For all the talk about the incoming legalization of recreational cannabis, the topic of medical cannabis seems to have been lost in the haze, says one Victoria businessman.

While recreational users will be able to walk into a retail store and buy pot as easily as a bottle of beer, James Whitehead said the Health Canada mail-order system to obtain medical marijuana can be bureaucratic and confusing.

As a result, many who use cannabis for pain relief, arthritis or insomnia end up buying it from one of Victoria’s three dozen dispensaries.

The problem with that, Whitehead said, is that not all dispensary staff are qualified to give medical advice.

Whitehead has partnered with an addictions specialist, Dr. Neil Rockerbie, and a pharmacist, Michael Forbes, to launch the Cannabis Medical Centre, the first cannabis-focused clinic on Vancouver Island.

It is staffed with six physicians who will take patients and make recommendations on whether cannabis is appropriate and in what form. If the physician writes a prescription for cannabis, the patient will be assigned a “cannabis coach” who will help them register as medical users of cannabis and navigate the process of buying the product from one of the 18 Health Canada-licensed producers the clinic works with, Whitehead said. Patients are not charged a fee but the clinic takes a monthly fee from licensed producers for referrals.

The clinic has received Health Canada approval to operate as a clinic that specializes in cannabis and can bill to the province’s Medical Services Plan or to the patient’s health insurer.

“Lots of doctors don’t know enough about cannabis and don't feel comfortable prescribing it,” Whitehead said. “They can refer patients to this centre.”

There are approximately 300,000 registered medical cannabis users, according to Health Canada.

Philippe Lucas, vice-president of patient research and access for Tilray, a licensed marijuana producer based in Nanaimo, said he sees an important role for medical cannabis prescribed by a doctor even after recreational cannabis is legalized.

“We are seeing continued growth in the adoption of cannabis as the regular course of care that physicians are offering patients. I think it’s a useful tool in their tool kit, particularly in light of the opioid crisis,” said Lucas, who has conducted extensive research into the possibilities of cannabis as an opioid replacement. “I think it’s incredibly important to maintain that physician-patient relationship. That’s something that doesn’t exist if you’re buying cannabis from a retail outlet.”

However, he hopes the federal government will ensure that medical cannabis is cheaper, either by removing the HST or GST or increasing private care coverage.

Insurers SunLife Financial Inc. and Great-West Life recently added medical marijuana coverage as an option for group benefits plans and Lucas expects all major insurers will offer cannabis coverage by the end of the year.

“We are at the turning point of private coverage for medical cannabis,” he said. “No insurer wants to lose a large-scale plan because they’re not offering this as an option for their customers.”

Legalized pot is expected to cost $10 a gram, according to federal Finance Minister Bill Morneau, speaking at a gathering of provincial finance ministers in December 2017.

Some Health Canada-approved licensed producers will subsidize cannabis for seniors or people on income assistance.

Tilray provides income-based discounts of up to 25 per cent, a 10 per cent seniors discount and a reduced rate for veterans, Lucas said.

Whitehead, who also owns the neighbouring cannabis dispensary Medijuana, expects the number of dispensaries in Victoria to shrink after business owners jump through the hoops of the provincial application process.

Existing dispensaries will have to apply for provincial approval to sell product provided by the Liquor Distribution Board. Retail stores will also have to comply with municipal bylaws, which in Victoria include a rezoning process that ensures cannabis outfits are not within 200 metres of a school.

The B.C. government has not yet said when it will open the online application for private cannabis retail stores but said last week that government-owned stores should be open by late summer to coincide with federal legalization.

Consumers can expect to see the term “dispensary” phase out, which retail stores will not be allowed to use.

Whitehead predicts that retail stores will face a massive supply shortage, as there are only 90 licensed producers across Canada approved to supply cannabis to the country’s provincially managed distribution boards.

However, in a press conference to introduce the Cannabis Distribution Act last week, Public Safety Minister Mike Farnworth assured that there would be sufficient supply and varieties of strains to stock store shelves.

Tilray has significantly increased its production capacity and square footage of growth space to meet the coming demand, Lucas said.

“Everyone is doing their best to make sure there aren’t supply shortages,” Lucas said. “But we do expect there to be an initial rush at legalization as people move from the black or grey market to the legitimate market.”