441-01468 (Health)

Background on cannabis for medical purposes in Canada

Canada’s medical cannabis regime was created and then shaped over time by successive court decisions, which resulted in the evolution of a framework of legal access to cannabis for medical purposes.

This model has evolved over the past two decades, from one that initially provided individual exemptions to enable medical patients to possess cannabis for their personal consumption, to a system of federal licensure that allows patients, with the support of their health care practitioner, to obtain cannabis from a licensed producer, to cultivate their own cannabis, or to designate someone to cultivate it on their behalf.

In 2015, when the Government of Canada announced the commitment to legalize and regulate cannabis for non-medical purposes, a Task Force was put in place to consult and provide advice on the design of a new legislative and regulatory framework for legal access to cannabis.

The Task Force engaged extensively with provincial, territorial and municipal governments, experts, patients, advocates, Indigenous governments and representative organizations, employers, and industry.

In the final Task Force report (2016), it was recommended that the federal government maintain a separate medical access system (from non-medical) and commit to reviewing it within five years.

Since October 17, 2018, the Cannabis Act and the Cannabis Regulations now govern Canada's cannabis for medical purposes program.

The Cannabis Act and Cannabis Regulations strictly regulate the production, distribution, sale and possession of cannabis in Canada, including cannabis for medical purposes. The oversight of cannabis production is a shared responsibility across federal, provincial, territorial, and municipal governments.

Under the Cannabis Regulations, Canadians who have been authorized by their health care practitioner can access cannabis for medical purposes in three ways:

1. purchase quality-controlled cannabis from a wide variety of federally licensed sellers inspected by Health Canada;
2. produce a limited amount of cannabis for their own medical purposes; or,
3. designate someone to produce it for them.

Individuals who are authorized to produce cannabis for medical purposes must abide by the requirements of the Cannabis Regulations. In addition, they must abide by all other applicable provincial, territorial, and municipal laws and by-laws, including complying with fire and building code regulations and any applicable landlord and tenant regulations.

Health Canada’s role

Health Canada is committed to protecting patients’ rights to reasonable access to cannabis for medical purposes and recognizes that most patients are using the medical access program for its intended purposes. Since the coming into force of the Cannabis Act and the Cannabis Regulations, however, Health Canada has seen a concerning trend with the size of certain personal and designated production sites and issues associated with them. 

As in any regulatory framework, there will be instances where individuals choose to operate outside of the law, and abuse of the medical purposes framework undermines the integrity of the system that many patients and health care practitioners rely on to access cannabis to address their medical needs. 

In April 2022, in an effort to address the risk of abuse and preserve the program’s integrity, Health Canada published Guidance on Personal Production of Cannabis for Medical Purposes. The document outlines proposed factors Health Canada may consider when making a decision to refuse or revoke a registration for personal or designated production of cannabis for medical purposes on public health or public safety grounds, including the risk of cannabis being diverted to an illicit market or activity. 

Health Canada continues to strengthen its oversight and reduce the risk of abuse of the cannabis for medical purposes registration program, using authorities under the Cannabis Regulations, by: 

• conducting additional verifications when warranted (e.g., contacting the Health Care Practitioner (HCP) to confirm the validity of the medical document and to confirm the daily dosage amount); 
• refusing or revoking a registration if it is determined that an applicant has submitted false or misleading information as part of their application, such as a forged medical document; 
• proactively sharing information with provincial and territorial medical licensing bodies about the authorizing practices of HCPs in their jurisdiction, to inform any action they decide to take; 
• verifying that there are no more than four registrations at any given production site—the maximum allowed in the regulations—to reduce the risk of large-scale production sites;
• conducting inspections of personal registration and designated production sites to further verify compliance with the regulations; and,
• acting on evidence from law enforcement that individuals who are registered to grow cannabis for medical purposes are not respecting the terms and conditions of their registration or the regulatory requirements.

As of April 30, 2023, Health Canada has refused or revoked over 1,800 registrations under the Cannabis Regulations, including over 1,200 for reasons of public health and public safety. 

Provincial, territorial, and municipal roles

It is important to note that different levels of government and law enforcement have roles in maintaining public safety with respect to cannabis. It is the responsibility of municipalities to enforce their bylaws with respect to cannabis production, and law enforcement has the authority to take action against illegal cannabis activity under the Cannabis Act and against those who operate outside of the legal framework. 

Some communities have been successful in creating by-laws to limit the impact of the production of cannabis in residential areas and we plan to address this issue in upcoming outreach activities.

Health Canada encourages all provinces, territories, and municipalities to use the tools at their disposal to confirm that individuals meet all standards and by-laws. This includes implementing any limitations on zoning, location, and nuisances such as noise and lighting that they feel are appropriate in their jurisdictions.

Municipalities could require building permits and inspections of electrical work at personal production sites. Please note that it is outside of Health Canada’s jurisdiction to enforce provincial or municipal legislation.

Municipalities may also wish to refer to the Municipal Guide to Cannabis Legalization developed by the Federation of Canadian Municipalities, which provides guidance in areas such as odour and other nuisances.

Health Canada engages and collaborates with provincial and territorial (PT) partners on a regular basis, including at a bi-monthly meeting with senior officials from each PT, and on an ad hoc basis regarding specific issues. In February 2023, Health Canada organized a multi-sectoral meeting with PT and municipal governments, as well as law enforcement partners, to discuss personal and designated production of cannabis for medical purposes.

Support for law enforcement

Health Canada actively supports law enforcement by providing a dedicated 24-7 service to confirm whether specific individuals are authorized to possess or produce a limited amount of cannabis for medical purposes. The Department also provides information, where appropriate, to law enforcement and other authorities to assist with active investigations.

Legislative review of the Cannabis Act

On September 22, 2022, the Minister of Health and the Minister of Mental Health and Addictions launched the legislative review of the Cannabis Act. An Expert Panel is leading the review and a report.

Among the key themes that the Expert Panel is exploring is the impact of the legalization and regulation of cannabis on access to cannabis for medical purposes.

The Expert Panel will also be focusing on identifying priority areas for action with regards to protecting young persons and protecting public safety.

Those who wish to provide input may contact the Cannabis Act Legislative Review Secretariat at legreview-examenleg@hc-sc.gc.ca.

A final report will be developed in the second phase of the review and will include findings or recommendations, which will be tabled in both Houses of Parliament by March 2024.