Medical patients have always been the lifeblood of the fight for cannabis legalization.

In recent history, it was Neil Allard in 2016 who pushed a Federal Court judge to amend the Marihuana for Medical Purposes Regulations (MMPR), ruling it a constitutional right to grow cannabis for medical purposes. A year prior, activist Owen Smith won a challenge in the Supreme Court of Canada expanding the definition of medical cannabis to include edible products like pot brownies and oils.

Countless medical-system rejects—alongside their frontline workers and advocates—testified, rallied, and risked their freedom to earn Canadians a front-row seat to this historic shift. But as the country basks in its lauded global status as the first G7 country to federally legalize weed, it’s the recreational consumers who have taken centre stage while the patients have somehow slipped, yet again, behind the curtain.

Health Canada has said it will revisit the existing program, the Access to Cannabis for Medical Purposes Regulations (ACMPR), in five years. In the meantime, consumers looking to medicate with cannabinoids will be left with two options: wait for a mail-order delivery from a federally approved licensed producer (LP) or queue up with the recreational users. Many believe the distinction between the consumers is in itself reductive and should be eradicated in favour of a therapeutic understanding of cannabis, which has been validated, given that everyone will be purchasing their cannabis from the same limited pool of prepackaged government-warehouse bud.

Packaging, branding, and consumer education have also been drastically limited by the Cannabis Act, which could have been remedied through customer interactions had the legislation not also effectively rendered Vancouver’s 100-plus brick-and-mortar dispensaries “black market”. For years, these shops served up, without permission, a wealth of knowledge for the dejected Canadians who’d slipped through the cracks of the western medical system.

Under new provincial laws, cannabis stores must close and apply for a new licence, restocking, if approved, with product sourced from the B.C. Liquor Distribution Branch (LDB).

In the B.C. legislature on Monday, Solicitor General Mike Farnworth, the NDP’s appointed weed guy, issued a warning to pot shops. He said if dispensaries hope to transition, it’s in their “best interest” to shut their doors. If they don’t, he says, the government will do it for them.

On Tuesday, Vancouver police chief Adam Palmer assured the community that illicit dispensaries won’t be forced to close in the immediate wake of October 17, but these aren’t comforting words to anyone who knows the raids will inevitably come.

“Most people like the novelty of having a dispensary, but they don’t really understand why it’s critical that they be in every neighbourhood,” says Dori Dempster, executive director of the Medical Cannabis Dispensary.

Before getting into her decade spent running one of Vancouver’s staple shops, she shares the story of Jim Ryder—a customer who passed away last October.

“Jim was an amazing person. He kept us grounded and helped us understand cannabis is medicine and is needed in many different forms,” she says during an interview at the East Hastings dispensary.

Mobility issues made for a long and arduous trip from Ryder’s home in East Vancouver to the B.C. Compassion
Club on Commercial Drive, one of only two shops available to patients at the time.

That all changed the day Ryder walked into Dempster’s shop. She recalls the man, then in his mid-40s, breaking down in tears at the relief of finding a dispensary within walking distance of his home.

“Member 27,” she says, smiling. Dempster would go on to serve Ryder for the final eight years of his life, right up to bringing him joints in the hospital near the end of his life.

“We remember our people. The beauty of having a frontline dispen­sary is that people have that added level of care; they get that sense of belonging to something and that somebody loves them.”

With easy access to his medicine, Ryder was able to live a relatively conventional life. He became a vendor for Megaphone magazine and began writing, eventually publishing books of poetry. And the dispensary staff made sure he was always looked after, helping with things like chauffeuring him to community events.

“Employees under the new employment agreements won’t be allowed to have these types of relationships with patients,” she says.

“My fear with nonmedical stores proliferating is the misconception that medical patients can just use that as an access point. It’s so backwards to how this will actually unfold.”

Health Canada left the decision on implementing store regulations to the provinces. On legalization day, there will be only one public legal store open in B.C., located in Kamloops.

And don’t think this is a battle to be fought only by activists and dispensary owners set to lose their businesses.

Dan Sutton, founder of the federally licensed cannabis producer Tantalus Labs, says the country’s already legal companies have a role to play in preserving the federal medical program.

“I truly believe anyone who contextualizes their cannabis use as therapeutic and derives any sort of wellness benefits from it should have access to a medical system,” he says in a phone interview with the Georgia Straight.

“I am glad the system is being thus far preserved and at the same time fearful that the excitement around rec[reational use] will drive other LPs to focus more on volume-oriented channels instead of the users with the most need.”

Tantalus has taken strides to prioritize its existing ACMPR patients, including absorbing the newly imposed medical excise tax on cannabis products.

“As an LP, we have a lot of incentives—both idealistic and business—which motivate us to preserve and grow our medical channel. The way that we do that effectively is to make sure that there is consistent supply to those patients,” he says.

As it stands, Sutton predicts that maintaining supply will be a significant problem for the province.

“The B.C. LDB was able to secure 18,300 kilograms for the next calendar year, and the aggregate demand, including the illicit market in British Columbia today, is somewhere around 200,000 kilos,” he says.

“Even if we were to double or triple production…we still wouldn’t be anywhere close to where we need to be.”

Even after the market stabilizes, the cannabis community fears that there will be no need to include pot in provincial health programs or to fund scientific research programs if it becomes detached from its unofficial classification as a medical substance.

Dempster says she fears that if B.C. doesn’t create more access points for patients, the most affected will be the homeless living in the Downtown Eastside. Without a fixed address or credit card, the process of registering with a producer will present barriers.

She recounts one instance of signing up a “sweet little man” several years ago.

“When I got to filling in the address, I said ‘Where do you live?’ and he said ‘Hastings Street.’ And, being so new back then, I said ‘Where on Hastings Street?’, expecting a number.”

The man told her he lived under theoverpass just a few blocks down the road.

“It was my first real confrontation with the fact that some people don’t have homes.”

Within two hours, the man had a membership and access to cannabis.

“It breaks my heart to hear the politicians say that the process will take some time…I always think back to that little guy who had just crawled out from his night sleeping under the overpass…and I think how is that man going to access his medicine?

“For that, no government at any level seems to have an answer.”