The people working for medical cannabis

Have we got we have got medical cannabis laws right? Russell Brown asks this at NZ Herald on Medicinal cannabis: For the love of her son:

The death of Rose Renton’s son prompted a dramatic change in the direction of her life. Russell Brown explores whether we have got medical cannabis laws right.

At the request of his family and doctors, Alex became the first New Zealand patient to be granted ministerial approval to import a non-pharmaceutical grade cannabis product in June 2015. The treatment couldn’t save him, but New Zealand’s conversation about medical cannabis turns on the weeks he spent in hospital, his brain in crisis.

In the course of approving the request to import an oil containing cannabidiol (CBD), Associate Health minister Peter Dunne had officials draw up guidelines for future applications, which had been provided for in law for years but never made before.

Helen Kelly applied, unsuccessfully, for another cannabis product under those guidelines. Dunne ordered a review and the Labour Party promised to make access easier.

This year, Dunne removed the requirement for ministerial approval for CBD products altogether.

And now, Alex Renton has landed his mother in court. Rose Renton, who lives in Nelson, is the most high-profile of a series of “green fairies” to face charges of growing, processing and possessing cannabis for supply.

Although Kelly very publicly eased her pain with the cannabis products people brought to her door, no one seemed inclined to make any arrests. That has changed this year.

That’s a shame. Police discretion could be used if it is not in the public interest to prosecute.

Shane Le Brun, who has participated here, has a different approach – to change the medical and legal systems.

A few kilometres, almost in line of sight of Rose Renton’s house, Shane and Kat Le Brun are fighting a very different battle — not to reject the system, but to make the system work better.

They had been married three months, he an army munitions officer, she an early childhood teacher, on the day in 2010 when their lives changed. Kat stepped out on an icy deck at the school where she was working, “my leg went from underneath me and I landed awkwardly on my back and butt. That was it.”

Doctors eventually discovered three of her spinal discs had prolapsed. In the seven years since, the 31 year-old has had spinal surgery and then been re-injured — knocked over by a child in a sandpit — and twice gone into respiratory arrest from opioids administered by emergency medics.

Her condition is managed to some extent with methadone, the only opioid prescribed for long-term use. It’s slowly destroying her teeth.

Over time, she’s had various powerful opioids, ketamine, gabapentin, valium and an anti-depressant (stress is known to aggravate her condition). She has tried cognitive behavioural therapy and acupuncture.

And on one terrible evening in hospital, when she couldn’t stop screaming, she was given an anti-psychotic and shut in a room by herself for the night.

But there is one treatment she’s not allowed — or at least, can’t legally get. Cannabis.
She says that the first time she tried cannabis (“I got it from a family member”) she slept well for the first time in four or five years.

Shane, who now works in IT, had already taken a nerdish interest in her pain medication (to the extent that they suspect he appeared to “know too much” and was incorrectly flagged as a drug-seeker by the system) and turned his attention to cannabis.

He formed a charity, Medical Cannabis Awareness NZ, which campaigns for the availability of affordable medicines via the non-pharmaceutical provisions first used by Alex Renton’s doctors.

Last year, MCANZ was responsible for 80 per cent of ministerial approvals for their use. Ministry officials who were once suspicious of medical cannabis now speak to him regularly.

Ironically, the one he hasn’t been able to help is Kat.

“I do find it very difficult,” she says. “It feels at times that he’s fighting harder for others than he is me. At the height of my pain, I have been known to throw a few pillows at Shane and say to him, you’re doing all this work and you have been for so long and I’m still not further ahead.

Her frustration is compounded by the stigma Shane’s advocacy attracts.

“I have been discriminated against because of what Shane does. I think people hear the world cannabis and freak out — because it’s illegal in their eyes. And all they know of when you say that word is getting high.

That’s a real shame, but eventually, hopefully soon, she will benefit from Shane’s efforts.

Kat’s own bid to be legally prescribed a cannabis product hit a familiar roadblock — doctors. A senior medic at Burwood spinal unit told them there was insufficient evidence for him to prescribe Sativex, the only Medsafe-approved cannabis product in New Zealand.

“I presented the doctor with a printout of a trial of Sativex for allodynia and hyperalgesia,” says Shane. “And he tried to change the topic because I basically knew more than he did.”
Kat adds: “The report came back and said ‘the husband seems to know a lot about cannabis’ and made it seem really dodgy.”

“We had to go doctor-shopping,” Shane says. “It’s disappointing, because she’s exhausted all reasonable options.”

The ministry has since taken a different view, acknowledging that a cannabis product is a benign option for Kat and approving access. Now, they face the other big roadblock for legitimate medical cannabis in this country: cost.

The cost of producing, testing and proving medicinal products is high, especially when there is a very restricted market.

Last year, MCANZ helped Auckland MS patient Dr Huhana Hickey win approval for a functionally identical product made by the Canadian company Tilray.

But that has ended up being more costly than they’d hoped and the couple are now pinning their own hopes on a similar product made by another Canadian company, CanniMed.

Remarkably, the Ministry of Health is now prepared to approve CanniMed’s whole dried cannabis products, for use in vapourisers. It has also tabled work on regulations for growing cannabis locally for research as part of advice to the new Government.

Shane believes local production to precise medical standards is the only long-term answer.

“The patient population views the green fairies and illegal suppliers as heroes,” he says.

“As a charity, we cannot condone or promote illegal activity. But come on — there’s 100,000 people who claim they use cannabis medically at least sometimes and around 50 people in the country accessing it legally at any one time. There’s just a huge disparity.

Lawyer Sue Grey has taken another approach.

She was a specialist in environmental law when, five years ago, she was asked to act for 61 year-old Golden Bay woman Victoria Davis, who had been charged with cannabis cultivation and possession. Davis had been growing for her husband John, a double amputee wracked with phantom pains.

Grey won her client a discharge without conviction, in part by presenting a doctor’s letter to the judge.

She thought she would move on, but in 2015, Davis recommended her to another Golden Bay resident in legal trouble, Rebecca Reider. Reider was facing serious charges after posting herself two bars of cannabis chocolate — which had been legally prescribed to her for chronic pain in California and delivered to her family’s home.

Again, Grey presented medical records and Reider was eventually discharged.

But she also studied the Misuse of Drugs Act and discovered that Reider was allowed to import a controlled drug if it was prescribed and she brought it in herself.

Then, advocating for terminal cancer patient Tom Harris, Grey challenged the Ministry of Health’s position that CBD is a controlled drug under the Misuse of Drugs Act. The Government’s own agency, ESR, wrote in unequivocal support of her argument.

CBD officially remains a controlled drug — but when Dunne announced this year that CBD prescriptions would no longer require ministry approval, it was effectively a surrender.

But the situation remains vague and confusing.

The law, Grey agrees, is a real mess. She says she feels for the police.

“I’ve spent a lot of time working with the Nelson police, the drug squad and the prosecutors. When I first started working with them they had zero tolerance for any excuse for medicinal or any other cannabis.

“Now, they’ve really learned a lot — but they’re in a difficult position because their job is to uphold the law. They have discretion, but they have to report to their bosses. They’re the meat in the sandwich, really.”

Ultimately it’s our MPs, our political parties, and our Government that put the front line police in an invidious position.

Dunne tried to progress things on the medical front, but was hampered by an unsympathetic National government.

Labour have promised progress, Greens should be a shoe-in for support, but it will still require support from NZ First or national to change out of date and hopelessly impractical laws.

But the Minister now responsible for the health side of cannabis, David Clark, could push progress along there.

And surely the Minister of Police Stuart Nash could give some direction on the policing side of cannabis, especially where illness is involved.

Renton, Le Brun and Grey have done a lot and have achieved a bit, but it’s time for our elected representatives to take responsibility for a messy and stupid situation.

If Jacinda Ardern chose to show leadership on this she would be likely to get a lot of popular support. People are suffering necessarily and sadly.

 

Rose Renton admits smearing poison on Nick Smith

One of the people who attacked Nick Smith with rat poison has admitted doing it, but denies touching his face.

Rose Renton, alsol known as a medical cannabis campaigner, and her husband were the two who accosted Smith, who lodged a complaint with the Police.

Stuff:  Nelson protester Rose Renton explains why she rubbed rat poison on Nick Smith

A protester who rubbed rat poison on Nelson MP Nick Smith’s clothes says she was making a “symbolic statement” against the Brook Valley poison drop.

Rose Renton confronted the Environment Minister near the Nelson Market on Saturday but denies shoving him or touching his face.

Renton lives in the Brook Valley, but says she is not part of the Brook Valley Community Group, which has opposed the drop. She said she only wanted to make “a stand against the environment Mr Smith has poisoned”.

“He is the Minister of our Environment, he did not attend The Brook poisoning unlike half our police force so my husband and I went to him,” Renton said.

“It was a symbolic gesture of his support of the poison drop without the required 48 hours notice to surrounding community.”

According to Smith the incident “became quite frightening when it escalated from verbal abuse and throwing rat poison at myself and volunteers to physical shoving and rubbing rat poison over my face and clothes”.

“It was a complete violation of the wildlife and people living in the Valley. I wanted Mr Smith to see exactly what it feels like to have poison in your backyard.

“He didn’t enjoy it, he felt violated?  Well so do the people in the Brook.”

The Brook Waimarama Sanctuary want to create a predator free area for native wildlife in the Brook Valley near Nelson, along similar lines to Zealandia in Wellington.

It says the poison drop was a necessary step in creating a predator-free zone behind the fence.

RNZ:

Renton says she doesn’t regret what she did, and says there was no risk to Smith.

Whether there was any actual risk or not physically accosting MPs in protest over anything is crossing a line, and she should be held to account under law.

 

 

Medicinal cannabis petition presented

A medicinal cannabis petition was presented to parliament today.

RNZ: Alex Renton’s mum presents reform petition to Parliament

A woman whose son died of severe epilepsy has presented a petition with more than 15,000 signatures to Parliament, urging the government to make medicinal cannabis more readily available.

Rose Renton’s 19-year-old son Alex Renton died in Wellington Hospital last year, after suffering from status epilepticus – an acute, prolonged epileptic seizure.

Part of his treatment before his death was medicinal cannabis, which Mrs Renton said provided him with some relief, but was given to him too late.

A report by Wellington Hospital specialists said the oil had no effect on his underlying seizures, and medical staff never saw any improvement.

There’s a range of products becoming available and it was a gamble that the one chosen may make a difference. There was no time nor any easy ability to try alternatives.

But Mrs Renton said Alex had died peacefully.

“A lot of those drugs that were so heavily layered over the months leading up to his death were taken off and drastically reduced and the [cannabis] oil doses were increased.”

The process to acquire the oil and get approval to use it was drawn out and far from easy, Mrs Renton said.

Medicinal cannabis was only granted after a long battle with medical staff for backing, and after 43 other drugs had failed.

Keeping pressure on Parliament, along with overseas moves to more freedom to use medicinal cannabis overseas, may eventually get our Government to move with the times and for the needs of people who suffer.