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Buying Cannabis Vahdat

These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The content of this summary does not necessarily reflect the official opinions of the European Union, nor the official opinion of the Republic of Tajikistan, and should be seen as the product of CADAP 5. Updated: August Studies on the prevalence of drug use among the population of Tajikistan were not carried out in In total, 5 respondents were interviewed, of which 2 The study found that the female respondents had a slightly higher awareness of the existence of drugs than the males. Some Among all respondents, Some 1. The survey results showed that However, When asked about drug use, 0. The consumption of inhalants was the most prevalent. According to the responses, 1. The use of marijuana or hashish was second most popular, with 0. The first experience with drugs most often took place at the age of 16 and usually the drug was marijuana, amphetamines, or tranquillisers. In a series of educational, sports and cultural events aimed at promoting a healthy lifestyle were organised. Participants were given information about the problems of drug use in modern society and its consequences. Health bulletins were issued and health information prepared in both the Tajik and Russian languages. Articles were published in newspapers and magazines and awareness-raising programmes were broadcast on three TV channels Channel One, Safina, and Jahonnamo and on the Republican radio. Anti-drug events are also organised annually to coincide with the International Day against Drug Abuse and Illicit Trafficking 26 June. Studies to estimate the population of opiate users, including injecting drug users IDUs , were not carried out in Drug treatment is carried out in the Republic of Tajikistan in specialised drug treatment facilities. The State guarantees anonymous drug treatment. In a total of 1 people received inpatient treatment in substance abuse treatment centres. Of these, The number of drug addicts who received hospital treatment in increased by The main strategic focus of this programme included:. As of 31 December , the country had 3 officially registered HIV cases cumulative number , of which The HIV prevalence rate was HIV cases have been registered in 66 of the 68 districts of the country. The average estimated number of HIV-positive people in the country ranges between 6 —10 Moreover, in recent years, the number of newly reported HIV cases among females has increased almost 2. Thus, in the proportion of women among registered new cases was 8. In , of the total number of registered HIV cases, In the country registered new cases of HIV infection, of which Among the newly registered HIV cases, people The number of reported cases of hepatitis C virus HCV in was According to the Centre for Health Statistics of the Ministry of Health of Tajikistan, in there were cases of syphilis infection among the general population, of which were male and were female. The official data from Tajikistan provide very limited information on the number of deaths related to drug use. Drug treatment is carried out in the Republic of Tajikistan at specialised drug treatment facilities. Services provided by specialised drug treatment agencies in the country include inpatient and outpatient care, anti-relapse therapy, rehabilitation programmes, work with drug addicts and efforts to prevent substance abuse. Treatment of drug dependence in the Republic of Tajikistan is conducted mainly at public drug treatment facilities, including:. The availability of substance abuse treatment beds in the Republic of Tajikistan is 4 per inhabitants. Harm reduction programmes are implemented to minimise the consequences of drug use. Geographically, the HR programme covers almost the whole of the country. In the Government of the Republic of Tajikistan reviewed and supported the letter of the Ministry of Health of the Republic of Tajikistan asking it to consider a pilot implementation of a programme of OST. Up to patients have received OST at this centre. This is the first gender-sensitive project in the Republic of Tajikistan. The centre provided low-threshold services laundry, showers, communication, leisure, food, sanitary napkins and legal advice and referral to doctors. In this centre, 62 were re-adaptation clients, 40 of whom abstained during the reported period, and two patients were referred for further rehabilitation to the Tangai Republican Rehabilitation Centre. These clients received low-threshold services and advice at the drop-in centre. Five hundred motivational packages were given to the most active clients. Harm reduction programmes were first introduced in the Republic of Tajikistan in in Dushanbe, Khujand and Khorog, mainly in the form of needle exchange programmes NEPs and via the distribution of information materials. In Kulyab a hour drop-in centre for drug users was opened by the non-government organisation NGO Anis. The NGO Volunteer, which implemented a programme in the Gorno-Badakhshan Autonomous Oblast GBAO , provided services 9 times during the reporting period, including services related to: social support 1 ; prevention 2 ; healthcare 2 ; information and counselling 1 ; psychological care and support ; legal services ; and social services The Social Bureau covered 1 clients people injecting drugs, 9 sex workers, 24 people living with HIV, 89 people with tuberculosis, 52 ex-prisoners with HBV and 15 with HCV, 1 minor at risk, and vulnerable women. As part of this programme, one mobile trust point and four NSPs were established, located on the premises of the National Tuberculosis Hospital in urban health centres Nos 2, 12 and During the reporting period, RAN served 1 clients. A total of syringes were exchanged and 23 condoms were distributed. In a total of 4 The steady increase in seizures of cannabis, primarily hashish, continued in , with the result that cannabis comprised This significant change in the type of drug seized was a result of an increase in the areas sown with cannabis in Afghanistan in recent years. The impurities in the samples of heroin that were seized were found to be from the manufacturing process — 6-monoacetylmorphine and acetylcodeine — and cutting agents of extrinsic origin — caffeine, acetaminophen paracetamol and dextromethorphan. No extrinsic substances were found in the narcotic opium seized in Starch-containing substances were found in just a few samples. The physical appearance of the cannabis resin that was seized was either in the form of a rod or of material compressed into rectangular tiles. The dimensions of tiles varied within the following ranges: width 14—16 cm, length 21—23 cm, thickness 2—3 cm. Drug prices in Tajikistan increase in proportion to the distance from the state border. The legislation of the Republic of Tajikistan in the field of drug control is based on the rules and recommendations of the United Nations Drug Treaties and Conventions , , , of which Tajikistan became a signatory in and The main purpose of Law No. Law No. The main objectives of the law are the protection of the rights and legitimate interests of people suffering from substance abuse and addiction, establishing bases and procedures for the provision of substance abuse treatment, and the protection and security of professionals providing drug treatment services. Article 6 of the Constitution guarantees the following types of drug treatment and social protection:. The main objective of this law is the realisation of the national policy and international agreements of Tajikistan in the sphere of licit trafficking of narcotic substances, psychotropic substances and precursors, countermeasures of their illicit trafficking, prevention of drugs and toxicomania and rendering of narcological assistance to people suffering from drug addiction and toxicomania. The main task of the law is to protect the rights and legal interests of people suffering from narcological diseases, establish grounds and a procedure for rendering narcological assistance and to protect the rights of medical and other workers rendering narcological assistance. According to Article 6 of the Law, the Government guarantees the following kinds of narcological assistance and social protection:. Chapter 22 of the Criminal Code of the Republic of Tajikistan effective from 1 September stipulates responsibility for the following violations of the law related to drug issues:. The National Strategy of the Republic of Tajikistan in the field of the control of narcotic drugs is aimed at preventing the use of the territory of the state by transnational organised drug traffickers to smuggle narcotics, international commitments and the establishment of strict control over the licit movement of narcotic drugs, ensuring the effective fight against drug trafficking, guaranteeing the medical care of patients with drug addiction and increasing international cooperation in this area. One of the measures taken by the Government of the Republic of Tajikistan in the field of drug control is the coordination of bodies at all levels of society in order to synchronise the activities of law enforcement agencies in the fight against drug trafficking, as well as the relevant ministries and agencies in the control of drug trafficking, psychotropic substances and precursors, and drug prevention. The main body that coordinates ministries, departments and organisations in the prevention of drug abuse, regardless of their form of ownership, is the Coordinating Council on the prevention of drug abuse, approved by Decree No. According to the decree, regional, city, and district councils for the coordination of drug prevention activities were established under republican subordination in the Gorno-Badakhshan Autonomous Oblast, Sughd and Khatlon regions, the city of Dushanbe, and other cities and districts. The Coordinating Council is recognised as the supervisory body of the interaction of ministries, departments and state bodies in the conduct of activities aimed at the prevention of the non-medical use of narcotic drugs and psychotropic and other drugs. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. Breadcrumb Home Publications Tajikistan country overview Tajikistan country overview Contents Drug use among the general population and young people Prevention Problem drug use Treatment demand Drug-related infectious diseases Drug-related deaths Treatment responses Harm reduction responses Drug markets and drug-law offences National drug laws National drug strategy Coordination mechanism in the field of drugs References. Agency on Statistics under the President of the Republic of Tajikistan.

Is Marijuana Legal in Iran?

Buying Cannabis Vahdat

Official websites use. Share sensitive information only on official, secure websites. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The Cannabis Act enables Canadians to possess cannabis purchased from a licensed retailer without authorization for either medical or nonmedical purposes. The Cannabis Act is currently the guiding legislation which governs both medical and nonmedical access. The Cannabis Act contains some improvements for patients but is essentially the same as its previous legislation. Beginning in October , the federal government is conducting a review of the Cannabis Act and is questioning whether a distinct medical cannabis stream is still required, given the ease of access to cannabis and cannabis products. Although there is overlap in the reasons for medical and recreational cannabis use, the distinct legislation of medical versus recreational use of cannabis in Canada may be under threat. A large segment of the medical, academic, research, and lay communities agree that there is a need for distinct medical and recreational cannabis streams. Perhaps most importantly, separation of these streams is necessary to ensure that both medical cannabis patients and healthcare providers receive the required support needed to optimize benefits while minimizing risks associated with medical cannabis use. Preservation of distinct medical and recreational streams can help to ensure that needs of different stakeholders are met. For example, patients require guidance in the form of assessing the appropriateness of cannabis use, selection of appropriate products and dosage forms, dosing titration, screening for drug interactions, and safety monitoring. Healthcare providers require access to undergraduate and continuing health education as well as support from their professional organizations to ensure medical cannabis is appropriately prescribed. Although there are challenges in conducing research, as motives for cannabis use frequently straddle boundaries between medical versus recreational cannabis use, maintenance of a distinct medical stream is also necessary to ensure adequate supply of cannabis products appropriate for medical use, to reduce stigma associated with cannabis in both patients and providers, to help enable reimbursement for patients, to facilitate removal of taxation on cannabis used for medical purposes, and to promote research on all aspects of medical cannabis. Cannabis products for medical and recreational purposes have different objectives and needs, requiring different methods of distribution, access, and monitoring. HCPs, patients, and the commercial cannabis industry would serve Canadians well to continue to advocate to policy makers to ensure the continued existence of two distinct streams and must strive to make ongoing improvements to the current programs. These new regulations enable Canadians to possess medical or nonmedical cannabis purchased from a licensed retailer without authorization House of Commons of Canada The overarching goals of this legislation were to eliminate the illicit cannabis market, to provide a safe regulated supply, and to prevent youth from accessing cannabis House of Commons of Canada Beginning October , the federal government is conducting a review of the Cannabis Act and is questioning whether a distinct medical stream is still required, given the ease of access to cannabis and cannabis products. As seen in Uruguay and certain US states, where cannabis has also been legalized, there is debate surrounding the best policy approach to cannabis use Kilmer In a systematic review on international perspectives regarding implications of cannabis legalization, Bahji et al. The majority of studies reported that cannabis use increased over time, and there were increases in the number and rates of emergency room visits for cannabis-related presentations, such as cannabis intoxication and cannabis-related hyperemesis; however, reductions in the rates of opioid prescribing were also noted. There remains significant controversy regarding the overall impact of legalization, especially on mental health and public policy Bahji and Stephenson Bahji et al. The current medical access program for cannabis has both strengths and limitations. Advantages of legalization of nonmedical cannabis include reducing harms from criminalization of cannabis possession, regulating the distribution and content of product, and increasing government revenue through taxation. However, one of the most important limitations is that the Cannabis Act does not ensure medical cannabis patients will obtain any healthcare provider support as the act does not require this interaction. The Cannabis Act should provide mechanisms to support both patients and healthcare providers. Patients using cannabis for medical purposes require reliable sources of information and guidance from well-trained healthcare providers. Similarly, healthcare providers require ongoing support such as continuing education programs and appropriate documents for authorizing cannabis. Although some resources currently exist for healthcare providers and the public including information provided on websites by the government of Canada and programs created by universities, they are sparse and inadequate Health Canada ; UBC CPD Beyond direct patient benefits, medical involvement has contributed to the discovery of new therapeutic applications for cannabinoids including chronic pain management, multiple sclerosis, chemotherapy-induced nausea and vomiting, epilepsy, and palliative care, in patients who are insufficiently managed via other modalities. As such, cannabinoids are generally a highly acceptable option for many patients and may play a useful role as an adjunct therapy Busse et al. In some reports, over half of cannabis consumers were able to reduce or adjust their use of other medications, including opioids, through addition of medical cannabis to their regimens Minhas and Lunn In a systematic review, Nielsen et al. Of the 19 preclinical studies, 17 provided evidence of synergistic effects from cannabinoids and opioid co-administration Nielsen et al. In general, randomized clinical trials provide stronger evidence than do observational studies, while rigorous observational studies provide stronger evidence than uncontrolled case series. Indications approved by national regulatory authorities, and for which they document conclusive or substantive evidence in a publication, includes chemotherapy-induced nausea and vomiting, patient-reported multiple sclerosis spasticity symptoms, and chronic neuropathic pain National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda Authors report moderate evidence for improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis and limited evidence for cannabis and HIV-associated cachexia, symptoms of Tourette syndrome, anxiety symptoms as assessed by a public speaking test, in individuals with social anxiety disorders , and posttraumatic stress disorder National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda A more recent systematic review and meta-analysis also reported on potential therapeutic benefit of cannabinoids McKee et al. The authors concluded there is limited evidence of the effectiveness of CBD to treat psychiatric symptoms McKee et al. Similarly, a systematic review on the effectiveness of medical cannabis for psychiatric, movement and neurodegenerative disorders reported that a definitive conclusion on cannabinoid efficacy could not be drawn Lim et al. It reported that upon evaluation of trials, there were significant methodological issues including inadequate description of allocation concealment, blinding, and underpowered sample size Lim et al. Another publication included an evidence map of 44 systematic reviews which included evidence from individual studies Montero-Oleas et al. Evidence was heterogeneous regarding the conclusions and quality of primary studies Montero-Oleas et al. Medical cannabis has also been examined for conditions such as gynecologic pain conditions, with most data from surveys of women in prospective cohort studies Liang et al. Although most women reported pain reduction, the authors caution that interpretation of data is limited due to varying cannabis formulations, delivery methods, and dosages precluding definitive conclusions Liang et al. Through the Cannabis Act, these changes can be documented and supported under medical supervision. Moreover, to better understand potential harms associated with cannabis use, Health Canada maintains a system for reporting adverse events associated with cannabis products through its Canada Vigilance website Health Canada a. The government of Canada outlines adverse event responsibilities for both retailer and healthcare providers. Consumers or patients who are using cannabis products for medical or nonmedical purposes and who have experienced a side effect are encouraged to consult with their healthcare practitioner for both management and for completion of side effect reports. This can be done online or via a toll-free telephone number. Guidance on how to complete the report is provided on the website, and additional information can be found at MedEffect Canada Health Canada b. It was created from the Canada Health Act and strives to comply with the five pillars of that act, which states that the system must be universal, publicly administered, have comprehensive coverage, portable across provinces, and accessible to the population. An important limitation of the current Cannabis Act is that decisions about retail cannabis distribution are delegated to individual provinces and territories, resulting in regional heterogeneity in retail approaches. For example, in Quebec, there are government retailers which sell cannabis, whereas in British Columbia, there are mixed public and private retail businesses Fischer et al. In terms of access, there are inequities across provinces. The Cannabis Act permits direct mail order and home delivery anywhere in Canada for individuals medically authorized to use cannabis. However, this is only available in certain provinces under the Cannabis Act, thereby limiting access to eligible patients. Regulatory variations across provinces contribute to uncertainty of healthcare providers about appropriateness of authorizing medical cannabis, namely cannabidiol CBD , to pediatric populations for the treatment of epilepsy Minhas and Lunn Provincial discrepancies have also raised concerns about disparities in cannabis use and harms. Following legalization of recreational cannabis, there has been increased concentrations of cannabis retailers in neighbourhoods of lower socioeconomic status Myran et al. The variation has been fuelled by rapid expansion of retail outlets in certain jurisdictions, especially those with a private retail market Myran et al. There are also limitations with the existing medical document which requires the clinician to provide the quantity authorized in grams of dried flower per day. Cannabinoids extracted from dry flower varies, which renders daily dosage conversion from milligrams of the desired cannabinoid to grams of dried cannabis highly variable and complicating the authorization process. Furthermore, different processes for cannabinoid extraction from dried cannabis plant may result in extracts with distinct cannabinoid, terpenoid, and residual solvent profile Hazekamp The most appropriate form of medical cannabis depends on the indications for use. Accurate and appropriate prescription of oral oils and capsules requires specifying milligrams of extracted delta-9 tetrahydrocannabinol THC and CBD. Furthermore, the medical document does not require specific dosing instructions. Documents should also be revised to allow for the inclusion of more than one product and those administered by different routes i. The most appropriate, accurate, and pragmatic solution is the use of a standard medical prescription document for all clinicians who authorize cannabis. From a fiscal perspective, there are also important considerations for accessibility to cannabis. The Cannabis Act allows costs for Canadian veterans and other patients, such as those suffering from workplace injury, to be covered by some public or private insurers. This process recognizes cannabis as a medical necessity for these patients. The process of medical authorization of cannabis enables coverage to be determined and maintained as deemed medically appropriate. Additionally, in contrast to other prescription medication, sales and excise tax add further inappropriate financial burden to patients. Most patients pay out of pocket due to lack of insurance coverage. As with all prescription medications, opioids are not taxed and are covered by government and insurance plans; there is concern that patients may choose opioids over cannabis even though they are less safe, on a patient and societal level, for long-term use Minhas and Lunn There are also noteworthy limitations with the Cannabis Act. Despite a regulatory system in place which allows access to cannabis for medical purposes since , regulatory requirements restrict researchers to using exclusively products manufactured under Good Manufacturing Practices GMP in human clinical trials. The purpose for this restriction is to ensure products adhere to quality standards of consistency and control Rueda et al. GMP cannabis not being commercially manufactured, renders the product, for the most part unavailable severely impeding research. Since the cannabis industry is not required to partake in the standard drug approval process when seeking approval for medical use, there is little incentive to support research to have their products approved for the medical market Rueda et al. Furthermore, researchers must wait in the same cue as licensed producers when seeking approvals from Health Canada, making for potentially lengthy waiting times and delaying study initiation. The goals of medical and nonmedical cannabis are very distinct. In our view, access to medical cannabis cannot be ensured through the current nonmedical framework, and these two streams require distinct access streams. Reasons for the separation of the two streams are outlined in Table 1. Several studies have been conducted on the use of cannabis for the management of diverse types of chronic pain. Research typically demonstrates moderate benefit of cannabis in chronic pain management. There is also evidence for efficacy of cannabis in the management of comorbidities, including sleep disorders, anxiety, and appetite suppression, and for managing symptoms in some chronic conditions associated with pain including HIV, multiple sclerosis, fibromyalgia, and arthritis. However, there exist several challenges within cannabis-based medicines and chronic pain research. With respect to some co-occurring conditions, there still exist relatively few controlled trials. As we reviewed, data related to comorbid conditions, it was not typically the primary focus of included studies and, subsequently, may be underpowered. The lack of comparative studies where the safety and efficacy of cannabis and cannabis-based medicine are compared with typical pain treatments is also problematic. In addition, challenges commonly exist with unmasking in placebo-controlled trials, representing potential risk of bias, especially as pain and many comorbidities are measured with VAS or other subjective measures Bell et al. Importantly, cannabis use may also be associated with both short-term and long-term harms, and these effects have significant inter-patient variability Health Canada Short-term risks include drowsiness, slowing of reaction time, reducing ability to pay attention, and impaired coordination, all of which can impact driving or operating equipment. Learning and memory can be adversely impacted. Cannabis can also affect mental health and induce panic and anxiety or trigger a psychotic episode Health Canada ; Siklos-Whillans et al. Over time, cannabis use can result in cannabis dependence in the form of addiction, cannabis use disorder, and problematic cannabis use. Addiction can lead to serious harm to health, social life, occupation, and financial future Health Canada ; Siklos-Whillans et al. As with all medications, optimal therapy requires clinical guidance to provide appropriate patient selection, safe dosing, method of administration, monitoring of efficacy and tolerability, avoidance of side effects, drug and disease interactions, and patient education Huntsman et al. Pediatric use, usually for management of refractory epilepsy, is an extreme example of the need for a medical stream to ensure not only safety and efficacy but also for access to specific CBD products Huntsman et al. Under the law, cannabis treatment for children must be authorized by a physician or nurse practitioners, which provides an opportunity for patient counselling and education Huntsman et al. This can only be provided through a medical framework. Additionally, if the medical cannabis stream is removed, then pediatric patients will be required to obtain cannabis from a dispensary. However, currently to purchase recreational cannabis, you must be 19 years of age. Another major consideration pertains to the stigma associated with cannabis, which remains a major barrier to use Troup et al. Patients require the support of a healthcare provider not only to manage their own trepidation but also to legitimize use to their family, employer, and broader social network. Moreover, the fact that licensed naturopathic doctors NDs are not included in the list of HCPs who can authorize cannabis should be re-examined. NDs are the very HCPs who are specifically trained in botanical medicine and pharmacognosy the science of natural drugs obtained from organisms such as most plants, microbes, and animals , but they were entirely overlooked in the Cannabis Act. NDs have prescriptive authority in Ontario and British Columbia, and naturopathic medicine is a regulated health profession with government oversight. Therefore, the Cannabis Act may benefit from an amendment to include a regulated health profession that is most familiar with plant-based medicines. Finally, government photo identification is required to purchase cannabis via dispensaries, but not in medical stream. This creates a further barrier for individuals without photo identification, as may be the case for homeless individuals who could benefit from using cannabis as a harm reduction tool. Cost is a major barrier to utilization of medical cannabis. Important issues also exist related to taxation. Currently, medical cannabis users in Canada must pay full sales tax. While this is appropriate for nonmedical use, cannabis is the only prescribed medication to which any taxation applies. We believe this is inappropriate. Currently, patients can claim costs of medical cannabis as a deductible medical expense, if approved by a physician, when filing their annual income tax. The absence of a cannabis medical stream will exclude any possibility of elimination of unfair taxation and remove the medical expense deduction. In Canada, prices of legal cannabis are significantly higher than those from illicit sources, largely due to taxation Health Canada This disincentivizes use of the safe legal source Rosic et al. Therefore, while the Cannabis Act was designed to remove the illicit market, it may actually be strengthening the illicit market when retail prices are too high. Despite the wide spectrum of opinions regarding the need for distinct medical versus recreational streams, there is broad agreement that there is an urgent need for medical cannabis research. There are many areas of cannabis medicine which require better understanding. In addition to regulatory challenges with conducting research, there are also challenges related to the fact that motives for cannabis use frequently straddle boundaries between medical versus recreational use. For example, in the context of stress management and anxiety, individuals frequently report cannabis use for these indications as both medicinal and recreational Mannes et al. In a self-report assessment of cannabis users in Canada prior to federal cannabis legalization, Turna et al. Compared to recreational users, medical users reported more problematic cannabis use and greater burden of psychiatric symptoms, such as anxiety, depression, and trauma. Participants in the dual-motives group reported more daily cannabis use and more alcohol and tobacco use. Moreover, participants using cannabis for both medical and recreational purposes more often used cannabis to treat psychiatric conditions compared to participants endorsing medical-only use. Interestingly, several participants reported decreasing their other medications, such as analgesics, anti-inflammatories, and antidepressants in lieu of cannabis Turna et al. As the authors highlight, reduction of antidepressant doses may be the cause for concern given that antidepressants are first-line efficacious for anxiety and depression Thus, differences in cannabis use patterns and preferences exist between recreational and medical cannabis users and within medical users. As suggested by the authors, dual motive individuals who use cannabis may warrant special attention as a subpopulation Turna et al. Research funding opportunities are made available, both at the federal level, for example, by the Canadian Institutes for Health Research and various provincial initiatives. The absence of a cannabis medical stream will work strongly against ongoing research support Rueda et al. Radio ; Webster In terms of strain and format availability, under the current 2-stream model, licensed cannabis producers offer a wide variety of medical cannabis products e. The absence of a dedicated medical cannabis stream will likely reduce demand for high CBD and low THC chemotypes in oral formulations. As many licensed producers tend to be fiscally motivated, the absence of a cannabis medial stream may reduce availability of appropriate chemotypes and accurate dosing formats. Although most trainees had little exposure to cannabis and cannabinoid-based medicine CBM in their curricula in the past Elkrief et al. Accredited continuing health education programs on CBM are widely available. However, the absence of a cannabis medical stream will likely reduce or eliminate the availability of ongoing medical education. Furthermore, stigma directed at CBM prescribers will likely persist, or even worsen, in the absence of a medical cannabis stream Troup et al. There is controversy within the medical community about the need for separate medical and recreational streams for cannabis Owens Our views are consistent with these latter healthcare associations which are in favor of separate medical and recreational streams. We recommend the continuation of a distinct medical cannabis stream, in addition to several adjustments to improve the current systems in place, as outlined in Table 2. New therapeutic potential for cannabinoids is discovered when observations are documented by HCPs and reporting under medical supervision, as provided through the Cannabis Act. Adverse event reporting could take place through the Canada Vigilance Program Huntsman et al. Community pharmacies are ideally placed to dispense medical cannabis products, as most already have the necessary infrastructure and experience in place for ordering and storing controlled substances and providing education and ongoing support Huntsman et al. Additionally, although it is not standard across the country, some colleges, such as the Ontario College of Pharmacists Ontario College of Pharmacist n. As pharmacists are trained to assess drug-drug interactions and adverse effects, we support the CPHA position statement on medical cannabis which states that pharmacists are best suited to advise patients and oversee the safe storage and dispending of medical cannabis Huntsman et al. Health Canada should also mandate reporting of serious adverse effects associated with medical cannabis by pharmacists and other healthcare providers. From an HCP perspective, we suggest creation of a simplified authorization process to help clinicians i. The tax placed on medical cannabis should be removed. We urge reform to the act permitting the use of GPP cannabis in clinical research as people who use cannabis for medical purposes currently access commercial products manufactured under GPP standards. We also urge for review the quality control regulations of products under the Cannabis Act, since patients who require close dose monitoring and particular formulations require assurance that their products are manufactured to an acceptable standard of quality. It is necessary to incorporate the consumer health products framework, since this will have impact on medical access to CBD products enabling pharmacy support and allow the Cannabis Act to focus on access to THC. Expanding all forms of research, including that on harm reduction and cost-effectiveness of cannabis, since real-world evidence suggests that access to medical cannabis is associated with reduced prescribed medication and healthcare utilization. Individuals using medical cannabis have less opioid use Boehnke et al. In prospective cohorts in Vancouver of persons at high risk of opioid overdose, consistent cannabis use was associated with increased engagement in opioid agonist treatment for opioid use disorder Hurd et al. Lastly, we suggest ensuring the perspectives of diverse patient representatives are taken into account prior to implementing any changes to the Cannabis Act. These reforms could substantially improve health-related outcomes as well as effectiveness and cost-effectiveness of many healthcare interventions. In fact, patient participation is not only regarded as a legal right of patients but is also considered an international gold standard for healthcare systems Vahdat et al. We are a diverse group of stakeholders consisting of clinicians, clinician researchers, nurses, pharmacists, and patient advocates active in the field of medical cannabis. Based on the need to fill a clinical knowledge gap related to cannabis-based medicines for the management of chronic non-cancer pain and co-occurring conditions, we performed an extensive systematic review to guide healthcare providers and patients. CTC and AB drafted the commentary. CM edited the commentary. All co-authors provided input into the contents of the commentary and critically revised and approved the final version. CC has received cannabinoid capsules in-kind from Tilray Inc. He is in the planning phases of becoming an investigator on a survey study sponsored by Doja, from which he does not receive any direct financial compensation; however, graduate students in his lab receive paid research assistantships. He is the coordinating principal investigator on a clinical trial of cannabis for PTSD that is sponsored by Tilray, from which he does not receive any direct financial compensation. Graduate students in his lab receive paid research assistantships from Tilray. She has received honorarium for research projects funded by Canopy Growth Corporation and Tilray. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Find articles by Cecilia Costiniuk. Find articles by Caroline A MacCallum. Find articles by Michael Boivin. Find articles by Sergio Rueda. Find articles by Gary Lacasse. Find articles by Zach Walsh. Find articles by Paul J Daeninck. Find articles by Shari Margolese. Find articles by Enrico Mandarino. Find articles by Jagpaul Kaur Deol. Find articles by Tatiana Sanchez. Find articles by Alan D Bell. Received Jan 18; Accepted Jun 21; Collection date Reasons requiring maintenance of a separate stream for cannabinoid-based medicine CBM. Open in a new tab. Similar articles. Add to Collections. 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Buying Cannabis Vahdat