Survey into Medicinal Cannabis use

A survey of users of medicinal cannabis has been launched. This should get useful information, but as a lot of medical cannabis use is likely to be illegal it may be difficult to get a comprehensive picture.


MCANZ launches its first study of Medical Cannabis users in NZ.

An unprecedented research project to discover how and why New Zealanders are using cannabis medicinally has been launched today by Medical Cannabis Awareness New Zealand.

The study, New Zealand Medicinal Cannabis Use Research Survey 2019, is an online survey of patients using cannabis for medical reasons based on Australia’s Cannabis As Medicine Survey and has been designed in conjunction with University of Otago researcher Dr Geoff Noller. It has been granted ethics approval and is MCANZ’s first research project.

“During the Select Committee process last year, it became apparent that no one had any data on the trends in illicit medical use, such as the rate of criminalization or even a decent snapshot of what conditions were most common for illicit medical use,” says MCANZ Coordinator Shane Le Brun.

“The only research relevant was a Ministry of Health study on cannabis use dating from 2012-2013, and frankly, medical use was only an afterthought in that research,” says MCANZ Le Brun.

“This research is a first for MCANZ and we’re delighted to be working with  Dr Noller. This first survey will give us a snapshot of current medical use in New Zealand and establish trends and areas that will need focus in the setting up of New Zealand’s new medicinal cannabis regime.” says Le Brun

“The intent is for this study to be conducted every 2 years, so the first study will serve as a baseline for the future, particularly to measure the impact of the Medical Cannabis Scheme,” says Lead investigator  Dr. Geoff Noller.

“The study covers topics ranging from perceived medical efficacy, knowledge of harm reduction such as vaping, and the impact of criminality on medical use,” says Noller.


If you use medicinal cannabis you can do the survey here:

New Zealand Medicinal Cannabis Use Research Survey 2019

The real work begins on the Medical Cannabis scheme

Media release from Medical Cannabis Awareness New Zealand after the passing of the medical cannabis bill in parliament today:


The real work begins on the Medical Cannabis scheme

MCANZ is delighted at the historic achievement of a solid commitment to produce Medical Cannabis in New Zealand, and is grateful for the amendments that were introduced broadening the scope of the compassionate clause, clarifying a more therapeutic “whole plant” definition of CBD, and allowing for native cannabis strains to enter the market, giving New Zealand Industry a competitive edge over Australia.

MCANZ Does note that the real mahi has yet to start, and close attention was paid to details in the Initial speech from David Clark.  Details were revealed around a consultation phase, with a mention of an advisory committee to be formed.

It is the view of MCANZ that a year has been wasted that could have been spent working on the scheme.
“We challenge the minister to get invitations for an advisory committee out before christmas to demonstrate it is truly a priority.” Says MCANZ Coordinator Shane Le Brun

“The challenge now lies in the MOH and its resourcing, we need the MOH to recruit more staff to assist in forming the scheme, and ultimately administering it, we hope that with a  budget surplus it should be fairly easy to get funds without resorting to the likes of industry levies.”

“Time frames are prone to slipping, especially with such large bodies of work, we hope that they can talk to other governments to learn from their experiences, and ensure that the scheme is implemented on time.”

“Our hope is that with early clarity on the direction of the scheme, manufacturers can be ready for the go live date, delivering products at much more affordable prices on day 1”

Medical cannabis: Terminal vs Severe and Debilitating?

Medical Cannabis Awareness NZ wants the Government’s medical cannabis bill to be expanded to cover people suffering from ‘severe and debilitating’ illness. It currently only allows an exemption from prosecution for using cannabis for people certified to have less than a year to live (but growing is still illegal, as is the supplying of cannabis to them).


Terminal vs Severe and Debilitating?

The exemptions outlined for the terminally ill by Labour’s Medical Cannabis bill do not go far enough, and have been universally panned by patient advocates and policy experts.

MCANZ Coordinator Shane Le Brun:

“David Clark’s excuse for failing to deliver on Labour’s election promise is that there is a high portion of New Zealanders with chronic pain, many of those however would not be severe such as those who suffer from comparatively mild conditions such as osteoarthritis”.

“The Ministry of Health’s Non-pharmaceutical application guidelines have a terminology of  “severe or debilitating condition” using that definition instead of terminal would be a far more effective way of protecting patients. If such terminology is good enough for prescribers it should be good enough for police and the courts.”

“If such a change creates any extra administrative load for the courts to determine ‘severe or debilitating’ it would be short term only, as police would be on the receiving end of an attitude adjustment, the cost in administration pales into comparison against the significance of what it offers a very ill and vulnerable cohort of New Zealanders”

MCANZ Feels that the best solution to the criminalization of patients is to disrupt police prosecution
habits directly, before they get to court.

“The Solicitor General’s prosecution guidelines could be easily reviewed and updated to include a specific clause in the public interest test section. Such a clause counting against prosecution could be worded along the lines of ‘where the Misuse of Drugs Act has been breached for a significant therapeutic benefit”.

“Intervention before prosecution is critical to the safety and wellbeing of patients, most of whom are on benefits who can ill afford costly legal battles, and the seizure of what for many is an essential medicine”.

MCANZ Spokesperson Dr Huhana Hickey MNZM”

“The contradictions in allowing terminally ill to access but not providing them with a way of doing it, is as bad as denying all with pain the chance of taking a medicine that works. We need to educate society over the benefits of medicinal and how it can change lives.”

“To deny Medical Cannabis any longer is to show a disregard for people in chronic pain and who are in effect suffering at the hands of government policy. Change it now, it’s need not be complex, it can be simple, but they need to work with those of us who can no longer take opioids and other strong drugs who want our quality of life back.”

“Green Fairies” are a symptom of unmet demand

A media release from Medical Cannabis Awareness NZ:


“Green Fairies” are a symptom of unmet demand

On Newshub’s 6 o’clock news last night, it was revealed 2 of the larger compassionate supplier’s aka “Green Fairies” are being prosecuted by the police, to the detriment of hundreds (potentially thousands) of patients.

“With over 140k people estimated to use Cannabis at least sometimes for medical purposes illicitly, it is no surprise that there are a growing number of compassionate suppliers in both quantity, and scope of their operations”.

“With the continued failure at the political level to resolve legal supply of safe sterilized Cannabis based products that a sickness beneficiary can actually afford, these people will be seen as martyrs and heroes to the patient community, and unfortunately it reflects poorly on the police”.

“The police seem quite able to turn a blind eye to the dealing of Class B Cannabis based products if your name was Helen Kelly, however the mere act of cultivating a C drug is viewed as a heinous crime that is beyond police discretion.”

“Police Discretion is an empty promise by Politicians to dodge the issue, Police I have dealt with fear setting a precedent by exercising discretion” says MCANZ Coordinator Shane Le Brun.

“MCANZ would like to see a political solution far more ambitious and detailed than provided by either of the major parties. We look to Canada as an excellent example to follow, where Cannabis products are so affordable that less than 2% of Medical Cannabis users seek permits to grow their own.

“Cannabis-based products are relatively simple, It’s just another Essential Oil.

“The Current regime ensures that only expensive products will be vaguely available, and that means patients will continue to break the law, often with the support of their specialists, and making criminals of otherwise law-abiding citizens.

“The costs are so high that I am aware of GPs and Specialists that are referring patients to “Green Fairies”.

“This is a direct response to increasing acceptance of its medical benefit, and the refusal to accept the cost of Sativex which is borne solely by patients”.

The domestic market in Canada is considered by MCANZ to be the closest model to ideal, where products are prescribed by GPs, and the cost per mg of active ingredients are 80% less of what is paid in New Zealand currently. Nevertheless, MCANZ is committed to advocating for patients for legal access in the current system, which can take over a year of advocacy to gain approval under the non pharmaceutical scheme and then months extra again to arrange import.

Shane Le Brun
Medical Cannabis Awareness Coordinator
http://www.mcawarenessnz.org

Do We Really Need “Pharma Grade” Medical Cannabis?

Part one of a series of opinion pieces by Shane Le Brun, Coordinator, Medical Cannabis Awareness New Zealand

There is strong public support for significant reform of Medical Cannabis (MC) regulation. The system currently in place, which focuses wholly on pharmaceutically trialed cannabis-based medicines, removes patient and prescriber choice, and costs are prohibitive. New Zealand may have the highest priced MC in the western world – a side-effect of our remote location and small market.

Most other western countries are looking to grow and make their own products to expand treatment options while reducing costs. Australia in particular, with its solid experience in poppy cultivation, is looking to create an export market and has at least a dozen companies exploring the pharmaceutical route, pouring 10s of millions of dollars into trials for a product that they will likely have trouble holding patents on.

We have already proved with one patient, Dr Huhana Hickey, that a comparatively simple standardised extract made in grapeseed oil, can do a better job than the registered pharmaceutical alternative. This is compared to the ‘pharmaceutical grade’ product Sativex, which is essentially “2 strains of hash oil in a spraycan”. The alternative is available from Canada for a much lower cost. Imagine the cost reduction if such products could be produced in New Zealand with our proven scientific capabilities. Our issue with cost can be resolved without granting patients the individual freedom to grow their own.

At MCANZ we have introduced a small handful of products from 2 companies in Canada. These products are not Pharmaceutical grade, but are close to it, yet they cost 30-60% less than Sativex to the patient. I refer to these products as “near pharmaceutical” the quality is good, the product is clean. We have never had a request to prescribe one of these products declined by the MOH and we need to differentiate them from the negative connotations of “non pharmaceutical” in the applications scheme.

These products are not dirty hash oils made in a Californian garage by a “Ganjapreneur”, but are developed under a regime regulated and monitored by the Canadian MOH equivalent, “Health Canada”. For these products, the MOH has said nothing but yes (the trick is convincing New Zealand doctors to apply). These products have been safely prescribed to thousands of Canadian patients already, so why shouldn’t we also use these products?

The cost savings per patient can be immense for customers. However, this also matters for public expenditure as currently, WINZ, ACC and DHBs are funding Sativex on rare occasions. I estimate there are tens of thousands of dollars to be saved per annum by ditching the pharmaceutical only mindset. Naturally, starting from such a low number, the projections will only increase going forward as the evidence of cannabis’ effectiveness for conditions such as chronic pain shores up. (It is trending towards conclusive in general terms.) This has massive ramifications for the potential financial vulnerability/liability for the likes of ACC if they are increasingly asked to pay up for Sativex or other Pharmaceutical grade products in the future. It also matters for patients if they refuse access due to this cost burden.

After our next product roll out, we will reach a point where the only way to get products cheaper will be to make them ourselves in New Zealand. Canada’s system of licensed manufacturers would be ideal for New Zealand. It delivers relatively standardised and safe, sterilised products 80% cheaper than Sativex (the only relevant product preapproved by MedSafe for use in New Zealand) for similar-strength products. Products can double in price when getting shipped internationally, if we allow “near pharmaceutical” products to be made in New Zealand without trials, then we could make these products available as unregistered medicines. Trials cost big money, a cost that is then forwarded on to the patients. With plenty of generalised evidence emerging, there is no need to reinvent the wheel and prove that a balanced cannabis product that is in essence similar to Sativex does the same job.

Instead, lets make the products locally, and make them available to GPs and specialists, and let the medical professionals use their own common sense about when to prescribe. Additionally, by forgoing the insistence on trials, we can race ahead of Australia in getting the potential industry to the export stage, with cost advantages to boot. We snoozed and loosed with Opium production in the 60s, and now Tasmania leads the world in that multibillion-dollar industry, lets not make the same mistakes with Cannabis just because a few conservative MPs can’t differentiate between a medicinal crop and the cash crop down at their local tinny house.

Part 2 of this series of opinion pieces will be published next week and will cover the finer points on the workability of policy allowing patients to grow cannabis at home.

Seeking support for new, cheaper medicinal cannabis

A silly headline but a useful article from NZ Herald: Medical marijuana: Is NZ dazed and confused?

A conservative lobby group is seeking support for new, cheaper medicinal cannabis for chronic pain relief.

Kat Le Brun, by her own admission, is a “grumpy” Christian student teacher from Nelson, and Jacinta, a tiger mother with a quickfire voice.

What do they have in common? Pain. Not bang-your-thumb-with-a-hammer pain, but the sort of pain that lasts as long as you do.

Chronic pain.

Many people suffer from chronic pain and legal pain relief products are not always effective – and can be addictive, like  morphine.

“I believe we have to focus on the medical at this stage. It might be selfish but it’s all getting muddled up. We need to look at one issue. This is too much for the politicians to deal with.”

This conflation of medical marijuana and general legalisation may be one reason why New Zealand seems stuck, while our neighbours and allies are moving quite fast.

Medical marijuana is legal in 25 states of the United States, half the country.

In Australia, Victoria and ACT are preparing to join the party.

Ross Bell from the NZ Drug Foundation says after all these years railing against the evils of marijuana our Government is in a bit of a quandary.

“They think they are the drug warriors. Medical marijuana is confusing them, ‘we should do something but we don’t know what’. Something’s not computing. They don’t know what to do to meet the needs of the 75 per cent.”

New Zealand is certainly lagging behind the US and Australia on enabling the legal use of medicinal cannabis products.

Like Kat, Nichola’s tried marijuana and finds it transformative.

“It works and it’s a crime that it’s not available to us,” says Nichola. But just like Kat she refuses to turn herself into a criminal.

“I have quite strong values. I don’t want to blur the lines.”

In the blurry world of right and wrong all these women have had more experience with hard drugs than any of the dodgiest-looking characters on the protest.

Tramadol, OxyContin, morphine. You name it. Nichola is even taking heroin substitute methadone. She longs for medical marijuana to be legal.

“That’d be incredible. I’d be burning all my drugs my methadone and fentanyl patches.”

Patient frustration at the fringe nature of the movement has birthed a new conservative pressure group.

The co-ordinator is Kat’s husband Shane Le Brun.

“It’s been a long journey. Before my wife was injured we chucked flatmates out for drug use once upon a time. Now the tables have turned,” says the former soldier and National Party voter.

It’s called MCANZ. Medical Cannabis Awareness New Zealand.

They are trying to normalise the health benefits only of cannabis products.

A report to Health Minister Jonathan Coleman obtained under an Official information request says “there is a lack of robust clinical data and evidence of patient benefit”.

Kat, Nichola and Jacinta’s daughter have carried out their own personal trials and believe it works for chronic pain. For them anyway.

Not a cure or anything but a great alternative to opiates.

“It means pain relief that doesn’t affect me in a bad way,” says Kat. “A natural solution without all these massive side effects.”

With one in five kiwi adults suffering from chronic pain, Shane believes there are thousands out there who could benefit from medical marijuana.

But he’s careful not to suggest that it’s a panacea.

“At one end conservatives say it gives you schizophrenia and is so addictive and horrible. Then you’ve got those who say it will cure all ills and you never need another drug again. The truth lies somewhere in the middle.”

Getting New Zealand to catch up with that middle is a challenge given the current Government’s unwillingness to change the law.

Revelations that Martin Crowe and Paul Holmes used marijuana to mitigate the effects of chemotherapy has no doubt bolstered public opinion in New Zealand.

Since 2003 the number of people in favour of medical marijuana has doubled.

“We have people like Sir Paul Holmes using it in his dying days,” says Shane.

“You don’t have to be a hardcore lefty for that to strike a chord.”

Helen Kelly is another high profile user of medicinal cannabis, the difference being she is going public while she is still alive (albeit dying).

Shane agrees there’s a lot of compassionate cultivation going on.

“Some people will just grow and do it on the sly to self-medicate.”

But as Ross Bell warns, if you are treating kids with seizures you probably don’t want just anyone boiling up cannabis oil, you probably do want pharmaceuticals.

MCANZ is supportive of Rose Renton’s work, but as a conservative charity can’t support home-growing.

“As the only patient-led group playing within the rules we hope to be taken a little more seriously. All we care about is getting medicine into patients hands and getting rid of the background noise.”

To that end MCANZ is trying to make two cannabis-based medicines from a Canadian company called Tilray available for patients.

But there are hoops.

First they have to be assessed by the Ministry of Health, then personally signed off by Associate Minister of Health Peter Dunne.

The MCANZ applications are expected to land on Dunne’s desk in the next few weeks.

In the meantime, Kat and Shane are contemplating a second baby.

They hope medical marijuana might be available by the time it arrives. Their first child was born addicted to narcotics because of all the painkillers Kat had been prescribed.

“What my son went through because of the medication … For two weeks he had to go through withdrawals. I would not wish that on anyone. That’s what opiates do.”

What is currently available legally has major drawbacks, generally and compared to cannabis products.

They are sharing this personal story in the hope the decision makers will listen.

“They should come and sit with us and see what goes on with our families on a daily basis,” says Shane.

“There’s so much suffering our people go through. All behind closed doors. The only way is to open it up.”

Seeking support for new, cheaper medicinal cannabis seems the sensible, logical, relatively safe and compassionate way to go.