SPOTLIGHT Interview: Daphnée Elisma of AUBE Patients

We are honoured to have some time to speak with Daphnée Elisma, a medical cannabis consumer and the founding member of AUBE: The voice of medical cannabis patients.

Disponible en français, ici.  

Question 1:        Thank you for taking the time to speak with us about your organization. Can you tell our readers about how AUBE Patients came to be?

This project is the result of a long reflection on the importance of improving access to medical cannabis for patients with a medical need. At the center of the creation of AUBE are Rebecca Fogel and Me Jaqueline Bissonnette, our co-founders. Both are strong and passionate advocates for the human rights, accessibility, research and education of the medical cannabis community. Together, we provide a community for patients and other advocates to voice their concerns and share their knowledge.

The primary vision of AUBE: The voice of medical cannabis patients is to build an evidence-based support community for medical cannabis and to put Quebec at the forefront of cannabis and cannabinoid research and public education.

Our main objective is to promote and defend the rights of the medical cannabis patient community while helping to raise financial resources to fund clinical research and contribute to the development of cannabis and cannabinoid education.

Our organization brings together patients and professionals from many sectors such as health, philanthropy, government, municipal, business, cannabis industry, academic and legal.
 
Primarily, our organization seeks to be an agent of change, particularly against the long-standing health-based discrimination of medical cannabis taxation, which has emerged as the primary access and affordability issue for many patients with legal access to medical cannabis in Canada.  

Question 2: We first met at the Grass on the Hill event hosted by the Cannabis Council of Canada. Your speech resonated with me and prompted an introduction. For those who were not in attendance, can you share a little about what you shared and why it is important?

We used the opportunity of our visit to Parliament Hill during the Grass on the Hill event to present the impact of legalization and regulation on access to medical cannabis. We wanted to highlight that despite several legal advances that have paved the way for medical cannabis in our country since 2001, medical cannabis patients are facing more barriers than ever to accessing this therapeutic product. In particular, the federal government's imposition of an excise tax on medical cannabis is totally unacceptable and inconsistent. This tax is usually applied to tobacco and alcohol, a tax that some call the " sin tax ". Applying it to medical cannabis, in our opinion, creates a social injustice and adds to the various barriers faced by patients and seems to us to be contrary to the tax treatment given to other medicines. We have urged the legislator to remove the excise tax imposed on medical cannabis. We have also argued that it is important for the government to contribute to the research on medical cannabis, as there is little research being done and little of it is of high quality and high standard. In our view, this is due in large part to the lack of funding and the complexities, requirements and delays in the approval process to obtain a research license. We encourage the government to relax the requirements and speed up the approval process for research licenses so that Canada can become a leader in cannabinoid research.

Question 3:        AUBE is focused on the medical aspect of the cannabis industry. How did you come to be interested in the medical cannabis? Why was founding AUBE an important thing for you to do?

As a patient on medical cannabis since 2014 to treat chronic migraines and alleviate the debilitating symptoms of complex regional pain syndrome following breast cancer surgery and as a trained jurist, I am particularly interested in studying discrimination based on health status and the undue hardship of taxing medical cannabis in Canada. 

I founded AUBE to encourage the government to rethink Canada's medical cannabis policy to allow non-discriminatory access to this medicine and to better serve the promotion of human rights by allowing medical cannabis patients to have the right to a standard of living adequate for their health as set outlined in the Universal Declaration of Human Rights.

It is for this very reason that our organization has four main objectives:

1. An organization that is proactive in defending the rights of the community of patients using cannabis for medical purposes.
2. An organization that supports the development of clinical research and the advancement of cannabis and cannabinoid education
3. An organization that promotes access to cutting-edge treatments for patients with chronic diseases
4. An organization that aims to improve the quality of life of patients with chronic and disabling diseases

Question 4:        The Federal Government is undergoing a review of the legislation surrounding the Cannabis Act. We understand that AUBE Patients participated in the public submission period for recommendations to changes to the legislation. Can you share with us what key recommendations you made, and how they will affect the public?

We welcome the fact that the federal government has taken a comprehensive approach to its review of the Cannabis Act by including those who access cannabis for medical purposes. In this legislative review of this ground breaking Act, we want to ensure that the legislators understand the importance of understanding the impact that discriminatory medical cannabis legislation can have on medical cannabis patients' lives.  Deeply convinced that our organization plays a critical role in promoting access to medical cannabis in our country and in advancing research, we believe more than ever that we must increase our efforts to advance medical cannabis research. We encourage lawmakers to take major steps in reducing stigma, eliminating taxation, and increasing resources for medical cannabis research, access, and education in our country. 

To do so, we recommend:

1. Abolish the taxation imposed on medical cannabis and thus ensure equal tax treatment to other medicines.
2. Adopt policies and programs to facilitate coverage of medical cannabis costs under public and private plans. 
3. Develop and implement a national pharmacare program, and include medical cannabis on the national list of federally and provincially insured drugs.
4. Transform the medical document authorizing the use of cannabis for medical purposes into a true prescription (in accordance with the Professional Code) 
5. Relaxing requirements and expediting the approval process for research licenses to make Canada a leader in cannabinoid research
6. Further develop training programs for physicians, pharmacists and specialized nurse practitioners (NPs).
7. Fund research related to mental health issues and medical cannabis use among women in the LGBTQ+ community.
8. Enabling greater ease of handling of containers in which dried cannabis is packaged for patients with health issues that limit dexterity.
9. Provide for the creation of a patient advisory committee with the specific purpose of better defining patient needs

These initiatives will result in more progressive policies that would reduce unnecessary barriers and difficulties for medical cannabis patients.

Question 5:         Given your expertise in medical cannabis, what advice would you give to someone considering cannabis as a medical tool?

I encourage anyone considering medical cannabis to speak with a medical professional to see if medical cannabis can be part of their treatment plan. Patients have specific needs that are not being addressed and should not be addressed by the recreational cannabis industry. Despite the fact that physicians and nurse specialists are currently poorly educated about cannabis during and after their studies, and are often more reluctant to provide medical authorization for medical cannabis and to develop care plans that include it. They are, nevertheless, the most skilled at guiding patients through the decision-making process. In addition, in our recently submitted brief, we also advocated for patients to be better informed about how to obtain medical cannabis while obtaining evidence-based information for the safe use of the different forms of cannabis, e.g., oil, dried flower, capsules, etc. 

Question 6:        You created AUBE Patients as a means to assist people in their journey with medical cannabis. Did you have people or an organization to assist you in learning about cannabis and how to best integrate it into your life?

After struggling with the use of opioids that were prescribed to me and caused me significant health problems, I wanted to try medical cannabis; however, my treating physicians at the time were afraid to provide me with a medical document. After a long search, Dr. Michael Dworkind, a physician at Santé Cannabis, agreed to help me in my journey to find the best treatment for my condition. By providing doctors and educators who together helped me determine what doses and products work for me, Santé Cannabis clinic has played an important role in my activism and understanding of the issues surrounding the use of medical cannabis in Canada.

Question 7:         As a non-profit working to support the greater medical community, AUBE’s vision is altruistic. How can our readers, and the greater population, assist AUBE in achieving its goals of advancing treatment for people with chronic illnesses, and furthering research into and education about cannabis?

AUBE seeks to engage members of the medical cannabis community to unite our voices as one for greater social impact. As such, we have several categories of membership corresponding to different levels of involvement and support. Whatever type of involvement you can commit to, we invite you to participate in amplifying our voices! 
We invite you to express your interest in joining our organization by visiting our website at 

https://aubepatients.ca/en/register/



Question 8:        The cannabis industry in Canada is a beacon for the rest of the world, helping show humanity the vast benefits of legalized cannabis. With Germany, Northern Ireland, the United States, and many other countries engaging in some level of discussion on legalized cannabis, what insights would you offer them about legalizing medical cannabis?

Any country wishing to legalize medical cannabis should avoid adding a tax on a medication that patients need, as this is a discriminatory and poor public policy that impacts access to medical cannabis for patients.

Recently, the U.S. Senate passed the Medical Marijuana and Cannabidiol Research Expansion Act, a bill introduced by senators with the aim of expanding research on cannabis-derived medicines. 

Once signed by the U.S. President, and to the extent that this legislation achieves its goal of facilitating research on cannabis and its potential health benefits by expediting the application process for scientific studies on cannabis and removing existing barriers for researchers that frequently delay the research process, we risk losing the opportunity for Canada to become a leader in cannabinoid research, particularly on the four priorities of safety, efficacy, dosing and administration. 

It is therefore imperative that Health Canada be able to relax the requirements and expedite the approval process for research licenses so that our country can establish a strong reputation in the cannabis research race. Canada must not lose the advantage of being one of the first western countries to legalize access to medical and recreational cannabis. We believe that Canada must move from being a pioneer to a leader in the field of medical cannabis.

Question 9:        For the readers and greater community looking to support AUBE Patients and its’ mission, how can they contribute to your mission?

Fundraising is an integral role to ensure that AUBE can continue to advocate for medical cannabis patients in Quebec. By donating, you are demonstrating that the health of patients is important to you. Your contribution allows us to go further so we can provide patients with a platform to be heard and listened to, along with so much more.

The readers and greater community can also support AUBE’s mission by following us on social media and sharing the content we post. This will assist us in spreading awareness toward the underlying stigma and injustices toward medical cannabis patients.

Patients and industry advocacy is also a vital key in supporting AUBE. The more patients and members of the community find power in their history and journey while collaborating with AUBE; the stronger and more impactful our voice becomes as one.

Question 10:       If there is anything else you would like to discuss, mention, or highlight for our readers, please feel free to include it here.

In closing, I encourage your readers to take action by writing to their member of parliament especially on the issue of taxation of medical cannabis and request that they remove this undue hardship on patients.

We invite them to advocate with us for vulnerable populations and their ability to use cannabis in a safe and supportive environment.