The ideological, illogical war against cannabis

I’ve introduced a bill which would allow fines to be waived for the personal cultivation and use of marijuana for people suffering designated medical conditions. This would be on the proviso that a medical practitioner has signed a palliative cannabis certificate, saying that the person is suffering from a specified illness or disease, the symptoms of which might be palliated by the smoking or consumption of cannabis or cannabis resin.

Given that in South Australia cannabis is a controlled substance and is illegal under normal circumstances, under this legislation the medical practitioner is given protection.

Cannabis is a drug that has been referred to in literature in all cultures. It was being used in China as a herbal remedy 5,000 years ago; in the US the 1896 edition of the Pharmacopeia had 20 pages devoted to its uses; and until 1934 cannabis was widely used in pharmaceutical preparations in the US. Queen Victoria is said to have used it to relieve period pain.

It is because of individual’s different responses to drugs that cannabis should be part of our palliative armoury. There are some people with conditions that cannot be alleviated with the normal range of chemically-synthesised drugs. Some of these conditions include multiple sclerosis, and up to 30 per cent of people in Europe who suffer with multiple sclerosis use cannabis to alleviate their symptoms. A British study showed that the use of cannabis by MS sufferers resulted in improvements in walking speed, reduction in muscle spasms, pain relief, and better sleep.

People who have nausea and vomiting associated with chemotherapy, as well as people with body wasting because of AIDS, find that cannabis suppresses the nausea and vomiting. Other conditions that can be assisted are glaucoma, depression, bursitis, control of seizures, and neuropathic pain associated with spinal cord injuries.

One of the short-term effects of THC in cannabis is to expand the airways in the lungs, helping people who have asthma; however, cannabis users may develop tolerance to this effect.

Like all drugs, there is a potential for side-effects, and the use of cannabis for medical conditions, just as with other drugs, needs to be tightly controlled.

Each year in Australia there are approximately 19,000 deaths from the use of tobacco, 2,000 from alcohol and 1,000 for all other illicit drugs combined. Paracetamol kills 400 people per year, and even aspirin causes more deaths than cannabis. In fact, ABS figures do not show cannabis as causing any deaths.

There is not anywhere in the literature a causal link between cannabis and psychosis. Certainly, there is evidence that shows that some people who are psychotic have a tendency to self-medicate with cannabis and, of course, that is interesting in itself because there is an ingredient in cannabis called CBD that inhibits psychotic symptoms among schizophrenics. It may be, in fact, that they have cottoned on to that and are using it to effectively alleviate some of their symptoms.

Dr Syril D'Souza and Dr Asif Malik from Yale University published an article on the website psychiatrictimes.com they say:

If cannabis causes psychosis in and of itself then one would expect that any increase in the rates of cannabis use would be associated with increased rates of psychosis. However, in some areas where cannabis use has clearly increased, e.g., Australia, there has not been a commensurate increase in the rate of psychotic disorders. Further, one might also expect that, if the age of initiation of cannabis use decreases, there should also be a decrease in the age of onset of psychotic disorders. We are unaware of such evidence.

The AMA, to whom I provided a copy of the draft bill, has rejected the bill because of safety concerns, but what I find interesting about that is that there do not appear to be the same concerns in relation to prescribing drugs that come from chemical companies. Some drugs our medical practitioners already legally prescribe - for instance, there is Strattera for ADHD have side-effects that include suicidal thoughts, weight loss, chest pain and swollen testicles: but doctors still prescribe it.

There has been a lot of research into the effect of benzodiazepines and the relationship with hip fracture in the elderly. Research on that by Eileen E. Ming at Harvard University states:

In long-term care sessions where 45 to 70 per cent of residents fall each year, 1,600 falls occurred per 1,000 person years. Compared to the rest of the population, which is 224.

It continues:

One to two per cent of falls result in hip fracture, and the risk of hip fracture increases almost 100-fold from age 60 to 64 to 80 to 84. In the year following a fracture, there is a 23 per cent mortality rate, compared to an expected 8 per cent; 50 per cent of the ambulatory lose the capacity to walk independently; one-third of the community-dwelling require long-term nursing care; and many are incapacitated by the fear of falling again benzodiazepines have been found to impair basic psychomotor function and postural sway in normal volunteers, a side effect which lasts at least through four weeks of continuous use; impairment increases with dose...Sedatives slow reaction time and reduce coordination and alertness ... protective responses at the time of a fall may be too late to prevent a hip fracture.

So, here we have another drug that among the elderly in particular has some quite catastrophic side effects in terms of losing balance and falling and hip fractures. The range of increased risk is between 1.5 and 5.8 times compared to those not using psychoactive substances.

Thalidomide is another very dangerous drug. I am sure most people will recall that in the 1960s it was prescribed to prevent morning sickness in pregnant women, and many of those women subsequently gave birth to children with deformities. It has now been rehabilitated, so to speak. It still causes those effects, which are disastrous, but it is being prescribed by doctors now for blood cancer and leprosy. Among the drugs that doctors prescribe is morphine, because it has a very important role to play for the relief of extreme pain. But everybody knows what morphine in its illegal forms can do. In relation to this whole question of harm, the US Institute of Medicine concluded:

Except for the harms associated with smoking, the adverse effects of marijuana are within the range of effects tolerated for other medicines.

Let us look at what is happening in other countries.

In the United States, 12 states have removed criminal sanctions for possession of marijuana if it is used to relieve medical conditions.

In terms of the application of the law in those 12 states, some give out ID cards to the users. Most state laws are silent about the procurement of marijuana; whether users can grow it themselves or buy it from somebody and, if so, from whom. In New Mexico the governor himself introduced legislation which envisaged a state licensed and protected system of cannabis production, and that was passed last year. Regulations to allow this are now being prepared, and at least 150 people have already formally applied to be able to use the drug. In addition to the states' involvement, both patients and carers will be able to grow their own cannabis.

Polling in 1995 showed that two-thirds of Americans believe that medical marijuana was justified. Proposition 215 in California, which brought about the decriminalisation of marijuana for medical use, got a strong 56 per cent of the vote. In California, hundreds of medical marijuana dispensaries are now offering assorted varieties for sale and providing advice about which varieties are best for differing medical conditions. Cannabis dispensaries were never authorised: they just sprang up.

The Bush administration has been trying to stop the legitimisation of cannabis, and threats have been made to arrest state legislators if they proceed down this path. Doctors do not prescribe under California law; rather they write a statement saying that they think it is OK for a particular patient to use cannabis, which is similar to the proposal in my bill.

Despite all the foregoing, US federal law still prohibits the growing, possession, supply or use of cannabis for medical purposes. The DEA can, and does, conduct raids in states where medical marijuana has been decriminalised. However, this year the bill has been introduced by former presidential candidate, Ron Paul, to make it legal at the federal level.

In Israel, cannabis is being used on a limited basis to treat PTSD (Post traumatic stress disorder) in former soldiers. Additionally, trials are taking place in many other parts of the world. The Israeli Health Ministry grows marijuana which it gives away to more than 150 registered patients with cancer, AIDS or chronic inflammation of the intestine. The facility is being expanded, and consideration is being given to distributing through government-approved hospitals and perhaps private pharmacies where it could be sold.

In Canada, federal government regulations, under the Controlled Drugs and Substances Act, allow people with certain illnesses to apply for permits to possess and/or grow marijuana for personal medical purposes, or to designate another person to grow it for the person who has the permit. All usages must be prescribed by physicians.

In the Netherlands, there is a medicinal program that allows pharmacies to sell standardised quality-controlled marijuana from authorised growers to sufferers of chronic or terminal diseases. It is a program that is not working very well because cannabis coffee shops are able to sell cannabis at a cheaper rate.

There is a lot of support, and growing support, for the use of medical marijuana here in Australia from organisations like the Country Women's Association (who see that it could be used for people who are experiencing the effects of chemotherapy when having cancer treatment); the New South Wales Cancer Council; the AIDS Council of Victoria; and the South Australian Voluntary Euthanasia Society.

In the United States, support for medical marijuana has come from the United Methodist Church, the Episcopal Church, the United Church of Christ, the Union for Reform Judaism, the Progressive National Baptist Convention, the Presbyterian Church and the Unitarian Universalist Association.

US presidential candidate Barack Obama who, when recently asked whether, if he became president he would halt the Drug Enforcement Administration's raids on medical marijuana growers in Oregon, replied:

I would, because I think our federal agents have better things to do, like catching criminals and preventing terrorism. The way I want to approach the issue of medical marijuana is to base it on science and, if there is sound science that supports the use of medical marijuana, and if it is controlled and prescribed in a way that other medicine is prescribed, then it is something we should consider.

The war against marijuana is ideological; it is a matter of what substance fits with what set of values. In the West there is a view that nature is bad and synthesising is better. It is time for us to consider the use of medical marijuana as part of being a humane and compassionate society. If we know that a substance works by improving the health of people and we continue to deny access to it, particularly when so many people use it illegally without any bad effect, then there is something else driving the argument - and it is certainly not science.

Bit by bit the demand for medical marijuana is growing and, bit by bit around the world, the medical efficacy of this drug is being recognised. This is the second time such legislation has been introduced in South Australia, and I am sure it will not be the last, given the phoney “tough on drug” stance of most members of this parliament - most of whom drink alcohol and less of whom smoke tobacco. However, like the vote for women, it is an idea whose time has come and, eventually, such legislation will pass.