 | archive: Background information to the Medicinal Cannabis Amendment Bill |
 The Misuse of Drugs (Medicinal Cannabis) Amendment Private Members' Bill balances the needs of patients with concerns about non-medical cannabis use in a way that deserves to be considered by politicians and the community.
This page contains useful background information and answers to questions commonly asked about the medicinal use of cannabis.
“cannabis has been shown to be effective in providing relief for some medical disorders ... the issue of medicinal use should be dealt with independently from the legislation regulating general use”
- New Zealand Health Select Committee, report of the inquiry into the public health
strategies related to cannabis use and the most appropriate legal status, 2003
“Marijuana is beneficial to many patients”
- Jocelyn Elders, former US Surgeon General
“Federal authorities should rescind their prohibition of the medical use of marijuana for seriously ill patients and allow physicians to decide which patients to treat.”
- The New England Journal of Medicine, January 30, 1997
1. What conditions are helped by the medicinal use of cannabis?
Modern research suggests that cannabis is a valuable aid in the treatment of a wide range of clinical applications. In particular, the NSW Working Party on the Use of Cannabis for Medicinal Purposes (2000) agreed with the United States Institute of Medicine (1999) and the UK House of Lords Standing Committee on Science and Technology (1998) that the active ingredients in cannabis can be useful in treating:
HIV-related or cancer-related wasting,
nausea caused by cancer chemotherapy,
muscle spasm in neurological disorders or spinal cord injury,
pain unrelieved by conventional analgesics
Emerging research also suggests that marijuana's medicinal properties may protect the body against some types of malignant tumours and are neuroprotective.
2. How many people may benefit from using medicinal cannabis?
Evidence suggests medicinal use of natural cannabis is widespread. Estimates of how many New Zealanders suffer from conditions potentially alleviated by cannabis and how many may be already using cannabis illegally may be gauged by extrapolating from Australian figures. Hall et al (2001) estimated NSW could have 19,000 medical marijuana users, suggesting New Zealand could have on a population basis 11,400 medical users. Similar figures are noted in the report by the UK House of Lords’ Select Committee on Science and Technology (1999).
In New Zealand a 2003 survey of 500 doctors revealed:
One in five doctors had patients using cannabis medicinally;
47 per cent knew of patients who had discussed the option of using cannabis;
32 per cent would consider prescribing legal medicinal cannabis products;
10 per cent felt they had patients who would benefit from it;
30 per cent indicated they should be able to prescribe it.
In general, the survey indicated that there is a general lack of knowledge among doctors about medicinal cannabis, but the more knowledge a doctor holds, the more likely they are to support the use of medicinal cannabis and (NZPA, 3 October 2003).
3. What is the overseas experience and what are other countries doing about it?
Internationally, a number of jurisdictions have moved to legalize medicinal cannabis by various means. For example, in the USA eleven states allow patients to grow their own cannabis or nominate someone to do it for them. Eight of these require patients to be listed on a confidential state registry, the others do not. The federal government also supplies pre-rolled marijuana cigarettes to patients registered under its Investigational New Drug Programme. Canada legalized the possession and cultivation of medical marijuana in 2001 and licensed the cannabis-derived medicine Sativex in 2005, which is now available there by prescription through pharmacies. Although Sativex is not yet approved in the UK, the Home Office has allowed doctors to treat patients with it on a case-by-case basis since 2005. In the Netherlands the Bureau of Medicinal Cannabis (part of the Ministry of Health, Welfare and Sport) distributes two varieties of standardised medical-grade cannabis flowers through pharmacies.
4. What do international health organizations think about medicinal cannabis?
Currently, more than 60 U.S. and international health organizations - including the American Public Health Association, Health Canada, the US Institute of Medicine, the US Presbyterian Church and the Federation of American Scientists - support granting patients immediate legal access to medicinal marijuana under a physician's supervision. (See www.norml.org/index.cfm?Group_ID=3388 for a complete listing.)
5. Answers to possible concerns about medicinal cannabis
"Surely existing provisions are adequate, why do we need this?"
The truth: While the Misuse of Drugs Act and the Medicines Act both theoretically allow cannabis to be approved on a case-by-case basis or for a category of patients, these provisions have proved to be too cumbersome, onerous and burdensome to be practical or useful. The fact that no applications have been approved is evidence of this. However, these provisions will remain and could be used alongside this Bill, which provides an alternative mechanism that will speedily satisfy the needs of patients and doctors.
"Smoking a medicine is just not right!"
The truth: For seriously ill or terminally ill people smoking is the least of their concerns. This bill does not presume that the medicinal cannabis must be smoked, and in fact smoke can be avoided entirely through the use of vaporisers, tinctures, and cannabis-based food or drinks. However, inhalation provides instant onset and ease of dose titration, unlike swallowed pills which take up to 2 hours to have any effect, and hard to keep down in the case of someone suffering nausea from their condition or other medications. It is also worth pointing out that marijuana smoke is not the same as tobacco smoke. Several recent studies have shown a "protective" effect and found that marijuana smokers have lower rates of lung cancer than tobacco smokers and even non-smokers (eg, Tashkin et al in Scientific American, 2006)
"Doctors may be pressured to recommend cannabis for people who do not need it"
The truth: Doctors are trained to pick up so-called “drug seekers” as it is an ordinary fact of life for all doctors. In fact, this Bill is about returning control to doctors, who are medically trained to make these decisions, and removes the politics from the equation.
"What's all this about designated agents?"
The truth: If a patient is unable to grow their own plants, they can designate someone of reputable character to do it for them. The designated agent is most likely to be a spouse, family member or caregiver.
"Medical cannabis could be diverted to the black market!"
The truth: The size of the current cannabis illicit market makes it unlikely that cannabis grown for medical purposes will be diverted to the illicit market. Following from Hall et al (2001), the number of people who would be permitted under these recommendations to use cannabis for medical purposes is less than 2.5% of those using cannabis for non-medical purposes, so it is unlikely to have any substantial impact. Furthermore, police will know the names and addresses of license holders.
"Allowing medical cannabis sends the wrong message that we are condoning the recreational use of cannabis"
The truth: It is unlikely that allowing exemptions for medical uses of cannabis will be seen as condoning the non-medical use of cannabis. In the US, survey evidence shows majority support for medical uses of cannabis, yet there is strong support for the continued prohibition of non-medical cannabis use. In fact, allowing the medical use of cannabis sends a powerful message about the appropriate context of medicines and drug taking and therefore, if anything, sends a message against recreational use.
Ultimately, patients with certain illnesses will be able to use pharmaceutical cannabinoids or other drugs, but, in the meantime, the bill will allow these patients to use cannabis for medical reasons without changing the legal prohibition on non-medical use of cannabis.
6. References & further information
Hall W, Degenhardt L and Currow D, Allowing the medical use of cannabis, Medical Journal of Australia 2001; 175: 39-40 www.mja.com.au/public/issues/175_01_020701/hall/hall.html
Hall W, Degenhardt L. Estimated number of potential medical users of cannabis. Sydney: National Drug and Alcohol Research Centre, 2000. www.med.unsw.edu.au/ndarc/
House of Lords Select Committee on Science and Technology (United Kingdom). Cannabis: the scientific and medical evidence. London: The Stationery Office, 1998
National Academy of Sciences' Institute of Medicine, Marijuana and Medicine: Assessing the Science Base. Washington: National Academy Press, 1999
New Zealand Press Association, Greens Back Cannabis Call With Doctor Survey, 3 October 2003, www.mapinc.org/drugnews/v03/n1503/a12.html?228174
Tashkin, Morgenstern, et al. “Marijuana use and cancers of the lung and upper aerodigestive tract: results of a case-control study”, Presentation at the ICRS Conference on Cannabinoids, 24-27 June 2005, Clearwater, USA, in Scientific American of 24 May 2006
Working Party on the Use of Cannabis for Medical Purposes. Volume I: Executive summary; Volume II: Main report. Sydney: NSW Government, 2000. www.druginfo.nsw.gov.au/druginfo/reports/medical_cannabis.html
Useful websites:
www.cannabis-med.org
www.norml.org.nz/medical
www.greencross.org.nz
www.gwpharm.com
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prepared by the National Organisation for the Reform of Marijuana Laws, New Zealand Inc (NORML NZ)
PO Box 3307 Auckland. Ph 09 302 5255 Fax 09 303 1309 info@norml.org.nz
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