 yrs to help with chronic pain and arachnoiditis. Prior to it I was on very heavy does of Oxycontin, morphine, Tramadol…you name it, I’ve been on it.. I never felt well on Opiates. They made me tired, dizzy and life-less. The cannabis gives me hope. I don’t feel drugged out ,I can think and I’m able to do more than I could on Opiates. Sadly the high cost of cannabis via federally run companies is very expensive and is taxed. I don’t take the amount I should as cant afford to. Yet Oxycontin and other opiates are covered. How is this even fair?? Then lets add on taxes!! I feel the medical uses are getting screwed over here.
I feel Medical cannabis should be covered if it’s a medication !
That is exactly how I feel. I am provided opiates through government sponsored insurance but pay out of pocket for my cbd cannabis. I cant afford to buy nearly enough and its taxed to boot. I also have to pay for shipping now or buy larger amounts to avoid the fee. Pharmaceuticals are available without taxes or shipping fees(they can be picked up at a store front located in multiple locations in every town) and addiction is pretty much guaranteed from the opiates. This proves our government is not supporting us.
Another liberal money grab I hope all those liberal clowns get a disability and need to deal with no coverage oh wait Justin will help them and any other new illegal that enters our country but not a born and raised Canadian keep stringing people out on opioids u bunch of clowns
I find cannabis to be very beneficial. My mood is better. My mind is sharper and my disabilities are greatly helped. It’s greatest benefit is to the mind and it’s condition. For myself, I find life considerably more comfortable when using THC. And, since the mind is the epicentre of all that is real, the life value of this wonderful plant is precious.
It should not be taxed as a medical benefit and should be sold at low cost to the people living in near poverty or lower. Government greed should be absent in its’ sale of Medical cannabis.
We people of low incomes have no one to look to for assistance. Therefore we have no say in…anything!
You are better off buying from the black market! Cheaper prices & Safer product’s, as most growers Don’t use Pesticides in general & Never to the extent of LPs! LPs can use approx 22 Different Pesticides & most Irradiate their Poor Quality sweg, Irradiation Kills most of the “Good” in the Buds. If you are 1 of the Lucky 1’s to have ins. coverage, then the only reason to buy their crap is so you can be reimbursed for it. Unless you have a really large prescribed amount & have other drug prescription’s with no ins. coverage, then you can claim a Small amount on income tax, but its Not my choice, I choose the “black market” I pay $4-$5 a gram for Excellent Quality cannabis & also make my own Cannabis Oils, CBD & THC Capsules, Creams, Tinctures & Edibles using the Magical Butter Machine. Many LPs have sent out Moldy, Pesticide Contaminated products that have caused medical patients to become Sick!
There are Still black market Dispensaries in Ontario & many offer Prescription’s thru their own Doctor. It’s Your Health & it’s up to You if You’d rather Not use an LP & inhale their Pesticides then buy Pesticide Free from a Dispensary or find one on Social Media! Best of Luck!
if its prescribed its a medicine and should be covered
Why can’t readers write comments after Faces of Healthcare articles? Please change it so readers can leave comments.
I’m tired of the attitude that patients are stupid and doctors and other professionals need to think for them and make decisions for them.
Medical cannabis for medical use should not be taxed. Licensed producers are already overcharging for a poor quality product.
And they sell out of the desired product and suddenly begin to charge for shipping leaving the medical patients without or not being able to afford. I once bought cbd oil from an MOM LP that tasted like fish. (disgusting) I emailed my complaint and they wanted me to return it to them via courier. There was no guarantee my returned oil would be acknowledged, refunded, or that I would even be informed if my oil was tainted, or spoiled. But I’m forced to remain a medical patient and buy from LPs or risk not being able to return to my cannabis doctor