Ever since she was diagnosed with Crohn's disease at 16, Rebecca Fogel has been in and out of the hospital. She was prescribed opioids to manage her pain and eventually became dependent on them.
One physician she saw had previously worked at Santé Cannabis and suggested she try medical marijuana to manage the pain without opioids. That referral, the 28-year-old says, changed her life.
"We structured a treatment plan that was personalized for myself and since then I haven't had to use opioids unless in crisis."
But not everyone will have access to the care Fogel says "saved her life." Santé Cannabis is in trouble and just announced it will not take on any new patients due to a lack of funding.
The organization, which provides patients with resources on where to find and how to use medicinal cannabis, has relied on public funding and private grants from marijuana companies up until now. But with the pandemic hitting the pot industry hard, companies started pulling their grants – leaving Santé Cannabis dry.
"We had to scale down our staff to be able to focus on the continuation of care to our current patients," said Erin Prosk, president and co-founder of Santé Cannabis.
"That means thousands of patients across Quebec will not be able to have access to health-care professionals to support the safe and effective use of cannabis for therapeutic reasons."
Providing expertise but not products
Santé Cannabis is the only no-fee medical cannabis service covered by Quebec's public health insurance.
Patients would get a referral from their doctor, then be paired with a nurse-practitioner and physician to learn which cannabis products could work for their specific needs. The organization does not sell cannabis.
"It really is an essential health-care service that isn't offered by the SQDC, isn't available in pharmacies and clinics or hospitals across Quebec, we're here because there's an important and critical need," said Prosk.
The SQDC is the government agency that operates cannabis stores in the province, the Société québécoise du cannabis.
Most patients who go to Santé Cannabis deal with chronic illness and pain — conditions that can't be cured. They have to have tried other forms of treatment and therapies before turning to medical marijuana.
"So they're coming at the end of their rope. They are suffering. Chronic pain touches every corner of their lives," said Dr. Michael Dworkind, the co–founder and medical director of Santé Cannabis.
"The good news is that it makes a significant difference in people's lives, in such ways that they can sleep, can function, some even go back to work."
By law, only doctors and nurse-practitioners can write a medical document like a prescription for cannabis. But less than 10 per cent of doctors in Quebec actually prescribe cannabis, the lowest in Canada, said Dworkind.
Quebec's cannabis stores, run by the SQDC, are not allowed to give advice to their customers. They may only distribute recreational cannabis, said spokesperson Fabrice Giguère.
The SQDC generated a comprehensive income of $66.5 million in its last fiscal year, nearly double the figure for the preceding one. Prosk says Santé Cannabis would only need about one per cent of that figure to resume its normal operations.
"It's really not a significant amount of funding when you consider the service we provide and the availability of these funds," she said. "We're calling for that allocation to be prioritized for the vulnerable populations we serve."
A spokesperon with Quebec's Health Ministry would only say that medical cannabis is regulated by the federal government, while provinces regulate the sale and distribution of recreational cannabis.