Legal cannabis isn’t new to Canada—in fact it’s been available to patients with qualifying medical conditions since 2001. There’s no doubt that when cannabis became legal to all adults in 2018, it was made possible in large part by the persistence and advocacy of patients.

“We have to remember that it was medical patients who have allowed us to have a legal framework in Canada in the first place,” says Sabrina Ramkellawan, vice president of clinical affairs at licensed producer Terrascend.

But legalization for all adults hasn’t necessarily benefited medical users. In fact, some cannabis industry experts say increased barriers to access and affordability are setting patients back.

Financial barriers

The most common barrier to medical cannabis for patients is price, says Max Monahan-Ellison, vice president of Canadians for Fair Access to Medical Marijuana (CFAMM).

“The cost is especially challenging for patients who have little access to insurance benefits for their treatment, so these expenses come completely out of pocket,” he says, adding that in his experience, patient costs can range anywhere from $50 to over $2000 per month.Cannabis is taxed twice in Canada, provincially and federally; since there is currently no tax exemption for medical patients, they are taxed at the same rate as recreational consumers. “No other medicine is taxed in this manner; treating medical cannabis in the same way as a recreational or adult product makes it much more difficult for patients,” says Ramkellawan.

Access issues

There are no pharmaceutical points of access for medical cannabis, products are only available through mail delivery. Despite existing prior to legalization, mail delivery became more of an issue after adult-use cannabis became legal says Caryma Sa’d, a Toronto lawyer specializing in cannabis and tenant law. Both Sa’d and Monahan-Ellison shared multiple accounts of patient access issues ranging from condo security refusing packages to delivery issues.