Once a recreational cannabis user, Aganaba quit six years ago as part of a more general decision about sobriety. That all changed three years later, when she was diagnosed with multiple sclerosis (MS) — a chronic, progressive autoimmune disease of the central nervous system.
Symptoms of MS range widely; Aganaba’s include neuropathic pain, seizures, muscle spasms, cognitive impairment, trigeminal neuralgia, which is “like the world’s worst cluster-headache-slash-migraine,” and “MS hug” — a painful restriction of the chest.
The disease has no cure, and Aganaba, an interdisciplinary artist and musician, suddenly found herself contemplating a future in which the music and art that define her life would disappear, replaced by a grim refrain of chronic pain, prescription drugs and increasingly severe disability.
Until she rediscovered cannabis. But this time, it was as medicine.
“It keeps my symptoms under control in a way that allows me to show up in my life with my mental and, to a certain point, my physical faculties,” Aganaba said.
From a program including a dozen heavy-duty pharmaceutical prescriptions, ranging from muscle relaxants to painkillers and antispasmodics, Aganaba says she was able to transition to a cannabis-only regime that delivered results of an entirely different order than the drugs she’d initially been prescribed.
This transition was only possible, she says, “through the goodness and graciousness” of the people in Vancouver’s dispensary culture.
With storefronts able to provide immediate access to a wide range of cannabis products, from edibles to concentrates to raw and dried flower, Aganaba says she was able to experiment in small doses with a number of delivery methods to find a treatment that functionally controlled the vast majority of her symptoms.
She says the staff helped her narrow down which combinations of which strain would let her find relief. This has to do with the culture of education promoted by local dispensaries, she says.
Aganaba says in her experience dispensary staff understood how each strain’s particular combination of cannabinoids such as cannabidiol (CBD, a non-psychoactive compound thought to aid in treatment for ailments such as pain, osteoarthritis, epilepsy and cancer), delta-9-tetrahydrocannabinol (THC, the compound responsible for the cannabis “high”) and terpenes (responsible for cannabis’ flavour and aroma, as well as for influencing the effects of cannabinoids) interact to produce specific effects — a phenomenon known as the “entourage effect.”
Where once Aganaba walked with a cane and was in a state of constant concern over whether her she could afford — or stomach the side effects of — her prescription medications, she now bounces into a room, a smile stretching across her face.
Aganaba’s experience is arguably a unique product of the Vancouver cannabis space, where so-called grey market dispensaries flourished in the lead up to federal legalization last October.
Between 2013 and 2015, the number of these dispensaries doubled each year, according to the City of Vancouver, increasing from 60 to 100 storefronts in the first six months of 2015.
The brick and mortar stores, illegal under federal law, sold — and continue to sell — cannabis obtained from sources not vetted by any regulatory body. The cannabis and related products in those dispensaries often come from smaller, local growers, many of whom have been producing for years. None of these growers are licensed to sell to a retail outlet.
While many cities across the province and country chose to crack down on such dispensaries, Vancouver took a decidedly different tack. In April 2016, the city introduced a temporary licensing scheme known as the medical marijuana-related use (MMRU) model to which all dispensaries were required to adhere, in an effort to put the brakes on the their proliferation.
The plan included a limit on the number of dispensaries that could exist within a certain distance of one another, and on their proximity to schools or other areas where children congregate.
The changes were followed by the voluntary closure of 71 stores, according the city.
Some, however, decided to stay open through legalization — either while attempting to land a coveted provincial retail licence or in spite of their ineligibility to do so. And while some of those are currently involved in appealing a December B.C. Supreme Court decision ordering their closure, the rest — roughly a dozen — are at risk of legal action by the city.
Only a few dispensaries remain open.
Aganaba says that shift has been deeply felt by her and people like her. Whereas she was once able to point to a half-dozen stores in her east Vancouver neighbourhood that provided knowledgeable service on a huge range of products, she’s had to start looking further and further afield for a store which can serve her needs.
“Now, most of the dispensaries I relied on are gone,” she says. In their place have begun to emerge recreational cannabis shops, though only very slowly, and with a radically different mandate than the city’s former dispensaries.
While close to 500 B.C. completed retail cannabis licence applications are currently pending, only 21 have been approved, according to the province, and only three legal cannabis shops are currently open in Vancouver. None of them are located anywhere close to Aganaba’s Hastings-Sunrise home.
But aside from the dearth of legal storefronts, Aganaba says the province’s supply scheme — which makes the government the sole arbiter of which recreational cannabis products are available online or in person, provincewide — means none of the products she relies on are accessible through legal channels.
Furthermore, retail staff are prohibited from talking about the cannabis products in their stores or from making personal recommendations — due to concern over unqualified workers directing individual use of a controlled substance.
Ehren Richardson is a cannabis consultant and director of a dispensary known as Sunrise Wellness Foundation, a former grey market cannabis store now closed to make the move to provincially-licensed recreational outlet. Richardson likewise pointed to the loss of the advisory capacity of grey market dispensary staff as a casualty of legalization.
“I realize that a lot of this advisory has been partly subjective in nature, and also based anecdotally on user experiences. But we can’t discount that,” Richardson said in an interview
People have legitimate experiences with different forms of cannabis, he said, and that community expertise should be available to others who may seeking help. This grassroots knowledge is especially valuable right now, while the scientific study of cannabis is still developing.
“What we need is just more science involved so that we’re not relying on anecdotal user experience. And that’s coming … It’s just going to take a little time.”
For Aganaba, this cannabis culture is completely unrecognizable from the one that brought her hope for normalcy in the face of a crushing diagnosis. The online, federally controlled medical cannabis sector is scarcely better, she says, with long waits for delivery and few of the products she’s come to rely on.
Storefront dispensaries also offer an opportunity for a customer to see, smell and examine, a product, and then purchase in small amounts. In this way, says Aganaba, different products can be personally vetted and tried without significant upfront investment. Nor, she adds, are credit cards necessary for purchase. The need to possess a credit card for online purchases is a particular concern for people living on a fixed income, she says, such as those who find themselves unable to work because of a disability — a situation she herself has faced because of her disease.
Aganaba says she’s aware there are legitimate safety concerns associated with an illicit, grey market cannabis industry. The vast majority of the products she currently buys have not been evaluated for heavy metals, pesticides or microbial infections, for which licensed producers are required to test.
The city, meanwhile, has long echoed the federal government’s message emphasizing the risks associated with allowing an unregulated cannabis market to proliferate.
“If left unregulated, illegal dispensaries can pose a significant risk to public health and safety, particularly in youth,” the city said in a December news release.
But the regulatory focus on the potential for cannabis to drive crime and misuse, Aganaba says, is the very reason people like her are being left without hope for transparent, informed access to quality product in affordable amounts.
“Canada’s drug policy is prehistoric. That is the long and short of it,” she said. “Until we start approaching all social problems from a public health perspective instead of a policing perspective, none of this will change. I really believe that.”
And a choice between reliable, affordable access to technically illicit medicines that effectively treat her disease and a legal market that leaves her with few choices and multiple barriers, she says, is no choice at all.
Should the last dispensaries in Vancouver disappear, Aganaba says she fears what the future might hold without reforms that would permit B.C.’s long-established community of smaller, craft growers to provide low-barrier access to medical cannabis patients.
“I can’t even tell you what my future will look like,” she says, adding one thing she does know is reduced access to cannabis will begin a negative feedback loop of worsening symptoms fed by increased anxiety and stress.
“If my anxiety and stress go up, my symptoms become more pronounced. If my symptoms become more pronounced, the disability becomes more permanent. If it becomes more permanent, I’m in a wheelchair.”
Perrin Grauer is a Vancouver-based reporter covering community issues and Canada’s drug policies. Follow him on Twitter: @perringrauer