GOVERNMENT OF MANITOBA POSITION PAPER: LEGALIZING, REGULATING AND RESTRICTING ACCESS TO MARIJUANA IN CANADA Submitted by: Julie Frederickson Deputy Minister of Justice and Deputy Attorney General Manitoba Justice Room 110, Legislative Building 450 Broadway Winnipeg, MB R3C 0V8 Telephone: (204) 945-3739 Fax: (204) 945-4133 E-mail: dmjus@leg.gov.mb.ca October 2016 1 I INTRODUCTION In its 2015 Speech from the Throne the Government of Canada committed to legalizing, regulating and restricting possession and use of marijuana in Canada. It has formed a Task Force to engage in fact finding and consultations with provincial/territorial (PT) officials and experts on key issues, with a mandate to report to the federal Ministers of Health, Justice and Public Safety and Emergency Preparedness by November 2016. The Task Force met with representatives from the Manitoba Interdepartmental Working Group on Legalization and Regulation of Marijuana in Winnipeg on August 29, 2016. At that time, Manitoba Deputy Minister of Justice and Deputy Attorney General Julie Frederickson, in her capacity as co-chair of the Working Group, provided the Task Force with preliminary views on consultation issues relating to how best to minimize the harms of marijuana use; establishing a safe and responsible production system; designing an appropriate distribution system; enforcing public safety protection; and continued access to marijuana for medical purposes. At that time the Working Group was not in a position to provide an official Manitoba Government position or views on all of the Task Force consultations questions, but advised the Task Force that it planned to submit an official written position in the near future. This paper is the official written position for submission to the Task Force. II SUMMARY OF THE AUGUST 29 PRESENTATION TO THE TASK FORCE A) Manitoba’s preliminary views on minimizing the harms of use  Almost every policy decision a government makes will have an impact – directly or indirectly – on the health of the people it serves. Therefore, it is important to consider using the Public Health approach to psychoactive substances that aims to maintain and improve the health of the population using principles of evidence-informed policy and practice, social justice, equity and human rights.  The goal of a Public Health approach is to maximize benefits and minimize harms of psychoactive substances, reduce inequities within the population (including those who use or are affected by others who have problems with substance use) and ensure the harms associated with interventions and laws are not disproportionate to the harms of the substances themselves.  Some specific objectives of a Public Health approach include: o Ensuring measures are in place to protect children and youth from exposure to marijuana, whether in packaging, home grows, or second-hand smoke. o Building capacity in prevention, education and treatment before implementation. o Developing a clear, comprehensive communication strategy prior to implementation so that the public and other stakeholders understand what is permitted, as well as the risk and harms associated with use. 2  From a law enforcement and public safety perspective another important objective to minimize harms of use is to prevent marijuana from being illegally sold and to thereby deprive organized crime and other criminals of a revenue source.  It is also important to note that legalization of marijuana is a matter that involves various areas of provincial jurisdiction and also some areas of blended federal and provincial jurisdiction.  It is only through consultation and FPT collaboration that we will get to a policy that supports and minimizes harm for individuals and the public.  It is important to ensure that the areas of provincial jurisdiction are respected and that there is close collaboration between the federal government and provincial–territorial (PT) governments in the development of the approach and legislation relating to legalization of marijuana.  The need for close collaboration is perhaps best illustrated by the issues and recent developments concerning the medical marijuana program.  Significant regulatory changes to permit medical marijuana users to grow their own marijuana were implemented in August 2016. These changes were implemented without early notice and consultation with jurisdictions involved in FPT discussions relating to legalization of marijuana for recreational use.  The changes have significant implications for law enforcement and individuals and public safety as the home grow option is very difficult to monitor and control and medical marijuana can be easily diverted for illegal use.  Manitoba's Public Safety Investigation Unit has received several complaints regarding home grow operations for medical marijuana. Although these complaints were received based on home grow operations permitted under the former regulatory regime, the concern continues, and perhaps increases, under the new regulatory framework.  There are also concerns from the law enforcement community that the process for eligibility to access marijuana for medical purposes makes it too easy for persons to obtain a prescription to obtain and use marijuana.  The Manitoba Government takes the position that there should have been earlier notice and consultation about the new regulations for medical marijuana and any consideration on harms of use for the legalization of recreational use should involve a critical examination of the structure and foundation of the medical marijuana program. B) Manitoba’s preliminary views on establishing a safe and responsible production system  Issues of production are largely an issue of federal jurisdiction – it should be the responsibility of the federal government to set national standards for production, 3 including potency of the product, and to license, regulate, inspect and oversee production operations.  However, there is a need for collaboration as provincial governments have an interest in ensuring the adequacy of supply, for legitimate access to marijuana and to prevent users turning to the illegal black market to purchase marijuana, and the quality of the product for the purposes of distribution within the province.  There should be clear distinction between marijuana and industrial hemp production legislation in the new legal regime. Changes to production and distribution of marijuana for recreational or medical purposes should not negatively impact the hemp production or processing industry.  The law enforcement community has identified serious concerns about the operations of the medical marijuana program in terms of controls over the process for obtaining approval to obtain medical marijuana, federal oversight of compliance with possession limits and federal oversight of compliance with home grow limits to prevent diversion of marijuana for illegal use.  Investigations in Manitoba have revealed that some individuals are in possession of significantly more marijuana than allowed under their licenses.  The federal consideration of legalization of marijuana for recreational purposes should include a critical examination of the weaknesses of the medical marijuana program identified by the law enforcement community, such as the ease of access to prescriptions to obtain and use medical marijuana and difficulties in monitoring and controlling home grow operations, and address those problems, especially if the medical marijuana program is being considered as a possible framework for production of marijuana for recreational use.  The issue of home production, including designated growers for individuals, is challenging given the concerns about home production in the medical marijuana context and it would help to have more information from the federal government about how it would approach home grow production in the broader non-medical use context. C) Manitoba’s preliminary views on designing an appropriate distribution system  Issues relating to distribution of marijuana are a local issue and should primarily be a matter of provincial jurisdiction.  The goal of the distribution system (i.e. whether it is to reduce use or eliminate use) is something that can be discussed in subsequent collaboration discussions with the federal government. The Manitoba Government was not in a position to advance a view on this issue at the meeting with the Task Force. 4  Manitoba is considering issues about limits on where and how marijuana can be sold and minimum age for legal purchase, but was not in a position to definitively comment at the meeting with the Task Force.  Any concerns about a need for national standards on minimum age can be addressed by provincial-territorial collaboration.  There may be some joint federal-provincial responsibility in terms of federal criminal laws for illegal distribution and possession, and provincial regulatory laws to enforce provincial distribution requirements.  There is also joint responsibility and a need for collaboration on advertising and marketing restrictions. D) Manitoba’s preliminary views on enforcing public safety protection –  Enforcing public safety and protection is a matter of joint federal-provincial jurisdiction.  Provinces will need to consider possible changes to provincial crime prevention and public safety legislation, such as civil forfeiture laws, The Safer Communities and Neighbourhoods Act, The Fortified Buildings Act, and The Non-Smokers Health Protection Act, and also consider enacting limits on where marijuana can be consumed.  Manitoba’s Safer Communities and Neighbourhoods Act (SCNA) targets residential and commercial properties where: o illicit drug use, production and/or trafficking; o sexual exploitation; o organized crime activities; o weapons offences; and/or o other unlawful activities occur on a habitual basis and which adversely affect neighbourhood safety.  A unit of investigators who have been recognized by the Courts as experts on illicit drug production and trafficking and organized crime, conducts investigations under the SCNA. Where the evidence establishes that these activities are occurring, those involved in the unlawful acts can be forced to vacate the property and be subject to other conditions to prevent a recurrence.  Manitoba was the first province to establish SCNA legislation and its success has led to Yukon, Alberta, Saskatchewan, Nova Scotia and New Brunswick establishing similar Acts and investigative units. 5  The Unit has investigated more than 120 marijuana grow operations occurring in residential and commercial properties under the SCNA.  Manitoba's Fortified Buildings Act (FBA) targets properties where there are excessive fortifications which: o may prevent occupants from quickly exiting the property in an emergency; o may prevent first responders from quickly entering a property in an emergency; or o may be used to prevent law enforcement officers from entering to respond to illegal activities. This would include, for example, fortified gang and drug houses.  Investigations are conducted by Manitoba Justice. The FBA empowers investigators to obtain search warrants to enter and inspect suspected fortified properties and the Director of the Unit can issue Removal Orders requiring property owners to remove the excessive fortifications.  The FBA has been used to remove fortifications set up by drug traffickers and criminal organizations to protect marijuana grow and trafficking operations. As an example, an investigation conducted under this Act uncovered a marijuana grow operation worth in excess of $1.4 million that was being operated in a residential area of Winnipeg by a criminal organization.  Criminal property forfeiture is a civil court process through which government may apply to confiscate property or proceeds of unlawful activity and property used in committing crime, considered instruments of unlawful activity.  Since 2009, Manitoba’s Criminal Property Forfeiture Unit has operated under the authority of The Criminal Property Forfeiture Act. The Act allows the director of the unit to start civil forfeiture proceedings against property believed to be the proceeds or instruments of unlawful activity. A judge of the Court of Queen’s Bench decides whether to order forfeiture.  Civil proceedings under The Criminal Property Forfeiture Act are entirely separate from criminal law. They: o do not rely on criminal prosecutions; o are initiated against property, not people; o do not create criminal records; and o do not create findings of guilt or innocence.  In 2012, The Criminal Property Forfeiture Act was amended to allow a simpler process known as administrative forfeiture through which personal property valued at $75,000 or less may be confiscated without involving the courts. Proceeds of confiscated property are deposited in the Criminal Property Forfeiture Fund and managed or distributed as outlined in the Act, including Unit operating expenses, victim compensation and programs promoting safer communities. 6  The Act has been used to seize and forfeit 51 homes and properties used in marijuana grow operations.  Through The Non-Smokers Health Protection Act, the province currently regulates: i The advertising, promotion and display of tobacco and tobacco-related products, ii The sale of tobacco and tobacco-related products (e.g. prohibiting the sale of these products in locations such as pharmacies and to minors), iii Where individuals can smoke tobacco products (e.g. there is no smoking permitted in enclosed public places and workplaces with limited exceptions),  Unproclaimed amendments to the Act (pending the development of regulations required to implement them) will extend the scope of the Act to the regulation of e-cigarettes and vapour products in relation to advertising, promotion, display, sale and use.  The federal government will also need to consider changes to criminal laws, such as the Criminal Code or the Controlled Drugs and Substances Act, to create new offences to prevent persons from circumventing the limits on legal marijuana use and to impose meaningful consequences for those actions.  There will be a need for federal and provincial collaboration and synchronization in developing new federal and provincial public safety protection laws in order to prevent delays and gaps in enacting legislation.  Delays and gaps would defeat the stated objectives and undermine the mandate of legalization of marijuana for recreational purposes, by putting youth, families and public health and safety at risk in terms of: o increased access to marijuana; o the absence of necessary regulatory and enforcement laws; o the absence of strict quality and safety rules and o depriving law enforcement of the tools needed to effectively deal with illegal marijuana use and impaired driving.  As noted in the federal Discussion paper, a clear and robust legislative and regulatory framework is required.  The federal government should continue its role of prosecuting drug offences via the Public Prosecution Service of Canada.  Legalization of marijuana will impose new demands on police resources and the federal government will need to provide provinces and territories with sufficient financial resources to support law enforcement, especially training and equipment to deal with drug impaired drivers. 7  Care must also be taken to ensure that legalization of marijuana does not involve a law enforcement regime that puts an unnecessary strain on police, court and correctional system resources in terms of the extent to which it involves the criminal justice system to deal with persons who use, sell or otherwise distribute marijuana outside of the legalized marijuana regime.  The federal government will also need to provide sufficient resources for inspectors to ensure compliance with marijuana production and storage regulations, rather than trying to rely on police resources for inspections.  As well, there is a need for the federal government to provide sufficient resources for public education about the risks and harms of marijuana use. E) Manitoba’s preliminary views on continued access to marijuana for medical purposes  The medical marijuana program is primarily a matter of federal jurisdiction, as the federal government regulates and administers the program.  However, provinces also provide health services and provincial-territorial jurisdictions should be consulted to explore any potential implications at the service delivery level.  In addition, to the extent that the law enforcement community has expressed concerns that the medical marijuana program does not properly control access to medical marijuana or diversion for illegal purposes, there are resource and cost implications for provincial law enforcement agencies.  There is a need for better collaboration by the federal government on regulations for the medical marijuana program and a need to critically examine and correct existing deficiencies in the program.  Any future changes to the medical marijuana program need to be discussed with provincial and territorial jurisdictions before they are introduced. There are also concerns that when marijuana becomes available via the non-medical marijuana process, persons marketing marijuana products may make unsubstantiated claims about potential health benefits of the products.  The Canadian Pediatric Society position statement warns parents “against using medical marijuana to treat children’s health conditions as there is not enough evidence that the drug is either safe or effective”.  The Canadian Medical Association still believes there is insufficient scientific evidence available to support the use of marijuana for clinical purposes, including proper dosage and potential interactions with other drugs. 8  The Canadian Medical Protection Agency advises Physicians to consult with their College before agreeing to accept the transfer of marijuana from a licensed producer as many Colleges prohibit or strongly discourage their members from dispensing, providing, or accepting delivery of marijuana for medical purposes.  Manitoba’s College of Physicians and Surgeons Statement on Marijuana (Cannabis) for Medical Purposes (from March 2014) indicates that physicians must remain at arm’s length from licensed producers and be the treating physician for the condition for which marijuana is authorized. III CONSULTATION QUESTIONS TO WHICH MANITOBA HAS A RESPONSE The following are the consultation questions raised by the federal Discussion Paper or the Task Force that Manitoba addressed during its presentation: A) Section 1 - Minimizing Harms of Use Discussion Paper preamble to the Minimizing Harms of Use questions - Measures to regulate and restrict marijuana use include: a minimum age for legal purchase; advertising and marketing restrictions to minimize the profile and attractiveness of products; taxation and price controls to discourage the use of marijuana and provide the government with revenues to offset related harm reduction costs; restrictions on marijuana products, such as potency (i.e. maximum THC content) and types of products sold (e.g. edibles); limitations on quantities for personal possession; and limitations on where marijuana can be sold (e.g. whether marijuana should be available via retail distribution). Question 1 (Discussion Paper page 14) - Do you believe that these measures are appropriate to achieve the overarching objectives to minimize harms, and in particular to protect children and youth? Are there other actions which the Government should consider enacting alongside these measures? Manitoba response:  Almost every policy decision a government makes will have an impact – directly or indirectly – on the health of the people it serves. Therefore, it is important to consider using the Public Health approach to psychoactive substances that aims to maintain and improve the health of the population using principles of evidence-informed policy and practice, social justice, equity and human rights.  The goal of a Public Health approach is to maximize benefits and minimize harms of psychoactive substances, reduce inequities within the population (including those who use or are affected by others who have problems with substance use) and ensure the harms associated with interventions and laws are not disproportionate to the harms of the substances themselves.  Some specific objectives of a Public Health approach include: 9 o Ensuring measures are in place to protect children and youth from exposure to marijuana, whether in packaging, home grows, or second-hand smoke. o Building capacity in prevention, education and treatment before implementation. o Developing a clear, comprehensive communication strategy prior to implementation so that the public and other stakeholders understand what is permitted, as well as the risk and harms associated with use.  From a law enforcement and public safety perspective another important objective to minimize harms of use is to prevent marijuana from being illegally sold and to thereby deprive organized crime and other criminals of a revenue source.  It is also important to note that legalization of marijuana is a matter that involves various areas of provincial jurisdiction and also some areas of blended federal and provincial jurisdiction.  It is important to ensure that the areas of provincial jurisdiction are respected and that there is close collaboration between the federal government and provincial–territorial (PT) governments in the development of the approach and legislation relating to legalization of marijuana.  It is only through consultation and FPT collaboration that we will get to a policy that supports and minimizes harm for individuals and the public. Task Force Question 1 - Does Manitoba have views on timelines for implementation? Manitoba response:  There will be a need for federal and provincial collaboration and synchronization in developing new federal and provincial public safety protection laws in order to prevent delays and gaps in enacting legislation.  Delays and gaps would defeat the stated objectives and undermine the mandate of legalization of marijuana for recreational purposes, by putting youth, families and public health and safety at risk in terms of: o increased access to marijuana; o the absence of necessary regulatory and enforcement laws; o the absence of strict quality and safety rules and o depriving law enforcement of the tools needed to effectively deal with illegal marijuana use and impaired driving. B) Section 2 – Establishing a Safe and Responsible Production System Questions 1 and 3 (Discussion Paper page 17) - What are your views on the most appropriate production model? Which production model (home cultivation, governmentcontracted production, or a competitive market model of licensed producers) would best meet consumer demand while ensuring that public health and safety objectives are 10 achievable? What level and type of regulation is needed for producers? What would Manitoba like to have control over? Should a system of licensing or other fees be introduced? Manitoba response:  Issues of production are largely an issue of federal jurisdiction – it should be the responsibility of the federal government to set national standards for production, including potency of the product, and to license, regulate, inspect and oversee production operations.  However, there is a need for collaboration as provincial governments have an interest in ensuring the adequacy of supply, for legitimate access to marijuana and to prevent users turning to the illegal black market to purchase marijuana, and the quality of the product for the purposes of distribution within the province. Question 4 (Discussion Paper page 17) - The Marihuana for Medical Purposes Regulations (MMPR) set out rigorous requirements over the production, packaging, storage and distribution of marijuana. Are these types of requirements appropriate for the new system? Are there features that you would add, or remove? Are there weaknesses in medical mail program? Manitoba response:  The law enforcement community has not expressed concerns about weaknesses in the medical mail program.  There are concerns about the home grow option as home cultivation is very difficult to monitor and control and medical marijuana can be easily diverted for illegal use. There are also concerns from the law enforcement community that the process for eligibility to access marijuana for medical purposes makes it too easy for persons to obtain a prescription to obtain and use marijuana. The federal government will need to provide sufficient resources for inspectors to ensure compliance with marijuana production and storage regulations, rather than trying to rely on police resources for inspections. C) Section 3 - Designing An Appropriate Distribution System Question 2- (Discussion Paper page 19) To what extent is variation across provinces and territories in terms of distribution models acceptable? What would Manitoba like to have control over? Manitoba response:  Issues relating to distribution of marijuana are a local issue and should primarily be a matter of provincial jurisdiction. Manitoba is considering issues about limits on where and how marijuana can be sold and minimum age for legal purchase. Any concerns about a need for national standards on minimum age can be addressed by provincial-territorial collaboration. 11 D) Section 4 – Enforcing Public Safety And Protection Question 1 (Discussion Paper page 21) - How should governments approach designing laws that will reduce, eliminate and punish those who operate outside the boundaries of the new legal system for marijuana? Manitoba response:  Enforcing public safety and protection is a matter of joint federal-provincial jurisdiction.  Provinces will need to consider possible changes to provincial crime prevention and public safety legislation, such as civil forfeiture laws, The Safer Communities and Neighbourhoods Act, The Fortified Buildings Act, and The Non-Smokers Health Protection Act, and also consider enacting limits on where marijuana can be consumed.  The federal government will also need to consider changes to criminal laws, such as the Criminal Code or the Controlled Drugs and Substances Act, to create new offences to prevent persons from circumventing the limits on legal marijuana use and to impose meaningful consequences for those actions.  There will be a need for federal and provincial collaboration and synchronization in developing new federal and provincial public safety protection laws in order to prevent delays and gaps in enacting legislation.  Care must also be taken to ensure that legalization of marijuana does not involve a law enforcement regime that puts an unnecessary strain on police, court and correctional system resources in terms of the extent to which it involves the criminal justice system to deal with persons who use, sell or otherwise distribute marijuana outside of the legalized marijuana regime. Question 2 (Discussion Paper page 21) - What specific tools, training and guidelines will be most effective in supporting enforcement measures to protect public health and safety, particularly for impaired driving? Manitoba response:  As noted in the federal Discussion paper, a clear and robust legislative and regulatory framework is required. The federal government should continue its role of prosecuting drug offences via the Public Prosecution Service of Canada. Legalization of marijuana will impose new demands on police resources and the federal government will need to provide provinces and territories with sufficient financial resources to support law enforcement, especially training and equipment to deal with drug impaired drivers.  The federal government will also need to provide sufficient resources for inspectors to ensure compliance with marijuana production and storage regulations, rather than trying to rely on police resources for inspections.  As well, there is a need for the federal government to provide sufficient resources for public education about the risks and harms of marijuana use. 12 IV CONSULTATION QUESTIONS NOT ADDRESSED BY THE PRESENTATION The following are the consultation questions raised by the federal Discussion Paper or the Task Force that could not be addressed at the time of the presentation and the responses that are now being provided to those questions: A) Section 1 - Minimizing Harms of Use Question 2 (Discussion Paper page 14) - What are your views on the minimum age for purchasing and possessing marijuana? Should there be limit on who can possess (e.g. youth possession illegal)? Should the minimum age be consistent across Canada, or is it acceptable that there be variation amongst provinces and territories? Manitoba response:  Manitoba is considering issues about limits on where and how marijuana can be sold and minimum age for legal purchase, but is not in a position to definitively comment at this time. Any concerns about a need for national standards on minimum age can be addressed by provincial-territorial collaboration. B) Section 2 – Establishing a Safe and Responsible Production System Question 2 (Discussion Paper page 17) - To what extent, if any, should home cultivation be allowed in a legalized system? What, if any, government oversight should be put in place? Where is the line between personal use and distribution? Manitoba response:  The disposition of the home cultivation issue is critical and has cascading implications for the development of the other elements of the recreational marijuana regime.  Manitoba's Public Safety Investigation Unit has received several complaints regarding home grow operations for medical marijuana in terms of compliance with possession limits and compliance with home grow limits to prevent diversion of marijuana for illegal use. Although these complaints were received based on home grow operations permitted under the former regulatory regime, the concern continues, and perhaps increases, under the new regulatory framework.  The issue of home production, including designated growers for individuals, is challenging given the concerns about home production in the medical marijuana context and the risk of diversion of home grown marijuana for illegal purposes has the potential to undermine production and distribution restrictions in a legalized marijuana regime that are intended to prevent misuse of marijuana for illegal purposes. It would help to have more information from the federal government about how it would approach home grow production in the broader non-medical use context. 13 Question 5 (Discussion Paper page 17) - What role, if any, should existing licensed producers under the MMPR have in the new system (either in the interim or the longterm)? Manitoba response:  This is difficult to answer until the federal government has decided its position on the nature and scope of the legalized and regulated marijuana access regime. Task Force Question 2 – What would be the best way to exempt hemp from marijuana regulation (e.g. THC content)? Manitoba response:  The regulation of industrial hemp, grown for grain and/or fibre, should be distinct from that of all other Cannabis culture since it has low THC content and is as benign as conventional commodities like wheat, canola or soybeans.  Solution: Industrial Hemp to be defined as; Commodity Hemp grown for grain and/or fibre with a delta 9 THC value of less than 0.3%. That amount is not known to cause any psychoactive effects.  Regulation should be restricted to Possession Permits for production and processing, use of approved cultivars identified through a science-based THC testing protocol (see below) and registration of fields to allow Health Canada to track production. Task Force Question 3 – What are Manitoba's views on "boutique" growers as part of the recreational system? Manitoba response:  The federal Task Force, in consultations with Manitoba, referenced “boutique” growers as part of the recreational system. Manitoba strongly suggests that smaller, or “boutique”, growers should be held to the same regulatory standards as larger, commercial producers. Assuming smaller production facilities are somewhat benign will undermine the regulatory approach to production, increasing the risk for diversion to the black market while compromising the ability to control for high quality, safe and consistent marijuana products. C) Section 3 - Designing An Appropriate Distribution System Questions 1 and 3 (Discussion Paper page 19) - Which distribution model (restricted mail distribution, phased-in approach to distribution, storefront model, or local choice) makes the most sense and why? Are there other models worthy of consideration? Manitoba response:  Issues relating to distribution of marijuana are a local issue and should primarily be a matter of provincial jurisdiction.  Manitoba is considering issues about limits on where and how marijuana can be sold and minimum age for legal purchase, but is not in a position to definitively comment at this 14 time. Any concerns about a need for national standards on minimum age can be addressed by provincial-territorial collaboration. D) Section 4 – Enforcing Public Safety And Protection Question 3 (Discussion Paper page 21) - Should consumption of marijuana be allowed in any publicly-accessible spaces outside the home? Under what conditions and circumstances? Manitoba response:  Manitoba is considering these kinds of issues, including limits on where and how marijuana can be sold and minimum age for legal purchase, but is not in a position to definitively comment at this time. E) Section 5 – Accessing Marijuana for Medical Purposes Task Force Question 4 - Do we need a separate medical marijuana regime? If marijuana is accessible through non-medical model, is it enough? Or does it still leave room for black market? Manitoba response:  This is difficult to answer until the federal government has decided its position on the nature and scope of the legalized and regulated marijuana access regime. Question (Discussion Paper page 23) - What factors should the government consider in determining if appropriate access to medically authorized persons is provided once a system for legal access to marijuana is in place? Is there still a need for physicians to be involved in the process? Manitoba response:  This is difficult to answer until the federal government has decided its position on the nature and scope of the legalized and regulated marijuana access regime. 15