On a mild February afternoon in 2014, a pastor named Chris from the Maritimes sat outside his Jeep in a park near his home by the water, and smoked a joint. There was a sense of experimentation, curiosity even. Having never smoked weed as a teenager, Chris barely knew what he was doing. He got his hands on his first quarter ounce of weed less than two weeks earlier, and was still looking for the answer to a question: What did cannabis have to offer?

“I was sitting outside and smoking it, and running through my mind was, ‘I really want this to work,’” he says. “‘Please let this work.’”

Chris drove a minute or two down the road back to his house, and got out of the car. For any other pot smoker, on any other day, the act of getting out of your car and walking is entirely unremarkable. Remarkable, though, were the things left behind: a cane, left sitting in the front seat of his Jeep. The constant, debilitating pain in his back, resulting from seven herniated and two compressed discs that had left him bedridden and opiated for the better part of the past decade, had for the moment disappeared. (Chris has asked This Magazine to withhold his last name and the city where he resides, since not everyone at the church and in his community knows he uses cannabis.)

“Instantly, I could feel relief in my back,” he says. He made a decision: “I’m willing to do this. It seems to be working.”

It was an easy choice, because the alternative was so awful. The number of different medications he was on at one point or another stretched well into the double digits, and Chris can’t even remember how many he tried.“I was on fentanyl. I was on OxyContin,” he recalls. “It wasn’t actually doing anything for my pain, it was just numbing my brain.” At one point he was put on six opiates at the same time.

Chris is religious, a literal Man of the Cloth, a minister and technical director for a small church out east. The metaphors that come to mind—a come-to-Jesus moment, a revelation, an epiphany—seem to ring hollow. But the cannabis-induced relief in his back did show him that there was a way out of the heavy cocktail of opioids and chronic pain that had consumed his life. “Within a month, I had stopped taking almost all the other medications [my doctor] had me on,” he says.

The thing most cannabis patients have in common is that they are, in some fashion or another, always fighting: fighting illness and chronic pain; fighting a Byzantine system of medical administration; fighting to be taken seriously as medical patients. In just about every way, Chris could be the poster child for the possibilities of medical cannabis, but that realization meant he would need to fight for it. He had to detox, spending a week on the bathroom floor, when “every bone in my body felt like it was breaking,” as his body suddenly came back online after years of opiated numbness. These fights are tolerable, because many patients are getting so much back. Not long after he had smoked his first joint, cannabis had “given me my life back, given [my wife] her husband back, and given my kids their father back,” says Chris.

But four years later, Chris can barely afford it. Nearly two decades after medical cannabis was first legalized in Canada, and months before it will be legal for all adults, many medical cannabis patients still struggle to pay for weed. Many are out of work or, like Chris, can only work limited hours, and have to buy their weed out of pocket; those who can work rarely have their medication covered by drug benefit plans.

Medical cannabis patients are among the country’s sickest, its poorest, its most opiated. As the country lurches towards the dawn of legalization, the patients who most rely on cannabis are still struggling to pay for it. And there doesn’t appear to be any help on the way.

***

Medical cannabis, which has been legal in Canada since 2001, has always come with a steep price tag for patients. For many years, the fight was for access to weed; affordability was an afterthought. It was difficult to get the medical exemptions required to buy and use cannabis, and possession remained illegal. Affordability for medical patients, however, has emerged as a major concern in recent years, particularly as a result of major overhauls of the system at the federal level.

In medical cannabis’ original iteration—a program called the Medical Marihuana Access Regulations (MMAR) scheme—patients could buy their pot for $2 to $5 per gram. In 2013, that single-source system was overhauled, and the Marihuana for Medical Purposes Regulations (MMPR) scheme was introduced, allowing patients to purchase their cannabis from licensed producers (LPs). (The system would be further updated after the 2014 Allard v. Canada court challenge, which loosened restrictions around growing your own cannabis. The system is now known as the Access to Cannabis for Medical Purposes Regulations, or ACMPR.)

Were Chris a cancer patient, or had he suffered a broken leg, his care would likely be paid for by our system of socialized medicine. But weed comes with a sticker price

The new system improved access—a 33-page medical document was replaced with a two-page form, and a growing number of licensed producers meant that patients had far more selection when it came to what strain they could use—but hurt affordability in the process. The move to the private market, albeit a highly regulated one, meant that prices increased, getting closer to matching the established street price of about $10 per gram. Prices rose to their current level, with the average gram costing patients about $8.40.

The wide variation within the prices means that patients often find themselves on a sliding scale where the quality of their medication depends largely on how much they are willing to pay for it. The Markham, Ont.-based LP MedReleaf, for instance, sells a strain called Rex at $17.50 per gram, while some of the weaker strains from other LPs go for around $4 or $5 a gram. “Even at some of the crummier strains, I’m at $900 to a $1,000 [a month],” says Chris. Which end of the spectrum you end up on depends largely on what costs you are willing— or able—to bear.

As a result, “some patients have to choose between continuing to take their opioids, which are often covered by insurance, and pursuing medical cannabis as an alternative or supplementary medicine, which is not covered but might be more effective for their needs and have less negative side effects than traditional medicine,” writes Bryan Hendin, president of Apollo Cannabis Clinics, a medical cannabis clinic in Toronto, in an email statement. From a medical and health care standpoint, this kind of system creates other stressors that can exacerbate health problems. “Even for patients who can technically ‘afford’ medical cannabis, we’ve seen how the financial decision to pursue medical cannabis versus traditional medicine covered by insurance can even exacerbate symptoms related to pain, such as anxiety and poor sleep,” Hendin adds.

It can be hard to tease out the source of cannabis’ price. Despite costs being fairly low to produce—Aphria, another LP in the country, has brought their cost per gram under $2—prices soar. Few major LPs see massive profits (or any profits) at the end of the fiscal cycle, with most of their revenues going back into expanding their production capacity, both for existing medical demand and in anticipation of recreational legalization. Patients are but one part of a much larger industry, and the costs they bear will help finance the recreational market.

***

For many patients in Canada, cannabis is their saving grace. It has given Chris his life back—but getting there hasn’t been an easy process. Were he a cancer patient, or had he suffered a broken leg, his care would likely be paid for by our system of socialized medicine. But for Chris and those like him, it comes with a sticker price.

At the same time, the federal government is actively taking steps to make medical cannabis less affordable when legalization comes into effect by applying a $1 per gram excise tax to all cannabis, including medical weed. For patients, that amounts to a steep price hike for their medication.

Sarah Colero, a medical cannabis patient from Toronto, pays $864.45 every month for her cannabis. Two consecutive strokes when she was five years old left her with damage to her frontal lobe. She also suffers intense migraines. She began treating both with cannabis three years ago, after years on opioids.

But her illness means she can’t work. She receives $1,151 every month in disability payments—most of which is chewed up by the cost of cannabis, the only medication that lets her function properly. “No insurance companies cover it,” she says. The excise tax proposal will tack on an extra $90 to her monthly bills—about one-third of what she has left over each month. “Once I found out that the taxing was going to happen I totally broke down. What am I going to do?” she said. “My dad wants to retire, obviously. I don’t want to be reliant on him all my life, and obviously this isn’t working.”

When asked if Health Canada, who are responsible for the administration of the ACMPR system, would be taking steps to alleviate affordability concerns, spokesperson Andre Gagnon declined This’s request for an interview, but said in a statement that “costs of cannabis will be determined by the market.”

Stories like Colero’s are illustrative of a system that critics say favours the revenues of large cannabis producers over the well-being of patients. The country’s LPs—many of whom have seen major increases to their valuation in the stock market over the past year—acknowledge that affordability is top of mind for many customers. But they are also businesses, first and foremost, and balancing the demands of shareholders with the needs of patients is a challenge. Affordability is “a huge factor,” says Jordan Sinclair, a spokesperson for Canopy Growth, the country’s largest LP. “As Canadians, I think we’re lucky that most of the health care system is free, and pharmacare is mostly covered if you have a plan,” Sinclair says. “[But the cost of medical] cannabis falls outside of all of that.”

Canopy Growth was the first licensed producer in the country to introduce a compassionate pricing program. Customers who earn less than $29,000 a year get a 20 percent cut on the cost of their weed. That sort of scheme is more or less standard in the industry now, with most LPs offering some sort of compassionate pricing for people on low incomes. But even at discounted rates, the patient is paying for a hefty markup. According to recent financial filings, the all-in production cost for Canopy was $2.73 per gram, while the lowest you could buy it for is $4.80. Even that price is below what they could be selling it for, says Sinclair.

The industry is trying to avoid a race to the bottom. Driving prices down below sustainable levels will ultimately hurt patients, goes the theory, because without major companies to lead production, there simply won’t be anyone left to sell the weed. “It’s not a problem that can be explained away,” Sinclair says. “There is that reality that’s hard to escape—there’s a correlation between people who are using medical cannabis and people who tend to have a lower income.”

***

Few existing mechanisms by which medication and medical services are made affordable are available to patients who require medical cannabis. No provinces offer coverage for pot in their health or pharmacare plans, and none of the country’s major insurance providers—Manulife, and Desjardins, for example—cover medically prescribed cannabis as part of their standard package. “In terms of benefit plans, which are usually offered [by] a union or an employer, the decision really comes down to the plan sponsor,” explains Jonathan Zaid, co-founder of Canadians for Fair Access to Medical Marijuana (CFAMM).

Battling with administrators to try to get your pot covered is a battle that Zaid knows well. In 2014, he fought for his insurance provider at the University of Waterloo, where he is an undergraduate student, to directly cover the cost of his pot, which he used to treat a condition known as new daily persistent headache. When the insurance provider denied the claim—which almost always happens, since cannabis lacks what’s called a Drug Identification Number (DIN) from Health Canada that allows them to process claims—he went to his student union and asked for coverage.

That, he says, wasn’t easy. “That process still took eight months and a huge amount of deliberation on everyone’s side,” he says. In doing so, he became one of the first Canadian medical cannabis patients to have his medication covered by a private insurance plan.

Chris has to fight: to pay the bills, to afford his medication. He must grapple with policies that don’t always feel like they take his health seriously

Even in cases where an employer is open to covering the cost of an employee’s cannabis, it can be difficult to navigate. “That process is stressful and personal for many patients,” says Zaid. “The usual response is usually rooted in stigma. It’s about the fear of people getting high at work, employers not seeing it as a legitimate medicine, and so on.”

Patients, then, are sometimes put in the position where they not only have to advocate for the cost of their pot to be covered, but for medical cannabis patients to be taken seriously in the first place. The onset of legalization will leave the way the insurance industry handles medical cannabis claims more or less unchanged.

On February 15, Sun Life announced that it was changing its policy and would begin covering medical cannabis for patients whose plan sponsor is willing to include it in their benefit plan. The coverage will be available for specific ailments and symptoms, such as for those with cancer, rheumatoid arthritis, and multiple sclerosis.

***

More than two years after I first spoke to him about his cannabis use, Chris’s back pain is getting better—or at least more manageable. “The great thing is that it seems I haven’t had a lot of flare-ups,” he says. None of that was an easy fight; for cannabis patients, it never is. Doctors at first refused to prescribe him medical cannabis, forcing him to buy it off the street until he found a doctor who was willing to help him. Now, he is completely opiate-free. The pill bottles, the four years he spent on a fentanyl patch, and the week he spent on the bathroom floor toughing out his detox are now all behind him.

The beating heart of the fight for cannabis affordability is the people who have better lives because of it. It is an elemental fight for a form of health justice often ignored, cast in different language and different terms. Chris has to fight: to pay the bills, to afford his medication. He must grapple with policies that don’t always feel like they take his health seriously. But the fight to make medical cannabis more affordable underscores a deeper, more foundational problem for medical cannabis patients: The industry is becoming dominated by large corporations who serve a different master in their shareholders, and are increasingly serving as the main advocate for patients’ rights.

The degree to which the government is in the pocket of Big Weed is likely overstated by the industry’s critics, but its influence over policy can’t be denied, either. Without the successful development of an infrastructure that served medical cannabis patients from the private market, and without the flourishing of a regulated production model, it’s unlikely the legalization of cannabis would’ve ever gotten off the ground.

But then, the patients like Chris probably have a point: The launch and growth of the LP system has made millionaires of many people. Medically speaking, few of them have much in common with Chris and those like him.

Facing a multi-billion-dollar industry can feel, for patients, like a titanic problem, with their health and well-being hanging in the balance.

“Greed does what greed does,” says Chris. “It comes back to that almighty dollar…. It’s just a money business for them. At the end of the day, it’s about the dollar.”

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For over a century, criminalized drugs have been demonized, as were the people who used and sold them. Criminalized drugs have long been linked to marginalized and racialized groups, who have been depicted as outsiders to the nation threatening moral Canadians. Politicians, law enforcement, media and vocal spokespeople fuelled drug scares and circulated fabrications and lurid, exaggerated accounts of drug use and trafficking in support of punitive drug policies. Worn out tropes about people who use and/or sell drugs have promoted social injustice. However, today Canada is at a crossroads. Increasingly, drug prohibition is understood as a social justice and human rights issue.

History, however, is never definitive. Local stories, new discoveries and uncovered material can emerge, illuminating once again the danger of assuming history is static. Over the years, there have been many pivotal moments in Canadian drug prohibition and challenges to it. Community activists, people who use drugs, constitutional lawyers, researchers and service providers have long challenged Canadian prohibitionist policies. Knowing the history of Canadian prohibition can guide us to better understand current events and notions about drugs and the people who use them. Knowing about Canadian drug prohibition allows us to critically reflect on past practices, legal regulation, law enforcement, moral reformers and their agendas, new events and avenues to adopt. The field is wide open because people implement drug prohibition, and people can also dismantle it or change its course. Laws and policies are not static, nor neutral.

For more than a century, drug prohibition has been and continues to be an expensive failure. Our reliance on the criminal law to eliminate illegal drug production, selling and use has not proved effective. In fact, it has only worsened the health and well-being of those who use drugs, and it has also resulted in increased imprisonment, child apprehension and human rights violations. Importantly, criminalization (prohibition) has undermined health services such as harm reduction services and other programs that effectively counter hiv and hepatitis C epidemics and drug overdose deaths. The harms stemming from prohibition are not limited to illegal drug users and traffickers — families and communities also bear the brunt of our drug policies, as do other nations outside our borders such as Mexico and Colombia. For this reason, Mexico and Latin American nations have been critical over the last thirty years of international drug conventions and the devastating damage the Western-driven war on drugs and neoliberal policies have on them. Activists in Canada and around the world are striving to change all this.

International drug control treaties are outdated, inflexible and do not reflect contemporary societal, cultural and public health concerns. In fact, the Canadian Report of the Senate Special Committee on Illegal Drugs noted in 2003 that “the international classifications of drugs are arbitrary and do not reflect the level of danger they represent to health or to society.” The International Control Board (incb) has also come under scrutiny. Their lack of dialogue with nations, of accountability and of transparency, and their criticism of policies and public health and harm reduction initiatives have been increasingly questioned by scholars, government officials, drug user unions and national and international drug policy reform groups, such as Canadian Drug Policy Coalition, Canadian hiv/aids Legal Network, Global Drug Policy Conservatory, Mexico United Against Crime, Transform Drug Policy Foundation, Transnational Institute, International Centre on Human Rights and Drug Policy, Drug Policy Alliance, and Washington Office on Latin America. 

Supporters of punitive drug policies fear that drug use rates will skyrocket if prohibition ends. However, recent history demonstrates that such fears are misguided. In 1976, the Netherlands implemented de facto decriminalization through the Dutch Opium Act for the possession and sale of up to 30 grams of cannabis. In order to protect youth and separate them from illegal markets selling “harder” drugs such as opiates and cocaine, cannabis shops (similar to coffee shops) were allowed to be established under strict rules and regulations. Using the most recent drug-use statistics available, cannabis rates have not increased in the Netherlands, and cannabis use is much lower there.1 

Responding to sharp increases in heroin use, overdose deaths, and hiv/aids in the 1980s and 1990s, the decriminalization of personal use and possession of all drugs, not just cannabis, came into force in Portugal in 2001. The move away from criminal sanctions and stigma related to criminalization was part of a much wider social and health public policy strategy in the country. Decriminalization in Portugal co-exists with other measures, such as expanded prevention, treatment, harm reduction services and social supports. Rather than criminalization, pragmatism, humanism and social integration are key to Portugal’s drug policy. Since 2001, drug-related deaths and hiv infections have decreased, drug use has decreased for adolescents and those ages 15 to 24, and drug prices have not lowered (as opponents claimed they would).2

When Canada established the first federal medical marijuana program in the world, the sky did not fall down. Twenty-nine U.S. states have legal medical marijuana programs. Uruguay became the first nation in the world to end cannabis prohibition in 2014. Eight U.S. states and the District of Columbia also ended cannabis prohibition between 2012 and 2016; 20 percent of Americans now live in states that have legalized and regulated cannabis. The cannabis plant did not change; rather, attitudes about prohibition and the plant changed.

In those states, provinces and nations that have turned away from punitive drug policies, addiction and drug use rates have not increased substantially and youth were not negatively affected. Given Canada’s drug overdose death crisis, will all levels of government move quickly to set up more supervised injection sites, heroin assisted treatment, other flexible drug substitution programs and public education as the first steps to saving lives? In order to save lives now, will provinces defy federal law and set up overdose prevention sites that allow smoking, ingestion and injection (as B.C. has done) rather than waiting for federal approval?

Until 2016, Insite stood alone as the only authorized safer injection site in Canada. By May 2017, eight other sites received approval and the application process has become less obstructionist. Health Canada also announced a new process that will allow the importation and use of medications not yet authorized in Canada, such as legal heroin, to help stem the drug overdose crisis. Public health officials can now send a request to Health Canada for bulk quantities (instead of individual special access requests) of the drug so that it can be more efficiently prescribed to those most in need at clinics and other locations. It is too early to know whether long-held prohibitionist attitudes will curtail some public health officials from implementing change.   

The Federal Government also passed the Good Samaritan Drug Overdose Act in 2017. The Act provides an exemption from criminal charges of simple possession of an illegal drug for anyone who calls 911 for themselves or another person who is overdosing, and for anyone else at the site when emergency help arrives. Yet, people are reluctant to call 911 if they fear that they may be charged with another drug charge, such as possession for the purpose of trafficking.

In order to more fully stem the harms associated with prohibition, including overdose deaths, diverse Canadian groups and individuals have long advocated for an end to drug prohibition and the criminalization of marginalized groups of people, as have international groups. Yet, each group’s blueprint to legally regulate currently criminalized drugs differs slightly. Similarly, each U.S. state that voted to legalize cannabis created quite different policies for the production, sale, distribution and possession of the plant. And there are different city initiatives too. For example, in 2017 Oakland City Council in California adopted an Equity Permit Program for medical cannabis production licences. The Program prioritizes those who were unfairly impacted by the U.S. “War on Drugs”: long time residents in high arrest areas, racialized and poor people, including people convicted of a cannabis offence. The policy will extend to recreational non-medical cannabis producers in 2018.

On April 13, 2017, the Canadian Government tabled Bill-45, the Cannabis Act, to the House of Commons. The Act fails to make a clean break away from prohibition. Unlike tobacco regulation, the Cannabis Act includes harsh criminal penalties for some offences. However, changes can be made to the Act prior to its enactment. It is also unknown how each province, territory and municipality will take up their responsibilities in relation to cannabis distribution and sale.

The Canadian Government, thus far, has refused to direct law enforcement to stop arresting people for cannabis possession now rather than waiting until the Cannabis Act is finally enacted. It is unclear whether small cannabis producers, compassion clubs and dispensaries will be supported by federal and provincial governments to participate in the legal cannabis market if and when the Act is made into law. Will the expertise of medical cannabis and illegal cultivators be recognized in the policy making stage and invited to participate in the legal market set up? Will people who have a criminal record for cannabis possession be exonerated?

Will Canada choose to decriminalize and/or to legally regulate all illegal drugs? Will the Government address the historic violence and injustice of drug prohibition? If so, will Canada be successful in eliminating social structural violence and systemic race, class and gender discrimination against people who used drugs/plants that were criminalized? Or will we create a new regime to continue punishing people? Eventually, these and many other questions will be addressed in Canada. Current events will affect people’s experience of drug policy and ultimately, shape history.

Busted is available in stores and online from Fernwood Publishing.

The company that patented OxyContin, Purdue Pharma LP, has earned over $30 billion (US) from the drug since it was introduced in 1992. An aggressive marketing campaign focused on the drug’s revolutionary ability to treat severe pain over long periods of time, but the company has long been accused of concealing the risks of addiction inherent in its signature product.

In 2007, Purdue Pharma was forced to pay a $635-million (US) fine after three of its top executives pleaded guilty in a US Federal Court to criminal charges that they deliberately misled the government, doctors, and patients about OxyContin’s addiction properties. It was the largest monetary penalty in US pharmaceutical history, but it was equivalent to less than the amount of revenue the company earned on the drug every six months! In 2017, the company settled a class-action suit brought against it in Canada for $20 million, representing 2,000 Canadians who had become addicted to OxyContin. The company and other makers of prescription opioids continue to face lawsuits and accusations in many US states and in Canada concerning addiction, negligence, and misrepresentation of the drug’s benefits. And all makers of prescription opioids, like Vicodin, Demerol, Percocet, and their many generic equivalents, are bracing for a crackdown.

Sure, millions have found pain relief from OxyContin and its opioid cousins, but at the cost of thousands dead and tens of thousands addicted. The Globe and Mail reported that, since the turn of the millennium, over 6,000 people in Ontario alone have died from opioid abuse. Billions of dollars have been earned, but at the cost of billions more to the health-care system to treat addiction, and to the economy in lost productivity. And the true cost to families—that may be impossible to put a number on. In 2017, we’re starting to learn the tragic truth about prescription opioids. And even though pharmaceutical companies have been lying to the government and doctors for decades, it’s hard to forgive their ignorance. After all, these are opioids—powerful narcotics synthesized from the opium poppy—the same drugs that many governments sought to ban in the early twentieth century before they decided that it would be politically easier to demonize cannabis — a non-addictive, non-lethal drug.¹

After my car accident, my doctors prescribed me opioids for the pain—morphine, Percocet and Demerol at first, and later the infamous OxyContin. I was taking up to 80 milligrams a day just to be able to sit up, walk, and get through my agonizing physical therapy. I never questioned my doctors — I just wanted pain relief. I wanted some part of my life back. But with each patented time-release capsule I popped, I was unwittingly sinking deeper and deeper into an abyss of depression, addiction, and bodily harm. I suffered through the side effects—vomiting, dizziness, irritability, headaches, a zombie-like state of constant drowsiness—because I so desperately needed the pain to go away. Recent studies have shown that prescription opioids can wreak all sorts of gruesome effects on the human body, including irregular heartbeat, difficulty breathing, swelling of muscle and organ tissue, and cyanosis (when your skin, lips and fingernails turn blue from lack of oxygen). We also know (now) that the most catastrophic effect of long-term or excessive prescription opioid use, other than simply death by overdose, is liver failure. The liver is responsible for metabolizing opioids (and other drugs introduced to the body, from Tylenol to alcohol and cannabis). Medical science is just starting to learn how the liver’s basic metabolic operations can become over-taxed by opioids, so severe is the process of metabolizing them. It’s like running your car at 7,000 rpm for hours on end—eventually the engine is going to overheat, the oil is going to burn out, and your car will break down in a smoking heap of charred metal.

Your liver uses special enzymes to metabolize drugs and introduce their beneficial (e.g. pain-killing) properties into your bloodstream. These enzymes essentially die off during metabolism and need to be regenerated. Your liver works hard to reproduce them—sometimes so hard that the organ itself becomes enlarged and starts interfering with other bodily processes. This is what happens with opioids like OxyContin. The liver can also simply start to decay from being overworked. With alcoholism this is called cirrhosis. With opioids it’s simply called failure. And it was, in truth, a massive failure, not just of my own body, but also of the people and institutions that recommended opioids to me in the first place.

***

My doctors told me I had a year to live—maybe less. This was after I returned home from Cuba, after I registered at Vancouver General Hospital for a course of chemotherapy that left me strung out and vomiting and barely able to stand, after I was prescribed a second, more intensive type of chemotherapy which also failed to work. When I treat or counsel people—anyone who’s suffered from the trauma of cancer—I know I can look them straight in the eye when I speak to them about the difficult choices they face. I’ve faced them too. “Get your affairs in order,” Susan’s oncologist told her. “Get your affairs in order,” Manni’s oncologist told her. That’s exactly what my doctors said to me in 2004. Chemo wasn’t working. My body was too broken. Within a year, the doctors told me, either my liver would fail completely, or I might hemorrhage and bleed internally to death, or the cancer would simply destroy my immunity and a simple infection would be the death of me. “One year to live.” Maybe.

A photo of the author.

Ironically, it was in Cuba where I met the first doctor who warned me about prescription opioids. When he saw my prescription dosage, he was alarmed: “You’ve got to get off those.” He was shocked my Canadian doctor had said it was okay for me to have even one drink. After the extent of my liver damage was confirmed back in Canada, quitting opioids became the first priority to salvaging even one year of life. It wasn’t easy. Opioid addiction is chemical — the receptors in your brain get used to the drug and can’t function without it. This happens to about 25 percent of regular opioid users.² The addiction is also psychological—after using opioids for 18 months to mitigate the extreme bodily pain from my car accident, I was dependent on them to get me out of bed in the morning, to play with my kids, to sleep through the night. And so I had to face a difficult truth that made me feel weak and retrograde: I, Sam Mellace, am an addict.

My wife helped me enroll in a Suboxone detox program. Suboxone is the brand name of a mild narcotic called buprenorphine, which is used to treat pain and can be addictive, and is slightly less destructive on the body. It’s a rehabilitation drug because it helps wean opioid addicts off of hard-core drugs, the way a sugar addict might go on a crash diet but still allow himself a daily spoonful of honey to ease the shakes. But quitting prescription opioids even with the help of Suboxone was a wild nightmare. I was insufferably irritable, and I couldn’t sleep. My joints swelled up, and the orthopedic injuries to my hip and back returned, which brought on a bout of post-traumatic stress as I found myself reliving the accident again, feeling sorry for myself, then becoming enraged and finally just tired. Moreover, the doctors worried that my liver might not be able to handle even buprenorphine, and the realization that my liver might just shut down at any moment made me anxious. It’s no surprise I couldn’t sleep.

For the salvation of my life in that hopeless moment, I give full credit to my wife. And not just in the poetic sense of giving me something to live for—she saved me in a very real and medical way. After I’d lost a few days in detox and was sure I couldn’t survive, my wife got on Google looking for “alternative opioid treatment” and after a few clicks she found herself staring at a recipe for marijuana butter.

She called a friend, who called a friend, and within a couple of hours she had an ounce of some powerful strain of kush, and she followed that recipe to the letter. Neither of us recalls the web page, but it was probably one of thousands in those early days of the Internet when half the things online seemed to be taboo. She made a small tub of highTHC butter, and then baked up an enormous batch of chocolate chip cookies.³

She brought them to me at the detox centre the next day. I think I ate just three of them, but after about half an hour, my body began to feel light. The pain in my back became tolerable, like a dull thudding ache rather than a searing bolt of terror. My anxiety and nausea melted away, I became relaxed and calm, and within another hour I was fast asleep. I slept for three days, waking up only long enough to eat more cookies. I quit detox then and there. I quit every other type of medicine. My future, whatever it was, lay in cannabis.

In the weeks that followed, my wife and I read everything there was to read about cannabis—about Dr. Mechoulam and cannabinoids, Pierre Trudeau and the Le Dain Commission, Jim Wakeford and Terry Parker. We navigated the bureaucratic terminology and convoluted guidelines of the MMAR, and decided I had to apply for a Section 56 exemption. With cancer I was eligible—at the time, only patients of cancer, AIDS, epilepsy, multiple sclerosis, and severe arthritis could apply. Today, thankfully, there are dozens of eligible ailments. Sure, I could have called my cousins and landed an endless supply of black-market weed to self-medicate, but even in my desperation I felt resolved not to rekindle my ties with my dubious past. Health Canada obliged me to have two doctors sign off on the prescription, which wasn’t terribly difficult given the horror of my medical chart.⁴ A few months after my diagnosis of cancer, diabetes, liver disease, and opioid addiction, I became the hundredth or so Canadian to receive a Section 56 exemption under the MMAR. The license was full of warnings and jargon, but essentially the government of Canada said to me: “Okay Sam, we hear you’re going to die, so here, get high on us.”

1 Prescription opioids like OxyContin are classified as Schedule II drugs in the US and Canada, meaning they have a moderate potential for addiction and abuse. You’ll recall from Chapter Three that cannabis has long been a Schedule I drug, implying it’s even worse. That level of gross negligence in drug policy is the most unforgivable aspect of the whole sordid story of the “War on Drugs.”

2 By comparison, some studies of cannabis have estimated that about nine percent of heavy cannabis users will become addicted. But cannabis addiction and opioid addiction are vastly different things, in terms of what your body endures.

3 As an emerging diabetic, cookies may not have been the best idea for me. But facing pain and death from all directions, I deserved a fucking cookie!

4 The two-doctor provision of the MMAR was a terrible obstacle to most patients back then, because most doctors still believed that cannabis was a dangerous psychosis-inducing drug and only people facing imminent death should use it. Remember, the endocannabinoid system was not yet common knowledge in the medical establishment. Even today most doctors still view cannabis with suspicion.

Excerpted from The Great Cannabis Conspiracy by Sam Mellace. Pre-order the book here.