Dunne on the medical cannabis situation

Associate Health Minister Peter Dunne has blogged this week on the current situation regarding the availability and prospects for future availability of medicinal cannabis in New Zealand.

Forget the past and facts and fiction about Dunne and his position on drugs. There are people trying to establish a better way of dealing with medicinal cannabis that are finding that Dunne is receptive to positive change as much as our current law allows and as much as the reluctance of our current Parliament may allow.

In New Zealand, medical practitioners can prescribe medicines approved and registered under the Medicines Act. Registration occurs after a rigorous clinical testing process, and PHARMAC separately decides whether to fund the product. One medicinal cannabis product, Sativex, is currently so registered, and PHARMAC is currently considering whether to subsidise it. No other medicinal cannabis products have been submitted for registration in New Zealand.

Where medicines are unregistered and therefore unapproved, there has been a procedure set out in the Medicines Act for many years now to allow the Minister to approve the prescription of such an unapproved product, upon the application of a medical practitioner or specialist.

That application has to be lodged with the Ministry of Health, stating the product, the purposes for which it is being sought, the dosage, along with general clinical assessments of its likely clinical efficacy and safety. The Ministry then makes a clinical assessment of the case, and recommends a course of action to the Minister. To date, only one application ever has been made for a medicinal cannabis product, which was the case I approved earlier this year.

I am not a clinician, so therefore, in considering any such applications, I have made it very clear that I will be strongly guided by the clinical advice which I receive. The reason for the decision in such cases being made at a Ministerial level has nothing to do with cannabis, but is simply because the applications are being made as an exception to the existing law.

This is the current law and it requires Ministerial approval, but in effect the doctors and the Ministry of health determine whether medicinal cannabis can be used or not.

So, patients seeking access to medicinal cannabis products need to consult their medical advisers in the first instance. If Sativex is not deemed suitable, then they need to discuss what other alternatives might be best for them, and whether an application under the Medicines Act is the appropriate way to proceed.

If patients or parents of patients want to obtain cannabis products for genuine medicinal purposes then they should find a doctor who is prepared to seek approval for them.

Again, there is nothing unusual or particular to medicinal cannabis in that – we do not make any prescription medicines available without the support of the specialist or medical practitioner, for obvious reasons, and medicinal cannabis should be treated exactly the same way.

However, I would be concerned if it became clear that personal antipathy to cannabis was causing some doctors not to seek approval for medicinal cannabis products for their patients, in cases where it was potentially beneficial. My strong plea to them is to always put the best interests of their patients ahead of any personal views they might hold, when considering such cases.

We are watching closely the clinical trials being conducted in the United States and Australia, but they are not likely to produce results before 2016-2017 at the earliest. It is possible that were the FDA or the Therapeutic Goods Agency to approve medicinal cannabis products as a result of these trials our regulator Medsafe would look to follow suit here, but that is still some time away.

Things are moving fairly quickly now on testing and potentially approving of cannabis products, but it takes time to ensure it is done properly.

One of the worst things that could happen would be to rush access to a product that turns out to be ineffective or worse, detrimental to health.

What is clear, however, is that any approval is likely to be for a very limited range of products in highly specific and regulated circumstances, and certainly not the open slather situation some seem to be expecting.

The current attention is towards medicinal products that exclude intoxicating ingredients. This is not a back door to widespread smoking of cannabis.

Meantime, the provisions of our Medicines Act will continue to apply, including the opportunities for doctors to seek access to these products in the general interests of their patients. For my part, I will consider any case that comes before me on its particular merits, and without any reference to whatever external noise there might be at the time.

So anyone who wants medicinal product should try to find a doctor who will seek approval and will present a good case for it.

Leave a comment

10 Comments

  1. Rob

     /  15th October 2015

    Grow your own.

    Reply
    • For recreational use perhaps. But for medicinal use you need strains that are suited for that – generally low in the intoxicating THC and high in Cannabidiol (CBD) which is regarded as better for medicinal purposes.

      Reply
    • the seeds are hard to get hold of for high CBD strains, goto herbiesheadhop website and have a look at the medical range of Medical Cannabis seeds, its a pretty dissapointing bunch.

      Reply
  2. Alan Wilkinson

     /  15th October 2015

    That’s the most sensible commentary I’ve heard from Dunne in a very long time.

    Reply
    • I suspect this could be his last term and instead of doing what he thought he needed to do to survive he’s calling things just as he sees then more often.

      He knows that National are going to be very hard to move on cannabis in any form. But things are moving to the stage they may be forced to go with the medicinal need.

      Reply
      • Australia blazing a trail (comparatively speaking) and strong public support would be a lot of heat politically. Labour only seems to have reversed position and become staunchly in favor thanks to Helen Kelly.

        Reply
  3. I read that the plants that they extract CBD from are closer to Hemp strains. Hemp is legal to grow in Aotearoa/NZ(in fact, I’m sure it is being grown now) surely this could be just extended & selectively bred to get the best options !? :/

    btw; If Dunne is not a Doctor, why is anyone taking him seriously on Medicinal issues ?

    Reply
  4. traveller

     /  16th October 2015

    The reason for the decision in such cases being made at a Ministerial level has nothing to do with cannabis, but is simply because the applications are being made as an exception to the existing law.”

    That law is an ass in my opinion.

    Reply
  5. I think Dunne is just making excuses, to hang on to his DRUG of Choice : POWER !

    Reply

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