V-S REM: Stupid not to extend


IAT plan 2.JPG
Technical summary of Ile aux Tourtes bridge reconstruction. Note unassigned grey lanes in the centre, logical placement of double LRT line — possibly but not necessarily the REM.

Last week I attended a Ministry of Transport briefing on plans to replace the Ile aux Tourtes bridge by 2031.  In the 12-year meantime, the MoT proposes to keep the 55-year-old span open for the 86,000 vehicles a day it carries (their estimate). The new bridge will be built to accommodate a light rail commuter system down the road. Extending the Réseau express métropolitain (REM) to Vaudreuil-Soulanges was not part of the agenda. Encouraging off-island residents to use existing public transit was.

As currently configured, the 26-station automated electric light rail transit (LRT) system will begin service in 2021 and extend the western line to Ste. Anne de Bellevue two years later. The $6B network will link Montreal, Laval, the north and south shores — but not Vaudreuil-Soulanges and its 160,000 residents.

Our meeting was with Chantal Rouleau, the junior minister of transport as well the minister responsible for Greater Montreal in François Legault’s Coalition Avenir Québec cabinet.  She’s new to the National Assembly but she’s known in Montreal municipal politics, both as Pointe aux Trembles borough mayor and for her involvement in east-end sustainable development initiatives.

I was there to represent the Town of Hudson. Beside me were a representative of Greg Kelley’s Jacques-Cartier riding office, someone from Vaudreuil MNA Marie-Claude Nicholls’s office, Senneville’s general manager and Louise Craig, co-founder (with St. Lazare councillor Genevieve Lachance) of the Le REM dans/in Vaudreuil-Soulanges Facebook page.

While the West Island has been a part of the bridge discussion for some time, Vaudreuil-Soulanges is new to the table. And late. I don’t think it’s an overstatement to say the future of Vaudreuil-Soulanges will increasingly depend on fast, convenient public transit, both for 74% of the 160,000 residents who commute onto the island and for potential employees looking to commute to Vaudreuil-Soulanges to work. The Vaudreuil-Soulanges hospital has been promised by the end of 2026, creating 4,000 good jobs. 

We all know off-island and island traffic congestion is worsening.  INRIX, a global traffic-metrics provider, estimates the average commute into the city takes 75 minutes in optimal rush-hour conditions and often tops three hours both ways. The cost in lost hours of productivity is evidenced by the number of trucking firms relocating to Vaudreuil-Soulanges, strategically located at the junctions of highways 20,30 and 40.

For me, the idea of extending the REM to Vaudreuil-Soulanges is the logical thing to do.  Three years ago, I asked former Hudson councillor Tom Birch whether he thought the MTQ would include an LRT line in the design for the new span. “They’d be stupid not to,” Birch said. (Read Will Hudson miss the train again? WP blog June 27/17)

“Stupid not to” became the rallying cry for the creators of Le REM dans/in Vaudreuil-Soulanges, the Facebook page now approaching 1,000 followers. A series of radio, TV, print and online stories that resulted from St. Lazare’s adoption of a motion of support for extending the REM generated enough pressure to convince Vaudreuil-Soulanges MRC mayors to adopt unanimously a resolution to that effect. On Monday last, Hudson became the second MRC municipality to pass a motion similar to St. Lazare’s.

The CAQ government’s reaction to all this pressure was delivered at the March 6 briefing and news conference we were attending. On the minister’s side of the table were Soulanges (and Hudson’s) CAQ MNA Marilyne Picard and half a dozen MoT staff. A technical sheet on the bridge replacement was handed out. Rouleau described it as a concept, not a final plan. Eight lanes of traffic, two for buses only three in the direction of rush-hour traffic) and a re-engineering of both approaches to the span so that buses have priority. On the bridge’s north side (toward Vaudreuil-Dorion) a walkway will provide cyclists and pedestrians a lake view.

IAT bridge plan 1.JPG
IAT replacement critical path will include two public hearings March 18, March 27, followed by an environmental impact study. Public participation at this stage will determine what will be on the table at environmental impact hearings.

A REM extension to Vaudreuil-Soulanges via the new bridge didn’t come up until we asked. The replacement bridge, Rouleau told us, will be designed and built to carry “heavy public transit” — trains. She conceded it could be the REM — or it could be another technology adapted from one of many countries wrestling with the same traffic congestion. Until then. the minister added, “the bus is the best means we have” to move people to and from the REM terminal in Ste. Anne.

Rouleau was questioned on the logic of expecting a parent to rush his or her child to daycare, then drive to the bus station, park, then take a bus to the REM. Off-islanders need their vehicles anyway, so they’ll put up with traffic congestion instead of jostling for a seat. She was pushed on what will be done to expedite the flood of off-islanders wanting to board the REM, especially now that Ste. Anne’s mayor has insisted on fewer parking spaces and no interest in seeing her town’s streets clogged with new traffic.

The minister would hear none of it.  Our shared objective should be to turn drivers into riders before the REM opens and she urged us to start the ball rolling. “Your work will be to convince people not to use their cars…our roads can’t take more.”

At least she assured us her government has no plans to charge tolls.

Rouleau would not venture a date for an LRT line on the bridge. Before that happens, she said, this  government plans to encourage drivers to use public transit through exo, the agency now operating all train, bus and metro lines in the Montreal Metropolitan Community. Rouleau suggested additional trains on the Hudson/Vaudreuil line and more express buses like the A40 service between the Vaudreuil exo station and the Côte Vertu metro.

Feeling strongly about the REM and the future of public transit in Vaudreuil-Soulanges? The Ministry of Transport has scheduled two public consultations over the next two weeks. The first, next Monday March 18 is at the Centre Multisports, 3093 boul. de la Gare in Vaudreuil-Dorion between 2 p.m. and 8 p.m. The second is scheduled for 4-8 p.m. Wednesday March 27 at Senneville’s George McLeish Community Centre, 20 Morningside Ave. 

Technically, it’s not asking a lot to plan and build the new bridge to be able to carry an LRT line at some point in the future. They’re having to replace the old bridge anyway; it opened in 1965 and will be well past its 50-year lifespan by the time the new bridge is ready. While MoT insists it’s safe, maintenance is costing too much.

Politically, I can see that promising an LRT line to Vaudreuil-Soulanges as part of the new bridge may present a problem for the CAQ.

This government’s heartland straddles Montreal’s North and South shore past Quebec City.  It’s the reason Dev V-S, Vaudreuil-Soulanges’s economic development arm, is said by some to be beating its head against the wall for a transport-oriented industrial park in the county. Bécancoeur wants exclusivity and it’s part of the CAQ heartland. So are a dozen other fast-growing municipalities with traffic congestion, long commutes and fewer public transit options than Vaudreuil-Soulanges.

The CAQ inherits its political DNA from the Parti Action Démocratique, co-founded by Mario Dumont and Jean Allaire in the early ’90s. The ADQ was hyper-local, attracting its share of colourful candidates but not many votes as it wandered in the political wilderness. As the Coalition Avenir Québec, and with a pragmatic leader in François Legault, the party has moved the ball in every election before scoring a majority government a year ago. There’s no time to waste in acknowledging those years of support from regions where CAQ loyalists kept the party alive.

Clearly, it doesn’t hurt that Soulanges is represented by a CAQ candidate. (Legault himself made the announcement of Marilyne Picard’s candidacy at l’Auberge des Gallant last fall.) So far, Legault’s CAQ has been good for Vaudreuil-Soulanges. A 404-bed $1.5B regional hospital, promised by a succession of Liberal governments for a decade, was hurriedly announced by then premier Philippe Couillard and his health minister Gaètan Barrette immediately prior to last year’s election after Louise Craig talked Legault’s people into scheduling a news conference the following week at Whitlock Golf and Country Club. 

I asked Rouleau to confirm the new bridge project will be subject to hearings conducted by the Bureau d’audiences publiques sur l’environnement (BAPE). She said it would. My theory: the MoT decided to announce the LRT-capable bridge because its people knew extending the REM via the bridge would be an issue in environmental hearings. (Over half of the participants in a public consultation last fall told the provincial environment ministry they want to see a REM extension made part of the environmental impact assessment process. (Extend the REM, public consult urges, Feb. 5/19).)

There’s another question unanswered: once the REM extends to Ste. Anne, will exo and its ARTM overseers maintain the Vaudreuil-Hudson line in operation?  The REM’s electric trains will start at 5 a.m. and run until late, every 2 1/2 minutes during peak hours, every 5 minutes in between. Its financial model depends on moving full trains from the outset. I can’t see exo keeping that line in operation once it starts losing riders to the REM.

This is where Vaudreuil-Dorion and Hudson part ways. Mayor Guy Pilon, while voting in favour of the MRC motion in support of a REM on the bridge, expressed concern over how costs would be shared. Pilon is playing his own game. The other week he showed me how easily the REM could be extended to his city so that shuttlebuses from all over the region could pick up or drop off passengers without getting hung up in boul. de la Gare traffic. He keeps bugging me about getting Hudson to close the rail line between Vaudreuil and Hudson and turn it into a walking/cycling corridor. I remind him that the train a day each way is Hudson’s only negotiating tool as exo sets out to reorganize the MCC’s public transit networks and Pilon looks to make Vaudreuil-Dorion the region’s transit hub. We’re grandfathered, just like Vaudreuil-Dorion is grandfathered. 

At this point the V-S REM has been diverted to a siding. Rouleau, by kicking the REM can down the road, buys her government 12 years of not having to bother with the file while transferring responsibility to hapless Vaudreuil-Soulanges commuters to find their own solution. Given the fickle nature of the Vaudreuil-Soulanges electorate, I don’t think it’s an orientation with legs.
















When did statistics on golf course pesticide use become unavailable?

Was it before or after Quebec agronomist Louis Robert was fired for blowing the whistle on the chemical industry’s role in financing and vetting pesticide risk studies?

On Jan. 28, I captured the above screen shot of a page on the MELCC website.

On Feb. 27, almost exactly a month later, I tried to replicate the same screen capture. Below is the result.

An MELCC spokesperson told me to file an Access to Information request since this information is not publicly available.

Since when, I asked him.

They have never been public, he told me.

So what happened to the live buttons shown on the Jan. 28 Before shot?


As of next Wednesday, March 6, changes to Quebec’s pesticide law will ban the domestic and commercial use of neonicotinoids, a group of pesticides linked to declining bee populations, but with two controversial exceptions — golf courses and cropseed producers.

Quebec’s not-so-blanket neonic ban covers imidacloprid, the world’s most widely used insecticide and its iterations: acetamiprid, clothianidin, imidacloprid, nitenpyram, nithiazine, thiacloprid and thiamethoxam. All are prohibited throughout the European Union and in other countries as well as in several U.S. states because of a growing body of research-based concerns about harmful effects on mammals and birds. 

Because they are water-soluble and slow to degrade, there are concerns that neonics used on arable land are percolating into the aquifer and concentrating there at growing levels, thereby building up in the food chain.

Quebec has led Canadian action on banning neonics. Quebec was first to enact pesticide controls, thanks to people like Hudson’s Dr. June Irwin. In December 2015, Montreal banned all neonicotinoids – without exception – on all properties within the city limits, including the Botanical Garden, all agricultural areas and all golf courses, drawing pushback from the chemical industry and agribusiness. 

Under existing regulations, golf courses are required to submit annual reports on pesticide use and make them available to municipalities as well as to the environment ministry. The aim was to encourage golf courses to strive for year-over-year reductions in their use of insecticides, herbicides and fungicides in exchange for the privilege of continuing their unregulated use.

There is some evidence suggesting that not only has the golf industry been unable to reduce pesticide use, but climate change and golfers’ demand for perfect greens and fairways have pushed courses to use more instead of less.

The Ministry of the Environment and the Fight against Climate Change (MELCC) offers no explanation for the the policy shift. Instead, the MELCC pesticides page promises tighter controls and increased supervision for the rest of us.


— As of March 8 2019, ban the retail sale and professional application of neonics for use on grass in urban areas — except on golf courses.  

— Permits the retail sale of biopesticides and synthetic pyrethrins, now classed as Group 5 pesticides posing little risk;

— Places further controls on the sale of mixed pesticides for domestic use;

— Permits the injection of pesticides to control Emerald Ash Borer near daycares and schools.

— Permits the domestic use of pesticides containing D-phenothrine and tetramethrine against wasps, hornets and bees near daycares and schools.


— Neonics, long used to coat seeds so they don’t get eaten before they sprout, are approved for use on oats, barley, wheat, soybeans, canola, feed, seed and table corn — but are subject to stricter storage and usage controls.

— Neonic retail sales will be subject to a tighter permit system to ensure they are not sold for cosmetic use. For example, retail transactions will now require signed authorization from a licenced agronomist. 

— Existing regulations regarding wetland and watercourse protection and overspray prevention will be applied with greater rigour. 

— Farmers must keep registers of neonic usage; wholesalers must declare annual sales.


— Permits will now be required for fumigation with sulfuryl fluoride, magnesium phosphate;

— Railways and other transport corridors will no longer be required to remit the Ministry a report on pesicide application;

— All commercial pesticide purchases, sales and applications must be recorded on forms for that purpose; the registry no longer wants to see invoices or purchase orders.


Lost in congestion

INRIX 2018’s global traffic scorecard tells us a lot about what’s happening to the average Canadian commute. For the second year, Toronto can moan about Canada’s worst traffic congestion. Hogtown, 19th worst traffic city in the world, traded places with Washington, D.C. (now 20). Montreal sits alone in 34th; Calgary lags at 60th.

It may not seem like it, but Montreal’s traffic congestion has been improving in relation to its worst-traffic competitors. Montreal is down from 28th last year; in 2014, it was Canada’s worst traffic town, with construction and traffic jams adding up to a 21.6% delay and an average of 38.1 hours lost.  Internationally, Montreal’s traffic moves faster than it does in Rostov-on-Don. Montreal traffic is worse than Hamburg’s, where the time lost in congestion costs the average motorist more than 1,200 euros annually.

Congestion now costs the average Montreal driver 145 hours annually, says INRIX’s 2018 scorecard. That’s 15% better than in 2017. Montreal drivers average 12 km/hr in the final mile of their commute. The cost of congestion per driver isn’t available from the data collected in  Montreal, but we can compare ourselves to Los Angeles (47th, 128 hours lost to congestion), with an average cost per driver of $1,785. Average speed for that last mile: a blistering 14 km/h. Yes, L.A. traffic is less congested than Montreal’s. (Boston, #8 worldwide, has North America’s worst traffic, with the average driver losing 164 hours to congestion.) 

How does INRIX know all this? INRIX is a metadata consumer located on the U.S. west coast. It tracks the tower-to-tower handoffs of hundreds of millions of cellphones worldwide and uses movement data to determine at what rate traffic is moving in major cities. You don’t even have to be using your phone to be a droplet in the oceans of data INRIX feeds on.

INRIX began in 2005 and has been on a roll since. INRIX’s Roadway Analysis team works with cities, transport authorities and their agencies. INRIX traffic engineers and programmers produce software for in-vehicle navigation and location tracking systems for autonomous vehicles. In 2016, INRIX Research released its annual worldwide traffic scorecard, crunching data harvested from moving cellphones in 200 major cities around the planet.

INRIX’s scorecard is an effective marketing tool (you can bet that every newsroom in every one of those 200 cities will pick up their story) but it should be obvious it’s not scientific. The data doesn’t differentiate between cellphones riding ground-level public transit and cellphones in cars. Assuming there was a way of  separating them, would it make a big difference? Probably not, an INRIX spokesman told me some years back — buses in most cities still move at the speed of traffic.

What does any of this mean to our average Vaudreuil-Soulanges commuter? In a previous blog (Commute from Hell, Nov. 21/16) I explained how INRIX analytics work in determining average commute times and therefore the additional time lost to congestion. Two years ago, the average commute from the Bédard traffic light to the Guy off-ramp was 45-60 minutes. The ride home varied between 60 and 75 minutes. 

What I see from the latest INRIX stats is that there is no longer an average commute. Tieups are more frequent and take longer to unsnarl. The Ile aux Tourtes bridge averages an incident serious enough to halt traffic once a week. At what point does congestion become an integral part of the commute? 

This brings me to the Reseau express métropolitain (REM), the latest in a string of disappointments for Vaudreuil-Soulanges.  As I blogged last week, a preliminary environmental impact assessment found that over half of those who submitted opinions to a consultation regarding the replacement Ile aux Tourtes Bridge want the designers to consider a REM extension from Ste. Anne de Bellevue to Vaudreuil.  Current plans for the bridge show dedicated bus, cycling and pedestrian lanes — but no space for a REM extension.

The message is clear: by 2023, public transit from Vaudreuil-Soulanges will require at least one other form of transport to connect with the REM. If the Montreal Metropolitan Community (MMC) follows through with repeated threats to impose tolls on the bridges to Montreal Island, how many commuters will say ‘screw the REM’ and pay the tolls?

Vaudreuil-Dorion Mayor Guy Pilon, Vaudreuil-Soulanges MRC DG Guy-Lin Beaudoin and MRC prefect and Rigaud mayor Réal Brazeau presenting at the Oct. 19, 2011 PMAD adoption. The lack of interest in the room symbolized the MMC’s disregard for the 150,000-resident MRC. 

Everything I see and hear infers there’s a hidden hand trying to dissuade people from moving off-island. I’ve suspected this to be the MMC’s hidden agenda since the October 2011 adoption of its master plan at the St. Constant Railway Museum. The Vaudreuil-Soulanges delegation was shown perfunctory courtesy and zero respect. I found the public shaming embarrassing. 

Oct. 19, 2011 marked the beginning of the end for Vaudreuil-Soulanges political autonomy and it’s my belief the MRC and its 23 mayors still haven’t recovered after being bigfooted by the MMC. The Charest Liberals (followed by the Couillard Liberals) supported the MMC in forcing Vaudreuil-Soulanges to bring its master plan into harmony with the PMAD, the 82-municipality MMC’s master plan. A freeze was placed on farmland dezoning, nixing the original location proposed for the new regional hospital. (Was it any coincidence when history repeated itself with the current site?)

A direct result of the PMAD, picturesque towns like Hudson were ordered to densify their downtown cores on the basis of a  spurious transport-oriented development (TOD) pretext leading to the imposition of inappropriate multi-unit projects in heritage sectors. Transport-oriented development based on a train a day each way? Who are they trying to fool?

Officially, the REM changes nothing when the Ste. Anne terminal opens in 2023. The Vaudreuil-Hudson line will continue to operate one train a day in and out of Hudson. The A40 Express will continue to run between Vaudreuil station and the Côte Vertu metro. Shuttlebus and adapted-transport services will continue to those municipalities willing to pay. But the train’s days are numbered unless Vaudreuil-Soulanges elected officials and citizens demand the level of service available to the rest of the Montreal Metropolitan Community. And so is our autonomy. 










Vaudreuil-Soulanges REM update

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This Facebook page has been created to advocate for the extension of the Réseau express métropolitain (REM) line to Vaudreuil-Soulanges via the new Ile aux Tourtes bridge. 

When the REM surface line to Ste. Anne de Bellevue is completed in 2023, the $6 billion, 26-station automated electric light rail transit (LRT) system will link Montreal, Laval, north and south shores — but not Vaudreuil-Soulanges, Quebec’s fastest growing MRC.

In December, the government announced that a replacement for the nearly 60-year-old Ile aux Tourtes bridge would be completed by 2030. Plans for the new bridge include dedicated bus lanes and separate corridors for cyclists and pedestrians — but no LRT corridor.

Already, proposed parking at West Island REM stations is being cut back. Autorité régionale de transport métropolitain (ARTM), the MMC’s overseer of public transit, favours active transport (walking, cycling) and local shuttlebus service.

Unless regional public transit agencies are prepared to keep operating the existing Vaudreuil-Hudson commuter rail line once the REM is in service, Vaudreuil-Soulanges and its 150,000+ residents will lose their only mass public transit link to Montreal. 

Le REM dans/in Vaudreuil-Soulanges will work to raise awareness of the need to redraw plans for the Ile aux Tourtes replacement to include a REM right of way serving Vaudreuil-Soulanges and points west.

Without access to a high-speed mass public transit system: 

– Vaudreuil-Soulanges enterprises, including the promised hospital, will struggle to attract labour. By its projected 2026 completion, the hospital will represent some 4,000 jobs;

– Vaudreuil-Soulanges residents will continue to be at the mercy of Montreal’s worsening traffic chaos and the eventuality of tolls;

– the Montreal Metropolitan Community will have missed the opportunity to significantly reduce greenhouse gas emissions in the fight against climate change, a keystone of the MMC’s master plan.

Extend the REM, public consult urges


As announced in December, the new Ile aux Tourtes bridge will not include a right of way for an off-island extension of the Réseau express métropolitain (REM). Over half of the participants in a public consultation told the provincial Environment ministry they want to see a REM extension made part of the environmental impact assessment process. (John Kranitz photo)

An environmental impact study of the replacement Ile aux Tourtes bridge should include an analysis of extending the Réseau express métropolitain (REM) line to Vaudreuil-Dorion, according to a majority of opinions submitted to a public environment ministry consultation released Monday. 

As currently configured, the 26-station automated electric light rail transit (LRT) system will terminate in Ste. Anne de Bellevue when it begins service in 2021. The $6B network will link Montreal, Laval, the north and south shores — but not Vaudreuil-Soulanges and its 150,000+ residents. 

The public consultation — on which factors should be taken into account in the planning and reconstruction of the Ile aux Tourtes bridge — began on Dec. 12/18 and concluded Jan. 11/19. The 16-page document is a summary of observations from participants on the factors which they feel should be considered in a future environmental impact study. 

In December, the government announced that a replacement bridge would be completed by 2030 to replace the two-kilometre span, built in the early sixties and neglected for long periods. The new bridge will be 45 metres wide (the existing bridge is 29 metres), with dedicated lanes for public transit and carpooling. 

The consultation drew 28 briefs, 17 of which specifically urged the transport ministry to include an extension of the REM to Vaudreuil-Dorion as an integral part of the reconstruction project. 

Accessibility and public safety were significant concerns of most intervenors. Ten comments focussed on traffic congestion on the bridge and its approaches before, during and after construction. Recommendations including closing some on-ramps and exits to mitigate the risk of accidents and to restore fluidity, both in the planning stage and during construction. Others wanted a speed limit reduction, photo radar, reflective lane markers and the quick removal of snow accumulation. One brief suggested diverting all truck traffic to Highway 30 unless it is headed to the West Island.

Environmental concerns were well represented, with a number of briefs urging the addition of dedicated bicycle/pedestrian lanes and the development of policies to preserve prehistoric sites and natural habitats of Ile aux Tourtes and adjacent islands and shorelines. 

Noise and vibration from the roughly 83,000 vehicles a day — 10,000 of them trucks — were also raised as concerns. A number of contributors wanted the new span’s design and construction to reflect best practices worldwide.

Consultation participants raised concerns about the ongoing lack of transparency on the part of the transport ministry when it comes to the existing bridge and how traffic will be rerouted during construction of its replacement. Many cited a lack of transparency while the existing bridge underwent repairs and expressed concern at the foggy timeline for its replacement.

Article 31.3 of the Environmental Quality Act requires that after having received a directive from the environment minister, a project’s initiator — in this case the Ministère du Transport — is required to publish a notice announcing the start of an environmental impact evaluation, the first step in drafting an environmental impact assessment of the bridge replacement project 

Under the law, any person, group or municipality has the right to suggest what factors should be explored in the process of determining the project’s environmental impact. Once the consultation period ends, the environment ministry shares the results with the project’s initiator and posts factors it considers relevant on the Registre des évaluations environnementales page. 

Next step is an impact study to detail modifications to be made during the planning process and to address issues raised in the course of this evaluation process. No hard dates have been set for the start of construction or completion. The transport ministry hasn’t indicated whether the existing span will be demolished. 

Documentation and citations: 

Les observations sur les enjeux que l’étude d’impact devrait aborder:

Reconstruction du pont de l’île-aux-Tourtes entre Vaudreuil-Dorion et Senneville par le ministère des Transports

Consultation publique

réalisée par le ministère de l’Environnement

et de la Lutte contre les changements climatiques

3211-05-469 31 janvier 2019

Nom du projet :

Reconstruction du pont de l’Île-aux-Tourtes entre Vaudreuil-Dorion et Senneville

Initiateur :

Ministère des Transports du Québec

Document :

PR2.3 – MELCC. Observations et enjeux soulevés par le public, janvier 2019, 16 pages.

Date du dépôt du document :


Cannabis chronicles 3

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Canada’s chief public health officer Dr. Theresa Tam calls for safer opioids as she announces the death toll for the first half of 2018.

More North Americans die of opioid abuse than in traffic accidents. In 2017, 3,987 Canadians died from opioid overdoses. In the U.S., where widespread opiate and opioid abuse started earlier, the number of deaths topped 72,000. [Ed.: the terms opiate and opioid initially were used to differentiate between drugs derived from opium and synthesized variants. Opioid has become the umbrella term.]

Opioid abuse takes many forms, says a prominent Quebec pain control and addiction specialist. “Patients with prescriptions sell their meds or fail to store them safely.”

He sees adolescents, especially those who consume THC, buying opioids and becoming addicted. “THC consumed in adolescence alters brain structure and chemistry, leading to a decrease in verbal memory, especially if the person is also battle ADHD, anxiety or mood swings. Then they end up self-medicating with THC.”

How widespread is opioid abuse? He cites a study of 570,000 opioid-unaware patients receiving post-operative opioids who were followed for 2.7 years. “One per cent overused or abused, but with serious consequences […] The risk of abuse doubles with every prescription renewal, even one, regardless of dosage.” His conclusion: “Opioids should be prescribed in small doses over the short term, not repeatable.”

My source asked that I not  identify him. His campaign to sensitize patients and healthcare bureaucrats to the risks of opioids has  led to clashes with regulatory bodies responsible for ensuring the health and safety of patients. Instead, he says, these bodies act as if their sole intent is to ensure that alternatives such as cannabidiol (CBD) are hard to prescribe, obtain and assess for efficacy while giving the opioid industry free rein to do business as usual despite clear evidence of an epidemic of abuse.

I asked him whether opioids are effective, non-addictive painkillers when used as prescribed.

“I came to realize that my patients taking opioids for pain relief were fat, lazy, sweaty, non-functional — and still in pain,” he replied. The condition is called opioid-induced hyperalgesia, characterized by a paradoxical response whereby a patient receiving opioids for the treatment of pain could actually become more sensitive to certain painful stimuli.

Urinalysis and close questioning led him to conclude some of his patients were trading their prescribed drugs for more powerful alternatives on the black market. Others were selling all or part of their prescribed drugs for cash. His doctor-patient relationship prevented him from turning them over to the police. The response from the Collège des médecins du Québec (CMQ)? Stop prescribing.

Since his aha! moment, he has pioneered in the prescribing of cannabinoids in the treatment of chronic neuropathic pain. He also seeks to educate, offering two-hour seminars to healthcare professionals during which he dispels misconceptions about cannabinoids and explains the chemistry and psychology of neuropathic pain. (Indicative of an awakening taking place within the industry, his lectures are sponsored by opioid producers Purdue and Janssen.)

He scrupulously maintains an arm’s-length relationship with Canada’s get-rich-quick cannabis industry. “I didn’t invest because I want to remain credible,” he told me in November. “It’s a huge field and it’s just starting…I saw it coming because the current treatments for neuropathic pain are not working.” Big Pharma knows it, federal and provincial regulators know it, doctors and pharmacists know it, he adds, but that knowledge isn’t being shared with the patient.

It’s equally clear to him that unless the medical cannabis industry can demonstrate the science to support efficacy claims, the industry can’t advance. “There’s a real lack of understanding of [the body’s own endocannabinoids and how they act on our pain receptors]. Unless there’s a scientific basis, there’s no research money.” Without research on a proposed substance’s medical indications, attenuating effects, optimum dosage and clinical trials, Health Canada won’t issue a Drug Identification Number (DIN), the basis on which a drug can be prescribed for a specific use and covered by public or private drug insurance.

Theoretically, any licenced Canadian doctor has been able since 2013 to write a prescription for medical marijuana and its derivatives without the patient having to enrol in a clinical trial. Because of the determined efforts of the Collège des médecins du Québec, it’s easier to buy black-market or grey-market cannabis than it is to find a Quebec GP willing to write a prescription.

As of April 1, 2014, cannabis could only be prescribed in Quebec “within a research framework,” as it is not a medically recognized treatment. Quebec patients with the financial wherewithal had the option of consulting one of a growing number of private pain clinics. Those without the means were given the choice of buying products online (with no guarantee of purity or dosage consistency) or from First Nations distributors (the Tyendinaga Mohawk Nation south of Belleville has 57 outlets selling medical and recreational cannabis of varying potency and quality). Until Quebec’s pot police ordered them to stop, the province’s pet stores were selling out their supplies of veterinary-quality CBD to arthritic oldsters of another species.

However, Quebec’s insistence on patients having to enrol in clinical trials may have given cannabinoid researchers a leg up. In May 2015, the world’s first research database on the use of cannabis for medical purposes, the Quebec Cannabis Registry (www.registrecannabisquebec.com) was launched under the auspices of the Research Institute of the McGill University Health Centre (RI-MUHC) and the Canadian Consortium for the Investigation of Cannabinoids (CCIC).  

The Registry’s creators set a goal of 3,000 participants over a 10-year period. (The Registry stopped taking registrants in the fall of 2018 after enrolling the 3,000.) It curates clinical data from patients, sites and clinics throughout Quebec; each participant must agree to provide data for four years after recruitment. Any licensed doctor practising in the province wishing to authorize cannabis for their adult patients could enrol participants in the registry.

The CMQ sought to denigrate the Registry, claiming it doesn’t satisfy the criteria of true scientific research and therefore can’t demonstrate that cannabinoids offer a solid alternative to opioids for chronic pain relief. However, most I spoke to believe that research eventually will demonstrate that provincial pharmeconomies can save millions by replacing ineffective, addicting opioids and other prescription drugs with cannabinoids. In the end, it’s a cost-benefit analysis. What’s an overdose death worth? What’s the price tag on addiction? I understand the need for skepticism and caution but I find it incredible that in Canada, medical cannabis isn’t further ahead.

During a trip to Italy last fall, I was blown away by the percentage of Italians who use cannabidiol for pain relief. CBD is widely available throughout Rome, Florence, Milan and most larger cities. Italians who would never dream of smoking to get buzzed use CBD to treat arthritis, chronic pain, anxiety, insomnia and a list of inflammatory and autoimmune disorders. Significantly, Italy does not appear to have an opioid addiction problem.

The CBD sold in Rome was manufactured in Holland and certified 99% pure, which to my experience covering this issue is questionable.

While unlicenced extraction appears to be a crime nationally, one Quebec cannabidiol extractor told me he’s sourcing his CBD from non-psychoactive indica (hemp) plants. The active ingredient can be extracted with various easily available solvents. Ottawa’s legalization legislation, Bills C-45 and C-46, didn’t deal with this other than to stipulate that there would be a year’s delay before consumeables and edibles are legalized.  At an industry conference last spring, several major players told me tell me the non-THC demand will dwarf recreational and they’re happy to have the time to source CBD precursors and develop delivery systems.







Cannabis chronicles 2

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Human endocannabinoid receptors CB1 and CB2. Receptor sites are found in many organs and areas of the body, but CB1 receptors are primarily located in the central nervous system, which includes the brain. CB2 receptors are found primarily in the immune system.
Cannabinoids THC and CBD interact with these receptor sites like our endocannabinoids do. (from the Ontario Cannabis Stores website (https://ocs.ca/blogs/how-cannabis-works/endocannabinoid-system).)

In November 2018 I was diagnosed with advanced osteoarthritis of the left hip. I’m scheduled to see a specialist in early February, with a surgical date dependent on the surgeon’s hospital OR schedule. According to the Canadian Institute for Health Information, I have an 83% chance of getting my hip replacement within 182 days of my referral.

In the meantime, I walk with a cane or ski pole. The only exercise left to me is swimming. My osteopath has succeeded in reducing associated sciatic pain but walking, standing, sitting and lying down are painful, often acutely. I can no longer control the pain with NSAIDs. I refuse to consider opioids because of their risks. 

On the advice of my GP I enrolled in a clinical trial conducted by the Registre de cannabis du Quebec, the Quebec Cannabis Registry. I take 1.5 ml of prescribed cannabidiol oil under my tongue twice daily. CBD reduces the pain’s intensity, allowing me to get on with life. It takes approximately 90 minutes for the dosage to take effect. 

Because everyone’s endo-cannabinoid receptors are unique, there is no such thing as a universal optimal dose or CBD/THC balance. Instead, one embarks on a trial-and-error process of finding one’s optimal dosage. Every refill arrives with a Health Canada fact sheet urging the beginner to start low and go slow in increasing one’s dosage. 

My pain specialist prescribed Spectrum Yellow, 20% CBD and less than 1% THC. I’ve been keeping a daily journal on my results and observed side effects. On the plus side: my pain is reduced to a manageable dull ache, I enjoy deeper, more restful sleep, a reduced appetite (a positive because my GP says I have to lose 10 pounds or I’ll be using a walker), regularity, and heightened senses of smell and taste. Less welcome are the dry mouth and eyes and a loss of enjoyment for alcohol. I’ve also noticed interactions with coffee (too much or too little triggers fleeting headaches) and a tendency to slight depression if I don’t drink a lot more water than I used to.

Once a month, I complete a Registry questionnaire. Has my quality of life improved or deteriorated? How well am I able to function? I report side effects and possible adverse reactions to the supplier as they occur and fill out their questionnaire.

I talk about CBD because I think others should know about it. People ask me whether it makes me high (it doesn’t), whether I can drive legally (depends on my ability to pass a roadside sobriety test) or visit the U.S. Over the course of the last two months, I’ve been surprised by the number of those taking CBD for a wide variety of conditions. A friend’s COPD has improved, another’s arthritic pain is less crippling. I take them for what they are — anecdotal evidence of the efficacy of CBD as an anti-inflammatory and pain reliever.

As a journalist, I have covered Canada’s transition from Killer Weed and reefer madness to legal pot, beginning with the Le Dain Commission hearings into legalization versus decriminalization. My biggest regret is that the Trudeau Liberals made legalization of recreational marijuana their priority, launching Canada into the big experiment before the medical profession is set up to measure the effects on individuals and the healthcare system. At the same time I find it beyond idiotic that Quebec doctors are still being discouraged from writing medical cannabis prescriptions and I find myself wondering what it will take to show how federal and provincial regulatory bodies are conspiring with those who manufacture, market and distribute opioids to keep patients “sweaty, fat, lazy, unmotivated — and still in pain.”

Is CBD a medical magic bullet? Which markers determine whether someone will respond well to cannabinoids and who might be genetically predisposed to psychotic or allergic reactions? Why do men and women respond differently? Without research, without scientifically conducted clinical trials, we won’t know until the U.S. jumps in — which is happening as I write this.

The Quebec Cannabis Registry is said to be planning to release details from its database this spring. In the meantime, I’ve spent the past month plowing through the contents of Therapeutic and Recreational Cannabis: In Search of Answers, an 83-page Powerpoint shown to doctors, pharmacists and nurse practitioners.  It draws case histories from the Registry.

Powerpoint takeaways:

— Current knowledge of the body’s endo-cannabinoid system is fragmentary but we know it is involved in regulating the cognitive system, fertility, pregnancy, appetite, mood, pain sensations and motor learning.

The human body manufactures its own endo-cannabinoids: anandamide, which acts on the same pain receptors as THC, and 2-arachidonoylglycerol, or 2-AG, which appears to control the level of a certain fatty acid that limits body’s anandamide levels.  These molecules latch onto CB1 and CB2 receptors to regulate and control a range of bodily functions. The theory is that a correct ratio of cannabis plant-derived analogs tetrahydrocannabinol and cannabidiol can help rebalance the body’s endo-cannabinoid system. But drug basics — counterindications, dosage, interactions and side effects are fragmentary.

We know there’s an individual optimal mix of THC and CBD but we don’t know much about the 140 other compounds found in cannabis strains. We’re beginning to learn about the function of terpenes — aromatic components in cannabis extracts — in modulating the effects of THC and CBD.

Research, most of it anecdotal, has determined that ratios of caryophyllene, limonene, myrcene, pinene and terpineol play a role in determining the psychological effects of different cannabis strains. The farthest the industry goes in assigning specific benefits to terpene combinations is to describe them as having an “entourage effect” — a hypothetical mechanism by which compounds in cannabis largely non-psychoactive by themselves moderate the overall psychoactive effects of the plant.

The Powerpoint’s clinical observations about CBD and THC are convincing, not only in the treatment of neuropathic pain but the generalized symptoms of pain, psychic troubles, inflammatory and auto-immune disorders and neurological complaints can be mitigated. Studies show positive results in treating of epilepsy, anorexia, fibromyalgia, inflammatory bowel and intestinal disease, chronic migraines, acute pain sensitivity, chronic fatigue syndrome, bipolar disorder, autism spectrum disorders, insomnia, anxiety, PTSD, schizophrenia and depression.

The presentation begins with a pharmaceutical history of pain relief, then shows how CBD and THC are being used to treat the same disorders with positive results. By the 63rd slide, the dissertation gets into pain-relief specifics: preliminary results from the Registry show reductions in neurological and mixed back pain, radiating lower neck pain with or without dystonia, CRPS, post-operative visceral pain (abdominal and pelvic), post-traumatic chronic headaches and migraines, jaw pain and cancer-related pain (nausea, wasting).

“We are likely going to be able to show major pharmacological benefits and savings in pain treatment,” the presentation concludes. “Most psychoactive drugs will eventually be phased out.”

This is where some of the research is concentrating — on the use of CBD to wean opioid addicts off their drugs. (This presentation was funded by Purdue Pharma and Janssen Ortho, two major opioid producers.) North America uses 80% of the world’s prescription opioids. It’s a $2.6B industry. Access to replacement treatments using methadone and suboxone is extremely limited. There is an 85% risk of relapse. Even through the genetics and neurobiology of addiction are well known, funding for research is very limited. The subject is poorly or not taught in medical schools.

Pain researchers report immediate effects when CBD is combined with opioids. Pain relief is immediate and tolerance levels are lowered. Some patients stopped taking opioids. Others stopped taking antidepressants, anti-convulsants and anti-spasmodics. “…there is evidence that CBD…can play a role not in opioid withdrawal, but with other stimulants — nicotine, cocaine, amphetamines.” Doctors currently prescribing medical cannabis agree Quebec’s pharmacies are best situated to ensure compliance and provide advice to patients about the side effects of terpene profiles.

Quebec Cannabis Registry case histories:

#3 52-year-old female with chronic back and hip pain, migraines, chronic fatigue, insomnia off work for 2+ years and walking with a cane, treated with 30 mg of CBD and 7.5 mg. THC/day. No longer uses fentenyl patches, gabapentin, naproxyn, Cymbalta, Tramacet, Elavil, clonazepam.

#4: male, 70, with progressive chronic pain since 2004, fibromyalgia, neuropathic pain in hands, chronic fatigue and insomnia, treated with CBD 30 mg/day and THC 2×23 mg/day. Has ceased taking Cymbalta, oxycodone, ketamine, Tylenol, naproxyn, OxyNeo, gabapentin, Nabilone, Elavil, Senecot/Colace.

#5: 42-year-old woman with Lynch Syndrome underwent colon, brain and breast surgeries in adolescence.  Suffers from chronic head and abdominal pain. Treated with CBD and THC, she has stopped using Elavil, Constella, Effexor, dicyclomine,  Prevacid, naproxyn, gabapentin, citalopram. She continues to take meds prescribed for bipolar disorder.

#6: Female, 52, with Crohn’s disease underwent total colectomy, suffers from rheumatoid arthritis, chronic abdominal pain. Medications included prednisone, Statex, Gravol, Serax, Tylenol, Pantoloc, Purinethol. Since being placed on 15 mg of CBD and 10 mg THC at bedtime, she no longer uses prescription meds.

#7: 38-year-old woman diagnosed with fibromyalgia in 2005 and spinal arthritis in 2007, was given 26.3 mg of THC at bedtime and 20 mg. of CBD twice daily. She stopped using fentanyl patch, Elavil, Cyclopenzaprine, Topamax, Dexilant, Seroquel, Lax A Day and Gabapentin. By September, she was receiving injections of Certolizumab, a biologic medication prescribed for Crohn’s and several forms of arthritis.

#8: 35-year-old mother of four suffered kidney stones and related infections. Diagnosed with psychiatric disorder, addicted to dilaudid and other prescription painkillers. Unable to tolerate methadone, she was switched to the opiod Tapenadol. She is undergoing cannabis therapy while continuing Tapenadol and the antidepressant Effexor.

#9: 32-year-old woman underwent total colectomy and ileostomy in the course of an emergency caeserian and underwent nine more surgical procedures for adhesions. Suffers from chronic abdominal pain, took to injecting prescription meds to cope. Hospitalized, she was switched from hydromorphone to metadol and is undergoing cannabis therapy to wean her from metadol. She’s off opioids dilaudid and Contin and will stop taking the tranquilizer clonazepam and Trintellix, an antidepressant.

#10: Male, 37, suffered a crushed wrist in 2015 and subsequent neuropathic pain. Unable to tolerate prescription painkillers, consumed 6-8 grammes of dried cannabis per day. Switched to 2 grammes of THC/CBD hybrid cannabis flowers and daily doses of THC and CBD oils.

#11: Female, 56, severe chronic back pain, multiple intolerances to prescription painkillers, walks with a cane with difficulty. Placed on a dosage of 1-3 grammes of a mix of CBD and THC cannabis strains, she stopped taking her daily mix — Lyrica, Kadian, Emtec, Contin, dilaudid, naproxyn, Flexeril.

#12: 60-year-old male injured his left knee in a 2005 workplace accident and was forced to stop working 10 years ago as the result of chronic neuropathic pain. Opioid dependent, he became obese. Since starting to take gelcaps of a THC/CBD oil mix at suppertime, he stopped taking Oxyneo and oxycodone and has reduced his metadol prescription by two thirds. He has since returned to work and has lost 47 pounds.

The presentation’s conclusions:

— Our lack of understanding of neuropathic pain, addiction and pain hypersensitivity has led to the misuse of opioids.

— Opioids have their place, but new restrictions must be placed on their use.

— The preliminary results of the Quebec Cannabis Registry demonstrate an efficacy in  neuropathic pain, inflammatory diseases, and possibly in relieving pain hypersensitivity and the symptoms of opioid withdrawal.

— Cannabis isn’t tolerated by everyone and will not be covered until in-depth studies are published, which will take considerable time unless demonstrated savings in [drug, hospital and social costs] generate the political will to effect change.

— The Colleges [of Physicians and Surgeons] the faculties of medicine and the Order of Pharmacists should promote the teaching of these subjects to their members.

— What is considered recreational usage is often the result of self-medication for an undiagnosed condition. These individuals should be able to access the information required for healthy use of these products.

My growing cane collection.