This article was published 20/6/2019 (626 days ago), so information in it may no longer be current.
Canadian medical cannabis registrations will shrink by nearly 18 per cent over the coming five years, predicts a forecast released Thursday by U.S.-based cannabis research firms Arcview Market Research and BDS Analytics.
The latest "State of Legal Cannabis Markets" report cites a figure of 359,292 people using Health Canada's medical cannabis system in 2018, a figure initially reported by Health Canada as the number of active medical cannabis client registrations with licensed cannabis producers as of December 2018. (Some clients may have multiple registrations with multiple producers and others are registered to grow their own, so that number may not represent Canada's exact number of registered medical cannabis users.)
Arcview sees that figure slipping to 295,934 by 2024; it expects annual spending on medical cannabis to fall accordingly from US$457 million in 2018 to US$381 million in 2024. In Canadian dollars, that's a decline from $607M to $506M.
The projection is informed by declining numbers of registered medical cannabis users in U.S. states that have legalized cannabis for medical purposes and later gone on to legalize for the recreational, or "adult-use" market, said David Abernathy, vice-president of data and government affairs with ArcView Group.
"In some states, particularly states where it's very easy to maintain medical status or where there's a big tax incentive for being a medical (cannabis) patient, we've seen less attrition," he said.
"And in other states, notably California, where even though there is a minor tax incentive for maintaining medical status, the hurdles became significantly harder at the same time as adult-use (cannabis sales) kicked in, and we saw an almost-total dropoff. There are negligible numbers of people operating in the medical system in California now. Almost all of the sales are happening in the adult-use market."
But the projected decline in medical cannabis registrations doesn't necessarily mean fewer Canadians will actually be using cannabis for therapeutic purposes, Abernathy explained.
"It's less a question of having fewer actual medical patients, it's just a question of having fewer people who go through the extra trouble of being registered as a medical patient," he said.
Legal access to cannabis for medical purposes in Canada requires that kind of extra trouble: Patients first need a written authorization from a physician or a nurse practitioner, and must register directly with a government-licensed cannabis producer before they can order medical cannabis for mail delivery only. Canadians can also apply to grow their own medical cannabis or have someone else grow on their behalf, which adds an extra layer of bureaucracy.

Mario St. Michel, quality control manager, examines cannabis plants at the Verdelite Sciences Inc. cannabis facility in Sainte-Eustache, Que. (Ryan Remiorz/The Canadian Press)
Abernathy said Arcview's projection showing a declining number of registered medical cannabis users in Canada could change if it becomes easier or harder to register. He also expects that Canada's medical cannabis market could shrink if regulators approve new forms of cannabis-derived pharmaceutical drugs through the normal process for drug approvals, which would permit regular prescriptions.
"But I suspect that's going to be a relatively small effect overall, compared to the patients who are getting their cannabis from the adult-use market," he said.
In the meantime, Arcview expects annual spending in Canada's non-medical cannabis market to balloon to US$4.8 billion in 2024. The report praises Canada for achieving "the high-water mark for national (cannabis legalization) rollouts," but Abernathy says Arcview projects faster market growth in provinces that permit private retail cannabis store operators, like British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and Newfoundland.
Even with rapid recreational cannabis market growth expected in Canada, Abernathy expects Canada's cannabis industry will increasingly look for growth opportunities away from home.
"The amount of money that has been invested in Canadian licensed producers is an amount of money that can't reasonably be deployed just servicing the demand in Canada," he said. "It's too much money."
International market growth could involve increasing exports of Canadian medical cannabis supplies to countries like Germany that import medical cannabis, Abernathy said.
"If they spent all of the money that they've raised building infrastructure for the Canadian market, there would be an absolutely enormous oversupply issue."
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