The executive director of AIDS Saskatoon sees his clients using marijuana as a tool to fight a more harmful addiction to opiates.
Jason Mercredi said he believes in pot as a harm reduction measure. He worries it could become inaccessible to his clients as more and more landlords ban marijuana use from their properties.
Research suggests cannabis use could be therapeutic for opioid users and possibly decrease their opioid use, but researchers admit clinical trials still need to be done.
Mercredi said many of the people who access services at AIDS Saskatoon are opioid users and cannabis use is common among them.
"It's a form of harm reduction and it's about to be a legal form of harm reduction, except for people who are in poverty and are renting," said Mercredi
"It makes it quite difficult to cope with their conditions if they can't use in public or at home. There's going to be no smoking bars or anything like that."
Mainstreet Equity, which owns hundreds of rental units in Saskatoon, has announced plans to ban all types of smoking in its units and on balconies, starting this fall. The ban will extend to medical marijuana.
The Saskatchewan Housing Corporation has issued a similar notice.
The province has also announced there will be no smoking or vaping bars allowed.
"The number of apartments doing the bans make it fairly hard for people who are living in poverty to use, which is quite concerning," said Mercredi. "It's only a matter of time before it goes to the courts."
Edible marijuana products are not slated to be legalized under the new guidelines in Saskatchewan, so people without a prescription would have to stick to smoking and vaping.
'Prohibitive nature' of pot holding up studies
Mercredi identifies two reasons his clients abuse opioids: pain management and trauma.
At least one of the country's foremost researchers agrees, but the proof is in observational data, a low level of evidence. There is a move now toward clinical trials as legalization looms ever-closer.
"The clinical trial evidence which physicians rely on to make clinical decisions, that's not there," said Dr MJ Milloy, a researcher at the BC Centre on Substance Use.
There is no cure yet for opioid use disorder, but Mercredi said he sees cannabis improving the quality of life of his clients.
"It seems like a no-brainer to have it so people can use in their homes," he said.
Federal health minister Jane Philpott told media last June that legalizing cannabis and the issue of opioid use are separate and that the potential harms and benefits of marijuana still need to be fully explored.
The BC Centre on Substance Use is attempting to "fully explore" the issue in a new study funded by Canopy Growth Corp, a medicinal marijuana producer.
"These are studies where we randomly assign patients to use cannabis or not. Oftentimes they have placebos so people don't know what they're getting. This is the next step. That's where we'll learn if cannabis will be an effective treatment or not," said Milloy.
Prescriptions are important
Many marginalized people who live in low-income housing don't have strong relationships with family physicians and therefore may face barriers to obtaining a medicinal marijuana prescription, according to Milloy.
Without it, they have little legal standing in the fight to smoke pot in a rental unit that prohibits weed use.
A prescription requires a postal address, access to a computer, and the ability to order online — all barriers for many people suffering from opioid addiction.
"It's not really legalization if you're allowed to use it, but can't use it in your rented home or a park or a social setting," said Milloy.
He said that if those who need it for health reasons can't access it, "It becomes difficult to argue the true legal use of cannabis."
Pain and trauma treatment
Mercredi's theory that marijuana can help treat physical pain and PTSD may not be far off.
Dr Milloy's research also focuses on patients living with HIV. Chronic pain is a common symptom of those patients and they often have high levels of physical and psychological trauma.
"For those reasons we know cannabis use is very common. There's some evidence to suggest cannabis is useful in treating pain and PTSD," said Milloy.