The problems with medicinal cannabis

Only minor changes have been made to Ministry of health guidelines for approval of use of cannabis-based products – see Minor MOH changes on cannabis based products.

This leaves medicinal cannabis in a bit of a catch-22 situation – until products can be proven to be effective and safe they won’t be approved, but until they are used and properly assessed their effectiveness and safety will remain unknown.

Stuff reports: Guidelines for applying for medicinal cannabis barely touched following review

The feedback from the review was “unanimously supportive that the guidelines and process are sound,” Dunne said.

His position of a “robust and scientific” approach to cannabis has not changed, which means “identifying the greatest therapeutic benefits and determining the most appropriate ratios, dosage and delivery mechanisms”.

“Otherwise we are essentially flying blind and hoping for the best, an approach that flies in the face of evidence-based medicines policy.

“The consistent feedback from experts in their field was that cannabis-based products should be treated no differently to other medicines – evidence-based principles should and will continue to be followed”.

New Zealand will have to wait until adequate testing of cannabis based products has been done overseas.

In general this is a sound approach, the Ministry should not approve untested or unknown products.

However cannabis is already widely used in new Zealand, and cannabis based medical products are legally available in other countries and notably in some states of the USA, like California and Oregon (where all cannabis use is legal).

It has also been found to be legal to bring a month’s supply of prescribed cannabis based medicine into New Zealand.

So annoyance and frustration and anger here are easy to understand and empathise with.

This situation has left Helen Kelly, like others, in a situation where she is openly breaking the law.

Terminally ill Helen Kelly says the Government has made her a “criminal” after a review of medicinal cannabis guidelines ended with little change.

Kelly continues to illegally source her own drugs after her bid for medicinal cannabis was withdrawn – the result of a “complicated” application process, which required information that was “impossible to access”.

“I’ve been left to buy my own cancer treatment and take illegal cannabis – the whole system is stuffed.”

I can understand why she thinks the whole system is stuffed, I’d probably feel the same way if I was in a similar situation to her.

And I’d probably break the law too if I thought that illegal but available products would help easy pain and discomfort better than legal products.

The Police appear to be turning a blind eye to  Kelly’s use of cannabis product despite her openness, and it would look awful if they arrested a dying person, but it but this leaves the law looking like an ass.

It’s also understandable that the Ministry of Health and Dunne are unwilling to approve unproven medical products – it would look bad (and would be bad) if they approved one that turned out to be inappropriate or unsafe.

There seems to be no sensible solution in sight in the foreseeable future.

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12 Comments

  1. The obvious solution here is to take MC from being a Medical issue, to a social issue, as all other developed countries with MC have done successfully. Considering how well elucidated the negatives of cannabis are, and the fact that American MC products are stratifying into those that are Pharma grade minus the trials (due to a shortage of capital and federal issues) and those that are sloppy seconds, there is no reason we cant skim the cream (high quality products) off the top while avoiding the poorly prepared products.

    Its disappointing that not a single International expert was consulted on the review, esteemed American Medical Professionals prescribe more MC in 6 months than NZ has ever seen!

    Reply
  2. ‘The problems with medicinal cannabis’ : Dunne & this Govt.’s. excuses to maintain the status quo :/

    Constant inference that its just a back-door to recreational use.. even creating stumbling blocks, for terminally ill patients.. BLOODY DISGRACEFUL !! 😦

    Reply
  3. The scientific approach to medical use of Cannabinoids is summarised here: “The term medical marijuana refers to using the whole unprocessed marijuana plant or its basic extracts to treat a disease or symptom. The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine.

    However, scientific study of the chemicals in marijuana, called cannabinoids, has led to two FDA-approved medications that contain cannabinoid chemicals in pill form. Continued research may lead to more medications.

    Because the marijuana plant contains chemicals that may help treat a range of illnesses or symptoms, many people argue that it should be legal for medical purposes. In fact, a growing number of states have legalized marijuana for medical use. Read more about marijuana-related state laws at http://www.whitehouse.gov/ondcp/state-laws-related-to-marijuana.”

    The US Food and Drugs Association have not yet approved the use of cannabinoids as a medicine. The reason? “The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. So far, researchers have not conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it is meant to treat.

    Read more about the various physical, mental, and behavioural effects of marijuana in DrugFacts: Marijuana at http://www.drugabuse.gov/publications/drugfacts/marijuana.

    By and large Humanities have left decisions on the efficacy of medicine to the Medical Profession which has a tried and proven set of procedures to follow to identify and prove the benefits and side-effects of drugs before they are recognized as being approved for use with humans. History has taught us that not following these procedures is fraught. Thalimide is an example and so are the anti cancer drugs which politicians feel should be funded without following the full .

    I remain convinced by the medical evidence that use of marijuana for recreational purposes is not supportable, primarily due to long-term damage caused to immature brains. For people in terminable conditions, I sympathise with those who are dying and their family and friends. I do know that there are a number of alternative palliative drugs to alleviate pain and suffering, and recognise that some of these have unacceptable side effects. As I understand the rules in place in NZ, where the alternative palliative measures fail to meet the needs of a terminal patient, then use of medical marijuana can be approved on a case by case basis provided it has the appropriate documented specialist/physician support. If this is not the case now, then the procedures should be changed immediately. Finally, we must ensure that the matter remains out of the political arena, and that medical ethics must be applied.

    Reply
    • People who call CANNABIS; ‘Marijuana’ (in a medicinal context) need to do more research !

      * ‘Marijuana’ is a mexican slang name & was used to demonise & spread misinformation about this ancient plant in 1930-50s in USA. Cannabis has been used medicinally for 1000s years (esp. in Asia), prior to the current misinformation/’reefer madness’ being spread by those with an agenda, to prohibit it 😦

      Methinks Dunne & Co. are still pushing this B-S agenda.. are big pharma, pulling their strings ?

      Reply
      • Gezza

         /  20th May 2016

        Nah, I don’t think so Zedd. I think, if polls consistently showed the great majority of the population were in favour of easier access to medicinal cannabis for the chronically ill whom it would benefit, Mr Dunne would probably be strongly in favour of hurrying things along with the bureaucrats – unless National members of the Government were nevertheless all fiercely opposed & it might cost him a job in the next administration.

        Reply
      • Bill

         /  20th May 2016

        Big Australian Pharma are certainly a major player in the saga, Dunne’s said on numerous occasions, we will most likely follow Australia, we’ll see what Australia does, we’ll see what Australia brings to the table as products. He goes to Australia and comes back saying, he’s been briefed on the Colorado model and low a behold, Dunne’s Australian counterparts say, no it doesn’t look good, but a bit early to tell. My God this mans had more hands up his bum, than a Muppet reunion. If he was to ask Colorado itself, at a state level they’d give a different answer, even Greg O’Connor from NZ Police said take a look at Colorado’s model. On the other hand Australia might let us buy Cannabis based medicines off them from the Billion dollar industry they say, is coming their way.

        Reply
      • Zedd, I hope you feel better, and I will use “cannabis” if you prefer, though I have no doubt you understood what I meant. It is quite clear to me where you stand after reading your rant err post! I stand here, please read the law of NZ and Google Medsafe to see what constraints are applied in NZ on obtaining approval for a new medicine. Then read the Misuse of drugs Act 1975 to see where cannabis is (Class C schedule 3) and see what processes are legally required for cannabis extracts to be accepted as a medicine. You will find that NZ is bound to follow procedures contained in international agreements to validate the use of a new medicine. I am not persuaded that there is not a case for the use of cannabinoids in some neurological conditions and also disagree with the Dunne approach in that area. However, the harm that has been scientifically proven by in-depth scientific research to immature brains must be recognised when any decision is made to allow it to be used as a legitimate medicine. I also know how to look at “appeals to emotions” which are used to try and legitimise drug use and do not accept them as being persuasive. I repeat that this is a first world country which applies demonstratively correct adherence to the principles and practices of good medicine. We should all take a deep breath and await the results of the clinical trials which are needed to establish the viability of cannabis as an approved medicine. I support the trials and the processes identified by medical professionals and suggest that you all do the same and hopefully the right decision can be made – whatever that is!

        Reply
    • Bill

       /  20th May 2016

      This post emphasizes everything that the prohibition propaganda machine has done to misinform people. The website quoted as your reference material, sole purpose for existing, is for its negative stance on Cannabis. Try broadening your search tools, away from just what the US Federal Governments War on Drugs Machine would have you believe, just as the people of the US have been doing, by a state by state basis since 1996.

      I think you’ll find your claims of Brain damage are not scientifically proven and are little more than statements made in absence of evidence, further more. I don’t know of any group that’s advocating recreational use for children, other than some possible Black-Market sources maybe. This is a adult only marketplace and the only place where use by children would be appropriate, is as a medical necessity.

      We need to stop feeling we can define all people who use Cannabis the same way, as they are many and varied, like those that choose to use Alcohol. You can’t define a typical Alcohol user but its easy to spot a drunk.

      Reply
      • “I think you will find that claims of brain damage have not been proven”. Rubbish, there are many scientific research papers by scholars available by Googling “Scholarly research on effects of cannabis on immature brains (foetus to early 20’s brains are immature). One abstract says :
        Teratological investigations have demonstrated that agents that are relatively harmless to the mother may have significant negative consequences to the fetus. Among these agents, prenatal alcohol, nicotine or cannabis exposure have been related to adverse offspring outcomes. Although there is a relatively extensive body of literature that has focused upon birth and behavioral outcomes in newborns and infants after prenatal exposure to maternal smoking, drinking and, to a lesser extent, cannabis use, information on neurobehavioral and cognitive teratogenic findings beyond these early ages is still quite limited. Furthermore, most studies have focused on prenatal exposure to heavy levels of smoking, drinking or cannabis use. Few recent studies have paid attention to low or moderate levels of exposure to these substances. This review endeavors to provide an overview of such studies, and includes animal findings and potential mechanisms that may explain the mostly subtle effects found on neurobehavioral and cognitive outcomes. It is concluded that prenatal exposure to either maternal smoking, alcohol or cannabis use is related to some common neurobehavioral and cognitive outcomes, including symptoms of ADHD (inattention, impulsivity), increased externalizing behavior, decreased general cognitive functioning, and deficits in learning and memory tasks.”

        Amongst other articles are “Scholarly articles for Scholarly research on effects of cannabis on immature brains:
        … memory in adolescent cannabis users, alcohol users … – ‎Solowij – Cited by 85
        Behavioural consequences of maternal exposure to … – ‎Navarro – Cited by 73
        … DIFFERENCES IN MATURE AND IMMATURE BRAIN … – ‎Klee – Cited by 67”

        I could go on and on but won’t because I know a number of you have closed minds on the subject. If there is legal access to cannabis and its extracts, don’t blame me for the likely consequences on immature brains.

        Reply
        • Bill

           /  21st May 2016

          Please don’t assume that only closed minds come with wanting change and that all the material you have mentioned, hasn’t been reviewed. The bulk of these studies don’t make statements of proof and use a lot of unscientific language, like maybe and could. Also there can be a big difference in meanings, like possible changes in brain structure and brain damage.

          While we could arm wrestle every point and I could post you links to 1200 peer reviewed studies with positive outcomes. This is not in fact, what this debate is even about. The fact is, Cannabis is very much a part of wider society already and anyone who can’t acknowledge that point, is in fact doing a disservice to our young and vulnerable.
          It is not arguable what damage our two most favorite drugs Alcohol and Tobacco have inflicted on society, our third most favorite Cannabis, while even run by Black-Market forces, doesn’t come close. Prohibition on the other hand and this is not just my belief, but that of many experts as well, is that its been an utter disaster.

          I honestly can’t believe that some people think that this situation is about introducing Cannabis into society, over the blatant fact, that a NZ Cannabis industry worth close to a Billion dollars, already exists.So when we call for a change in approach, its not a free for all that comes to mind, but a highly regulated R18 platform that addresses issues, like the supply of minors.

          The criminal justice system can’t protect our society when it can’t even keep drugs out of our prisons, just like it has proven it can’t save one precious babies life with tougher sentencing, its an ambulance at the bottom of a cliff response. I wish I had a answer to to the abuse of our young, by those charged with there care, I don’t. But I honestly believe that over forty years of failed cannabis laws can be addressed, for a better outcome for all.

          Reply
  4. patupaiarehe

     /  20th May 2016

    I’ve been left to buy my own cancer treatment and take illegal cannabis – the whole system is stuffed.

    All the talk of medicinal use being a ‘gateway’ to recreational use would be laughable, if it didn’t have such a detrimental effect on those who actually need it.
    Recreational use is happening, and will continue to. The so called consequences of being caught with under an ounce of pot will normally just involve losing it, or if you are unlucky enough to encounter an asshole cop, maybe a small fine & an embarrassing (or not 😉 ) court appearance. The politicians who think that their silly outdated laws have any effect at all on cannabis use, obviously have a far higher opinion of themselves than anyone else. And are completely out of touch with reality.

    Reply

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