Medicinal Cannabis Bill, Not Good Enough

Historic though it is, the Medicinal Cannabis Bill that passed its 3rd reading last week is hardly the panacea patients were hoping for. Until cannabis is treated entirely as a health issue, patients are being denied access and punitive measures levelled at sick New Zealanders seeking, using or growing cannabis to alleviate symptoms. Thousands of patients, carers and compassionate growers are left wanting.

Eddy has refractory nocturnal epilepsy and enjoys more nights seizure free with medicinal marijuana.

It fails patients like my son, and countless more, who do not fall within the narrow confines of terminal illness or palliation. Patients with chronic pain or other severe, debilitating and complex conditions who could still die at any point in time; today, tomorrow, within the year to come; without recourse to a statutory defence. Directing Police to exercise discretion feels like shifting the burden of public accountability. Police already have discretion and we know they don't always use it.

Above: Rose Renton lost her son Alex to status epilepticus before he was granted legal access to medicinal cannabis. She was arrested earlier this year for cultivation, processing and possession of cannabis with intent to supply. Medicinal marijuana advocate and green fairy to hundreds of patients.

Amendments to the Misuse of Drugs Act exclude anyone consuming cannabis to mitigate chronic, neuropathic or emotional pain and mood disorders. It affords no protection to caregivers and compassionate growers who have been supplementing the lack of safe, affordable and accessible medicine in both raw and heated treatments in absence of a funding model and range of suitable products on the local market. Essentially performing a public service the government should be.

It's hard to see how regulating growing at home interferes with the market for affordable cannabis-based nutraceuticals or pharmaceutical products. New Zealanders are allowed to grow tobacco and brew alcohol at home, not that either of these practices disrupts demand for retail alcoholic drinks, tobacco or cigarettes. A sound patient-centred model provides choice and access to safe medicines in the mode of manufacture and delivery they feel most comfortable with.

Cannabis is Medicine Public Awareness Billboard Campaign by Helius via New York Times.

The National party attempt to stir moral outrage for “decriminalisation by stealth” and the prospect of medical marijuana patients smoking outside schools premises belies appalling ignorance of terms both palliative and terminal. The idea that any patient in the throes of death could or would muster the strength to depart hospital, hospice or home to linger in proximity of nearby students is indicative of a systemic lack of empathy toward anyone suffering pain and disease in our country.

Bridges' remark reveal a flagrant disregard for existing frameworks into which a marijuana model plugs neatly. Ministry of Health already enforce smoking bans in public, it stands to reason these laws could encompass cannabis too. Liquor licensing laws and the Psychoactive Substances Act naturally lend themselves to R18 restrictions on purchasing and fines for underage or unlicensed sale. Likewise driving under the influence could be extended from alcohol to marijuana since we already have the ways (police) and means (compulsory impairment and blood tests) at our disposal to check for this.

Behind the scenes shooting the Cannabis is Medicine billboard campaign for Helius. Despite the negative backlash it has been an international conversation starter that highlights the need for investment into both public and medical professional education programs.

Yet the single biggest obstacle facing the successful implementation of the Medicinal Cannabis Bill is misinformation. Inflammatory strawman commentary that confuse the ethical case for medicinal use with endorsement of recreational use is not helpful. If we are ever to destigmatise patient agency in choosing safe therapy to treat their symptoms we need to address this systematic alienation because shame is contingent on 3 conditions for growth; silence, secrecy and judgment. This campaign is a cry for help. We are sitting out here in isolation without your vocal support.

None of the parents, grandparents and patients fronting for Helius campaign would have agreed to it if we didn't feel the public were woefully misled on the safety and efficacy of cannabis as a medicine, especially in pediatrics. Hopefully this landmark public awareness drive becomes the impetus for New Zealanders to embark on evidence-based research together, to learn why this is such an important health issue. Public engagement will be instrumental in shaping inclusive regulations next year. Limiting discussion on the Medicinal Cannabis Bill is limiting opportunity for patient human rights to be acknowledged, limiting relief from marginalisation and exclusion.

Please don't let patients like Eddy and carers like me be stigmatised for choosing the safest medicinal option to improve our quality of life. Let's redirect the conversation around patient access to medicinal marijuana away from criminality.

Likening Cannabis to synthetic drugs is limiting this conversation. Likening cannabis to opium specifically is not a fair comparison for multiple reasons. Cannabis has no recorded deaths (vs 100s daily on opiods) and the fatal dose for cannabis is essentially a physical impossibility. You would die from rupturing your stomach as opposed to toxicity. Marijuana has been shown to be opioid sparing in the opioid-dependency and drug rehabilitation space. Salient points to consider for anyone confusing medical marijuana with street drugs.

Positing medical marijuana in the "bad" space alongside illegal activity is part of the social harm caused by a culture of prohibition. That era is over, it didn't work, and we need to meet that discourse of disgrace head on with health-based policy, grounded in facts not fear-mongering. Further we need to consider the vulnerability of patients and caregivers who are forced into these legally and morally murky waters without improved access and funding.

Patients like Edward are relying on the public to bring pressure to bear on government to address our very real concerns that patient access will be restricted when the regulations are written next year. We have good reason. Medicinal Cannabis has been legal in New Zealand for over a decade and yet patients continue to be denied prescriptions by their medical professionals and are unable to afford the products currently available on the market without a funding model. You can help.

You can stop people from steering any discussion of medicinal marijuana into recreational use. They are separate issues and there will be a referendum to address that in 2020. Meanwhile, the matter at hand is the regulations that will be written into law around patient access next year. Be vocal about patient rights to treat themselves with marijuana medicines and reduce harm. Educate others about how important it is for everyone to able to afford it - don't let this become a discriminatory medicine that draws a line in the sand between the have and have nots.

Read up on the excellent evidence-based proposal set forth by the Drug Foundation, which really has social impact and community wellness at it's core. Share public awareness campaigns like Helius on social, start conversations, write to your local MP or Ministry of Health and tell them how New Zealanders want to have access to medicinal marijuana, how we want more information, we want consultation and we want quality affordable full-spectrum products. If you know someone who would like more information about medicinal cannabis, please do share this post with them or on social. Feel free to get touch Katy x