Cannabidiol (CBD) can now be prescribed by doctors

A small but important step towards making it easier to access the medicinal cannabis extract cannabidiol (CBD), which is a non-hallucinogenic extract and believed to be beneficial for a number of ailments and for pain relief.

There are very few products available in New Zealand, but was they become available the way is clear for doctors to prescribe them. Currently approval has to be sought through the Ministry of Health.

Australia has already dome something similar so it will allow New Zealand to access the same CBD based drugs that become available in Australia.

Peter Dunne has driven this, getting the approval of the National dominated Cabinet.

Beehive notice:


Government to ease restrictions on Cannabidiol

Associate Health Minister Peter Dunne says New Zealand is to remove restrictions around cannabidiol (CBD), in line with international developments.

CBD is a substance found in cannabis that has potential therapeutic value. It has little or no psychoactive properties, yet it is currently a controlled drug under the Misuse of Drugs Act.

“At present CBD products for therapeutic use are only available if approval is given by the Ministry of Health.

“I have taken advice from the Expert Advisory Committee on Drugs (EACD) that CBD should not be a controlled drug and am pleased Cabinet has now accepted my recommendation to make this change.  Therefore, I am now taking steps to remove restrictions accordingly.

“In practical terms, the changes mean CBD would be able to be prescribed by a doctor to their patient and supplied in a manner similar to any other prescription medicine.

“Australia has already taken a similar step while other countries are also responding to emerging evidence that CBD has a low risk of harm when used therapeutically.

“This change is about future-proofing access to CBD products, as the reality is that there will continue to be barriers beyond New Zealand’s control to people accessing such products from overseas,” says Mr Dunne.

Currently there is a limited range of CBD products made to a standard where prescribers can be sure the products contains what is claimed – and strict import and export restrictions on products sourced from other countries, which will continue to impact the supply of CBD products in New Zealand.

“However, we do know of at least one CBD product in development made to high manufacturing standards that will contain two per cent or less of the other cannabinoids found in cannabis,” said Mr Dunne.

The changes will include removing requirements for:

  • Ministerial approval to prescribe;
  • pharmacies, prescribers, and wholesalers to have an import licence, and to meet certain requirements for storage, and the maintaining of controlled drug records and stock keeping.

Prescriptions would be allowed for up to three months’ supply, rather than one month. These measures can be achieved by amending the Misuse of Drugs Regulations 1977 in the first instance, pending any future amendment of the Misuse of Drugs Act.

Genter v Dunne on medical cannabis

In Parliament yesterday Green MP Julie Anne Genter questioned Associate health Minister Peter Dunne on the ease of access to medical cannabis.

Dunne said that the Australian system of registering medical users wasn’t working well, and the way the police are supposed to be ‘compassionate’ when deciding whether to charge cannabis users in New Zealand is ‘pragmatic’ and more effective.

But it means many medical users of cannabis products are still acting illegally.

Dunne suggests that those wanting to use medical cannabis should visit the Ministry of Health website for information:

Prescribing cannabis-based products

Please note that the Government does not support the use of unprocessed or partially processed cannabis leaf or flower preparations for medicinal use.

There are three types of cannabis-based products that may be considered for Ministerial approval:

  1. Pharmaceutical grade products that have consent for distribution in New Zealand. Consent for distribution means that the product has been determined by Medsafe to meet acceptable safety and efficacy requirements for distribution in New Zealand. The only product meeting this criterion currently is Sativex® for the treatment of multiple sclerosis. It may also be prescribed as a non-consented product for some other medical conditions.
  2. Pharmaceutical grade products that do not have consent for distribution in New Zealand, for example a product that has been manufactured by a pharmaceutical company overseas.
  3. Non-pharmaceutical grade products, that is products that are not manufactured to internationally recognised pharmaceutical manufacturing standards. They may, or may not, have been intended to be used as medicines.

The MoH has Guidelines to assess applications for Ministerial approval to prescribe, supply and administer

It looks very unlikely that National will even consider any possible law changes on cannabis, which means that under the current Government the current limitations are likely to remain at least until after the election.

Draft transcript:


Drugs, Illegal—Medical Cannabis

12. JULIE ANNE GENTER (Green) to the Associate Minister of Health: Will he recommend his Government change the law so that New Zealanders with terminal illnesses using medical cannabis are not at risk of being raided by the Police and prosecuted.

Hon PETER DUNNE (Associate Minister of Health): Patients using approved cannabis-based products, such as Sativex and other approved non-pharmaceutical grade cannabis products, are not at risk.

For those choosing to use raw cannabis or unapproved cannabis-based products, I have received a number of assurances from the Commissioner of Police that small-scale use by the terminally ill is not a priority, and that approach is consistent with the emphasis on compassion set out in the Government’s 2015 National Drug Policy.

I have considered the compassionate access scheme implemented in New South Wales. However, following very frank discussions with the Australian delegation at last month’s United Nations Commission on Narcotic Drugs meeting about the workability of such a scheme, I have concluded that New Zealand’s more pragmatic approach based around the pillars of compassion, proportion, and innovation that underpin the National Drug Policy is the more appropriate course to follow

Julie Anne Genter: So rather than changing the law to reflect the fact that we think that it is acceptable for sick people to use cannabis to alleviate their suffering, is he suggesting that people should continue to break the law hoping that the police will not pursue them?

Hon PETER DUNNE: I make two points in response. Firstly, there is huge distinction to be drawn between raw cannabis and cannabis-based medicinal products. The Government has no interest in making any legal change, nor does any other party in Parliament, as far as I am aware, to the status of the raw cannabis plant.

With regard to cannabis-based medicines, the best advice I would give any patient who feels they might benefit from such a medicine is to talk to their general practitioner and their specialist about accessing the pathway that is in place.

They can view that at the Ministry of Health website; it is a very simple pathway to follow and if it is determined that that is the best treatment available to them, then it can be made available to them.

For people who choose to go outside that system, then they do run the risk, particularly if they are using the raw product, but, as I said earlier, I have been assured by the police that they will adopt a compassionate approach.

Julie Anne Genter: Without a clear legal framework or a register for patients, how will the police be able to judge who is a legitimate medical user and who to be compassionate with?

Hon PETER DUNNE: The member raises a good point, and it was one that I pursued with the Australians when I discussed the matter with them.

The absence of a register is actually no salvation in this regard because they find exactly the same problem with the register in New South Wales in determining who is a legitimate name to be included upon it—and bear in mind in the New South Wales case you can include up to 3 other people as supporters.

But they have also found that a number of people who are suppliers, when confronted by the police about being suppliers, say that they only supply to patients with terminal illnesses. So the whole thing has become, essentially, unworkable. I think the pragmatic approach that we have here, provided it is exercised with compassion, is the far more prudent course to follow.

Julie Anne Genter: Without a law change, how can he ensure that terminally and chronically ill patients in New Zealand will not find themselves in court for using cannabis to alleviate their suffering?

Hon PETER DUNNE: I did not hear the first part of the member’s question, but I think what she was seeking was some clarification as to how we can protect people from the potential risk. I come back to what I said in response to the earlier supplementary question.

The very best step that anyone who feels that they would benefit from a cannabis-based medical product can take is to talk to their general practitioner about accessing the pathway set out so clearly on the Ministry of Health website.

People who resort to just growing a bit in the backyard or talking to a mate and getting some from them do run some risks.

If they have genuine health issues, my absolutely strong advice is to talk to their general practitioner about accessing the pathway that is currently available.


For more information on medical cannabis in New Zealand see this support site:

Medical Cannabis Awareness NZ

Minor tweak to medicinal cannabis approvals

Associate Health Minister Peter Dunne has announced a minor change to procedure for approval of medicinal cannabis, removing the need for the minister to do final approval. In practice this will make virtually no difference apart from removing a step in the procedure as Dunne had approved all applications that had come through the Ministry of Health.

Dunne has also criticised doctors for their reluctance to seek medicinal products for patients. He said that some medical professionals were too afraid of being labelled “Doctor Dope”

Ministry of Health to Decide on Cannabis-based Products

Following his decision on 1 December last year to remove the requirement for Ministry of Health approval to prescribe Sativex for Multiple Sclerosis, Associate Health Minister Peter Dunne has today delegated decision-making for the prescribing of all cannabis-based products to the Ministry of Health.

“Last week I wrote to the Director-General of Health, advising him that as of 8 February 2017, applications from specialists to the Ministry to prescribe non-pharmaceutical cannabis-based products will no longer need Ministerial approval. Approval for pharmaceutical grade cannabis products was similarly delegated some years ago” says Mr Dunne.

“As I stated in my delegation letter to the Director-General, when applications first began to be received it was my view that the final decision appropriately lay at Ministerial level, rather than exposing officials to risk, given the complicated and contentious nature of the issue – that is to say the buck stopped with me”.

“I have approved every application that has come before me with a positive recommendation – within a matter of minutes once the application came across my desk.

“Since the first application was approved, guidelines have been developed, consulted on and simplified to allow specialists who are interested in accessing such products for their patients a clear, straight-forward and unobstructed pathway to acquiring the appropriate products.

“I am satisfied that with the development of these guidelines, and with a number of successful applications having been subsequently completed, any risk associated with the early processes has largely abated and I have confidence in the Ministry of Health to handle the process in its entirety from now on.

“It is my intention to write to the New Zealand Medical Association and the Pharmacy Society of New Zealand outlining my decision and my ongoing expectation that medical professionals consider the prescribing of cannabis-based products with an open mind.

“I also intend to include a list of internationally available cannabis-based products that are either pharmaceutical grade or Good Manufacturing Practice certified, to provide additional clarity on the issue”, Mr Dunne said.

For further information go to http://www.health.govt.nz/our-work/regulation-health-and-disability-system/medicines-control/prescribing-cannabis-based-products

Dunne has said more to media. NZ Herald: NZ doctors too prejudiced about medical cannabis, Government says

Associate Health Minister Peter Dunne has accused New Zealand doctors of being too conservative about prescribing medical cannabis, saying some of them are rejecting their patients’ applications because of their “downright prejudice” about the drug.

Some medical professionals were too afraid of being labelled “Doctor Dope” and needed to be more open-minded about medical cannabis, Dunne said.

He plans to write to organisations representing doctors and pharmacies to urge their members to take a more evidence-based approach.

“What I want to see from them is an open approach, not one where I think to date has been based a little on their wariness and in some cases downright prejudices,” he said this afternoon.

“And I want to see an end put to those things.”

Small steps, but at least they are in the right direction.

Legal challenge of MoH on medical cannabis

A post by Russell Brown at Public Address asks Is the Ministry of Health acting outside the law on medical cannabis?

The key barrier to the use of medical cannabis – or to even discovering what its uses might be – has long been marijuana’s illegality under the Misuse of Drugs Act. But what if it transpired that a key component of cannabis is not, and has never been, controlled by the act? And that heavy restrictions on its use and importation are in fact taking place outside the law?

…it’s the subject of an intended legal challenge notified by Nelson lawyer Sue Grey.

From a letter from Grey to Associate Minister of Health Peter Dunne outlines her claim.

NOTICE OF INTENDED LEGAL CHALLENGE RE STATUS OF CANNABIDIOL “CBD” UNDER THE MISUSE OF DRUGS ACT

I write on behalf of various interests who seek urgent clarification of the legal status of Cannabidiol “CBD” under the Misuse of Drugs Act.

In summary:

  1. CBD is not explicitly scheduled under the Misuse of Drugs Act.
  2. CBD does not meet the statutory criteria under Section 3A for scheduling under the Misuse of Drugs Act1 as there is no evidence that it poses a very high, high or moderate risk of harm to individuals or to society.
  3. Information obtained under the Official Information Act and from the Ministry of Health website identify a significant disagreement within the New Zealand government officials over the status of CBD under the Misuse of Drugs Act.!!Some from the Ministry of Health claim CBD is indirectly covered by Schedule 2 (1)(2)2 as a Class B drug based on their assessment that it is “an isomer of tetraDhydrocannabinols” (THC). In contrast, the government’s leading expert analytical chemist, Dr Keith Bedford and his expert team at Crown Research Institute Environmental Science and Research, “ESR”, have published a paper explaining why THC is not within this definition, because CBD has a different chemical formula, structure and function to THC and accordingly it is not caught within the definition of “an isomer within the same chemical designation”
  4. Dr Bedford’s expert view has been made clear to the Ministry of Health and to his colleagues on the government’s Expert Advisory Drug Committee (“the EADC”). The minutes of the EADC’s April 2016 identify no scientific or legal reason why Dr Bedford’s view is wrong. It appears the different views relate solely to policy consideration and perhaps vested interests, although it remains unclear to me why some members of the committee would prefer to continue to treat CBD as if it is illegal. Clearly government policy cannot override the law that was written by Parliament, and in particular s3A of the Misuse of Drugs Act.

Grey also claims.

  • Medicines containing CBD are (in my view unlawfully) treated as if Ministerial approval is required under Regulation 22 of the Misuse of Drugs Regulations, resulting in considerable bureaucratic hoops and hurdles, delay in access and unnecessary cost for patients who are typically already very ill, and their families who are typically already very stressed.
  • The complex situation is compounded by the apparent policy of Medsafe (disclosed in documents obtained under the Official Information Act) to attempt to prohibit foods or other products which contain CBD from being sold as foods or dietary supplements, apparently because CBD is also scheduled under the Medicines Regulations. I can find no lawful basis for this policy and do not understand how Medsafe can reconcile this with the law or with the FSANZ proposal to approve the sale of hemp seed foods for human use.
  • I understand from other Official Information Act responses and from recent coverage on TV3’s Story (on the use of CBD as a supplement for managing Alzheimers by Mr Robinson, father of Nicky Evans) and other documentation that I have been shown, that NZ Customs have been instructed to seize products that contain CBD at the NZ border. This is despite the expert advice to the Ministry of Health that CBD has no known harmful effects to individuals or society and it is outside the scope of the Misuse of Drugs Act schedules.
  • The current policy of Ministry of Health, and adopted by NZ Customs to treat CBD as if it is covered by the Misuse of Drugs Act to try to justify the seizure of products which contain CBD, is in my view unlawful, unreasonable and unjustified as CBD is not covered by the Misuse of Drugs Act.

Grey asks for the Court to make declarations on:

A) CBD is not explicitly prohibited under the Misuse of Drugs Act

B) CBD has a different chemical formula and different structure and function to THC and accordingly it is not restricted as “an isomer within the same chemical designation as tetrahydrocannabinols”and is not covered by Schedule 2 of the Misuse of Drugs Act ;

C) CBD does not meet the criteria of section 3A for classification under the!! Misuse of Drugs Act, as it does not cause a very high, high or moderate risk of individual or social harm;

D) Products containing CBD do not require Ministerial approval to be prescribed or recommended under Regulation 22(1) of the Misuse of Drugs Act because CBD is not subject to that Act.!!Regulation 22(1) of the Misuse of Drugs Act does not apply or is being unlawfully applied to medicines and other products containing CBD

E) The actions of NZ Customs in seizing or restricting access into or out of New Zealand of products because they contain or may contain CBD is unlawful.

It will be very interesting to see how the Court deals with this, if it has to go that far. Brown posts:

Grey has received a response from Customs minister Nicky Wagner, explaining that Customs – which has been seizing medical CBD products at the border –  is guided by the advice of the Ministry of Health, which is that “CBD is a class B1 controlled drug as it is an isomer of tetrahydrocannabinol. Customs has acted on that basis.”

“How long do we have to wait? We’ve got people who are sick now,” Grey said. “They don’t want to have to wait another six months or two years for the advisory committee to align itself with what the law already says.

“I’m still hoping that the Minister of Health will get some control over his officials and ask what are you guys doing, why don’t we just listen to what the experts are saying and accept that it’s not covered by the Misuse of Drugs Act and it doesn’t need to be? Then we won’t need to go to court. But if they don’t come to that conclusion fairly quickly, then we will file in court.”

 

 

Dunne on cannabis products

Peter Dunne has given a summary of the slow progress on medicinal cannabis, saying that there has been a lack of proven products available but hopes that will change next year as New Zealand benefits from what is happening in Australia.

Stuff’s Prime Minister Bill English needs a ‘clear stamp’ on his leadership.

With his health hat on Dunne says not a lot of medicinal cannabis products have come onto the market this year, which makes progress more difficult.

“I think the reality is between the wishful thinking and the actuality there is quite a gap. The fundamental problem remains a lack of reputable product.”

“The problem with trials in New Zealand is the perception from the pharmaceutical companies that the market isn’t big enough.”

New Zealand would be a good trial market for new products but the lack of Government will to lead on this probably rules us out as much as market size.

Dunne is working closely with the Australian Health Minister and hopes they’ll approve a couple of new products next year that Kiwis can piggy-back off.

That sounds like slow progress at best.

So far it’s been done on a case-by-case basis, which will continue, and while the “numbers are not large, everyone that has come through has been approved,” he said.

You still have to find a medical specialist who will make your case to the Ministry or Health.

While recreational cannabis remains a “political no-no”, he says, the “willingness to keep looking at medicinal cannabis” won’t stop under English.

“Political no-no” means that National won’t consider going there, and Dunne can’t do anything about that except cop the flak. A convenient cop out for National.

I haven’t seen Peter Dunne state whether he will stand again or not but he implies that he will contest Ohariu again next year:

…he’s well aware that he’s got to win his Ohariu seat to survive next year’s election.

If he survives, and if National stays in government, and if he is appointed Associate Minister of Health (with responsibility for diverting attention from National’s intransigence on cannabis law reform, then progress on medicinal cannabis is likely to remain slow.

If Labour lead the next Government then Dunne is unlikely to be in the mix, so it will be up to Labour and Greens and possibly NZ First to push things along, but cannabis is unlikely to be a priority.

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.

Minor MOH changes on cannabis based products

The Ministry of health has made minor changes to guidelines for medicinal cannabis applications.

Changes to terminology around applications for cannabis-based products

The Ministry of Health has made changes to terminology used in its descriptions of and applications for cannabis-based products.

These changes are visible on the Ministry’s website, where the previously used description medicinal cannabis has been replaced by cannabis-based products.

Additionally, the previously used term criteria has been replaced byguidelines to better reflect how applications in this area are assessed.

Forms used during the application process for such products have been changed to incorporate the new description.

The changes do not impact on the legal status of cannabis or any cannabis-based products.

They have been made to provide more clarity and consistency in describing cannabis-based products, when compared to other products or substances in the area of medicines control.

More information is available on the Prescribing cannabis-based products page.

Additionally, the Ministry is today publishing a document which it believes may be of public interest. The document outlines external consultation which recently took place on the guidelines used to assess applications to prescribe cannabis-based products.

Included is an amendment to the guidelines which means that a patient no longer needs to be hospitalised when treatment with a non-pharmaceutical grade cannabis-based product is initiated:

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

Almost no changes have been made to guidelines for people applying for medicinal cannabis –  a process that failed to deliver pain relief for former union boss Helen Kelly.

The guidelines were introduced last year after Nelson teenager, Alex Renton, successfully applied to Associate Minister of Health Peter Dunne for a cannabis product, Elixinol.

Those guidelines were subsequently used by Kelly, former Council of Trade Unions boss, who criticised the process for being too complicated and requiring information that is “impossible to access”.

Kelly was diagnosed with terminal lung cancer more than a year ago – she is illegally sourcing her own cannabis for pain relief.

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.

“It is my hope that by releasing this feedback it will go some way to balancing out the irresponsible and ill-informed messages being passed off as fact, and provide a degree of reassurance to those who are genuinely looking for respite to significant health issues,” he said.

 

 

NZ to follow Australia on medical cannabis

New Zealand is likely to wait on Australia and follow them in allowing wider use of medicinal cannabis, according to Peter Dunne and common sense. We don’t have the resources to do the necessary testing ourselves.

But in the meantime Ministry of Health guidelines that are being reviewed may make it easier for patients to import their own cannabis derived medicines.

Jo Moir at Stuff: Guidelines for medicinal cannabis applications are under review as access looks set to broaden

The reality is simple. The Government is not sitting on its hands doing nothing. In fact Associate Minister of Health Peter Dunne is one of many driving change.

Just last month he called for a review of the guidelines for considering medicinal cannabis applications.

As it stands the only approved medicinal cannabis in New Zealand is the mouth spray, Sativex. It is not funded by Pharmac and costs over $1000 a month. Any other product must be approved by Dunne.

As of the end of January the ministry had received 120 applications for medicinal cannabis, of which 105 have been approved. Another five are still in progress and 10 have not been granted for various reasons.

So there it is – people are applying for access to medicinal cannabis and in most cases being granted it.

Dunne is on the record saying he is keeping a close watch on research and random-control trials of cannabinoid products in Israel and the United States. Once manufacturers make a product and it passes MedSafe checks it will be available in New Zealand.

The point in doing it this way is that it makes no sense to reinvent the wheel in New Zealand.

We’re not big enough to have the medical professionals and patients available to do the trials so it makes sense to piggy-back where possible, including in Australia.

And in an interview on Radio NZ Peter Dunne repeats the ‘follow Australia’ line: NZ likely to follow Australia on medical cannabis

New Zealand is likely to follow Australia once it provides medical cannabis for use, says Associate Health Minister Peter Dunne.

Mr Dunne said trials to assess the safety of such drugs were underway in Australia but were probably still two years off completion.

“Clinical trials that produce viable products in Australia that the therapeutic goods agency approves as being able to be prescribed, it’s very likely that MedSafe would follow suit.”

Mr Dunne said no manufacturers had come forward expressing an interest in conducting clinical trials in New Zealand for a medical cannabis product.

For medical cannabis products to be approved they need to have passed clinical trials. For the good of patients and for the good of the availability of cannabis products they must be proven to be safe enough to use.

Dunne also said he did not expect people to be prosecuted for using medical cannabis.

“I do not expect, and it’s not my responsibility anyway, but I do not expect the police or the authorities to be running around persecuting people who are using cannabis sourced illegally.”

However it has happened – see Rebecca Reider’s legal costs.

Helen Kelly has admitted self medicating with cannabis products, but I think there would be an uproar if she was investigated or prosecuted.

I doubt that police or politicians would want to stir that one up.

The drug is already legal for medical use in several American states, and both Queensland and Victoria in Australia expect to legalise it next year.

If you are prescribed cannabis products overseas you can carry a month’s supply into New Zealand. Travelling to the US to stock up would be expensive, but Australia would be more attractive. But once Australia legalises more medicines New Zealand seems likely to follow soon after.

Moir points out:

In short, if the United States’ Food and Drug Administration (FDA) approves something in America, which is only a matter of time, there’s no reason it wouldn’t be of a good enough standard for New Zealand.

Then it would be a case of Pharmac negotiating a price and potentially subsidising it.

But not yet.

National MPs including Prime Minister Key have been resisting any loosing of cannabis laws, but that may not be needed.

Prime Minister John Key moving away from his staunch position that there was no need to look at the system as it stands, to instead being open to research and evidence that shows the efficacy of medicinal cannabis.

A law change is almost entirely unnecessary. It would simply be a case of having medicinal cannabis products regulated under the Medicines Act 1981.

But safety has to be assured.

We live in a country where there’s processes for doing things and, yes, they’re tedious at times, but the flipside of that is we live in a country where making sure people aren’t put at greater risk is considered a priority.

Patients need a little more patience.

But if I was dying and thought that medicinal cannabis may help ease my suffering I’d be bloody impatient.

Refurbishment debacle

The Ministry of health has been accused of “serious financial mismanagement” which at least looks like a mess in relation to the refurbishment of their head office.

Stuff reports:

A multimillion-dollar miscalculation on the $24 million refit of the Health Ministry’s head office in 2014 has bought a strong rebuke from Treasury, accusing the ministry of “serious financial mismanagement”.

Health Minister Jonathan Coleman also confirmed it led to a major shakeup in the the ministry’s finance department.

Independent auditors were called in to investigate how the ministry “miscalculated” the levels of its cash reserves, and came up short of funds for the refit.

Director-General of Health Chai Chuah said the ministry’s corporate finance team made a mistake in its forecasts, TVNZ reported.

It said the Treasury was very concerned about the funding miscalculation, citing papers describing it as “serious financial mismanagement”.

In a letter to Chuah, Treasury chief executive Gabriel Makhlouf said the “the new bid for funding brings into question the governance and financial management practices of the ministry”.

This is seriously embarrassing for a Government that promotes itself as a sound financial manager.

And there’s another potential embarrassment as well:

Meanwhile, the Ministry of Business, Innovation and Employment is facing a major problem in its payroll system that may affect up to 3000 employees.

MBIE Minister Steven Joyce said the issue involved how holiday entitlements and shift pay were calculated. It could potentially involve millions of dollars but ministry chief executive David Smol had told him it would involve only small amounts in individual cases, though Joyce could not put a dollar figure on those.

The system was installed more than 10 years ago at the Department of Labour but was used for the merged super-ministry MBIE.

Holiday entitlements and pay calculations are core functions of a payroll system.

How this could have taken ten years to be identified is hard to comprehend. With a big payroll in particular it is normal that some employees would query pay calculations. So why wasn’t a problem found in the first year or two?

Holiday entitlements are complex and can be very difficult to manage and are farcical under some situations, perhaps the Government could address that at the same time they sort out the MBIE payroll.

 

Review of medical cannabis guidelines

Peter Dunne has asked the Ministry of Health to review their guidelines for dealing with applications from medical specialists for their patients to use medicinal cannabis products.

I hope they come up with something that gives the comfort and needs of suffering and dying people a much higher priority than bureaucratic and overcautious process.

Dunne requests further consideration of medical cannabis criteria

Associate Health Minister Peter Dunne has asked Ministry of Health officials to review the guidelines for considering medical cannabis applications.

Mr Dunne said this is a new policy area for New Zealand’s Ministry of Health and the wider medical profession, so there will inevitably be fine tuning as the process develops.

“The guidelines were set up at my request following the Alex Renton case in 2015, so far the only case where ministerial approval was granted, following an application from Mr Renton’s treating clinicians to administer the restricted product Elixinol,” said Mr Dunne.

The guidelines  were more recently applied to an application for medical cannabis made on behalf of Helen Kelly but subsequently withdrawn by her oncologist before any Ministerial decision was required.

“While I am satisfied that on the whole the guidelines are sound, they were prepared as guidance only.

“They  allow for flexibility across different clinical situations, and are certainly not set in stone as some have claimed.

“Nonetheless, some further review would be beneficial and I have asked officials to undertake further consideration of them.

“I am not ruling out seeking external input into this review process”, Mr Dunne said.

Mr Dunne will also be discussing these issues in Canberra next week at the Australian Drug Foundation’s National Drug Summit.

While there he will also be meeting with Federal Ministers to discuss a range of drug policy issues, including medical cannabis and preparation for the United Nations General Assembly Special Session on Drugsb (UNGASS), which takes place in April.

The procedures were criticised after an application by Helen Kelly’s oncologist failed to provide the Ministry with sufficient information.

Oncologists and doctors can legally prescribe drugs like morphine that can impact significantly on the quality of a dying person’s life – and also impact on the length of their life.

It seems remarkable that they still have to jump through procedural hoops to give suffering patients something less dangerous and probably beneficial, at least in giving the patient some improved comfort.

Having to apply to the Ministry of Health still seems over-cautious and cumbersome, but I hope the Ministry will at least come up with ‘guidelines’ that make sense, make it much easier and put the needs of the patients first.

It can mean the difference between dying with less suffering and dying with more frustration (and I wouldn’t be surprised if there’s some anger as well).