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Mathew (last name with held) smokes a joint (also know as Marijuana, weed, grass, pot, chronic, joint, blunt, herb, cannabis, hashish, Mary Jane) at Victory Square in Vancouver's downtown Eastside August 20, 2013.

John Lehmann/The Globe and Mail

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When a new public policy is introduced there is, presumably, a purpose, a goal.

But, try as one may, it is virtually impossible to decode what the Conservative government is trying to achieve with its new medical marijuana rules.

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First, let's review a bit of the history and rules.

Canada has allowed access to cannabis for medical purposes since July 2001. The move was designed to show compassion for patients with certain medical conditions – chronic pain, epilepsy, nausea caused by cancer treatments, severe arthritis – and few effective alternatives.

To get medical pot, patients could apply for what was essentially an exemption from the law that outlaws possession. Doing so required a form signed by a physician and submitted to Health Canada, but not shared with police or physicians' regulatory bodies.

Under the terms of the Medical Marihuana Access Regulations, approved patients could either grow their own cannabis or purchase it from a licensed provider, all of which required a bunch of paperwork.

Under this regime, the number of medical marijuana users grew slowly but steadily, from fewer than 500 initially to the current number of 37,400. There were also 4,200 licensed growers, none of whom were allowed to supply more than two patients. You could also buy seeds or pot from Health Canada but virtually no one did because the quality was poor. Compassion Clubs – where people went to smoke their medication – also sprung up in a legal grey area.

The new rules, which took effect Tuesday, are similar but have some small but important differences.

First of all, the new regulations place far more onus on medical practitioners. They must declare conventional treatments have been tried and found to be ineffective and essentially prescribe cannabis as an alternative. This has made a lot of physicians uncomfortable because there is little good evidence for the clinical effectiveness of marijuana and no clear guidelines on dosage. (To be fair, these studies have not been done because of draconian drug laws in the U.S.; some, like Dr. Sanjay Gupta, argue that the research that does exist is compelling.)

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As the Canadian Medical Association said in response to the new regulations: "Expecting doctors to write prescriptions for marijuana without the existence of such evidence is akin to asking them to work blindfolded and potentially jeopardize the safety of patients."

The CMA position is not supported by all doctors but it is a reasonable one: If you want to treat marijuana as a prescription drug, then it should be subject to the same rules as other prescription drugs. If, on the other hand, you want to make it available for compassionate reasons, then do so, but be explicit about that approach.

The biggest change is that patients will no longer be able to grow their own cannabis or purchase it from small suppliers. They will now have to purchase dried cannabis from licensed suppliers, all of them large-scale pot farms.

The thinking here is that oversight of a handful of big, commercial growers will be easier than policing thousands of small hobby farmers. The RCMP has long argued that these small-time growers are fronts for grow-ops and that the licensed marijuana growers are selling to a lot more than patients with a permit.

Buying pot from Health Canada will cost $9 to $12 a gram, a substantial increase from the current cost, which ranges from zero to $5 a gram. So much for the compassionate aspect of medical marijuana, though the crackdown on small growers can be seen as consistent with the government's law-and-order approach.

Most puzzling of all – especially for a government that still embraces the War on Drugs – is that Ottawa is heralding these changes as business-oriented and for their potential as an economic driver. Health Canada predicts that, within a decade, there will be 450,000 users of medical marijuana, a market worth $1.3-billion a year.

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This suggests that, within 10 years, the number of Canadians living with otherwise untreatable chronic pain is going to grow ten-fold. If that's the case, from a public policy perspective, we had better have a much better plan that selling them all a few overpriced doobies every month.

On the other hand, if the public policy purpose is to generate revenue, then why limit ourselves to sick people, and why implicate doctors in the enterprise?

Why not just legalize marijuana, sell it at the local liquor store, and do away with all the paperwork and bureaucracy for those living with chronic pain?

In a bid to have it both ways – be tough on crime, yet cash in on the popularity of marijuana (medical and otherwise) – Ottawa has a created a set of rules that are nonsensical and untenable.

It makes you wonder what they've been smoking.

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