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The Forbidden Painkiller


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This morning, in his Lower Hutt home, Richard will heat and inhale a few drops of cannabis oil.

The thick smoke carries delta-9-tetrahydrocannabinol (THC), an active ingredient that helps him relax, reducing muscle tension and therefore pain.

In Levin, Billy McKee will today smoke five joints, each containing about a gram of the dried plant. His supply at the moment is "garbage", so he needs larger amounts than usual.

Often he will smoke only five small balls of weed each day in a pipe. When he gets top-quality cannabis, he'll eat the "beautiful, herby" plant fresh.

Billy, 52, and head of lobby group GreenCross, is wheelchair-bound after a drunk-driver crashed into him 30 years ago. He has lost one leg, the other is continually painful, he has occupational overuse syndrome in his hands from using walking aides and now he's getting pressure sores on his hips and bottom. Cannabis soothes his aches, enabling him to work industriously on his various lobbying and community projects. "It just lets your mind go somewhere else."

Richard, a former mechanic, was crushed under a car while working in his driveway in 1991, and this week checked out of hospital after his third operation related to the accident. He has tried to return to the workforce repeatedly during the past 16 years, but each time his back has forced him to retrain and try a new career. He functions better on cannabis than any prescription painkillers with comparable pain-relief results.

He smoked cannabis recreationally before the accident, then found afterward that it provided relief from some of his symptoms. He is no longer a recreational user. He smokes only within his own home, only when he requires pain relief. He sometimes has two to three sessions a day, each session consuming a spot of oil smaller than a pea.

Now, with three convictions for possession and three for cultivation, he's strongly behind a Green MP's member's bill calling for cannabis to be legalised for medicinal use. And Health Ministry papers released to The Dominion Post under the Official Information Act show officials have advised the health minister that there is enough evidence to support use of cannabis on compassionate grounds.

Is it possible that Richard and Billy will one day soon be able to legally grow cannabis and smoke cannabis in their homes without fear of prosecution?

What is the law now?Cannabis use in New Zealand is prohibited under the Misuse of Drugs Act 1975. Cannabis is a class C drug and cannabis preparations are class B drugs.

However, under the Misuse of Drugs Act and the Medicines Act 1981, a medical practitioner can - with the health minister's approval - import and prescribe controlled drug medication, such as cannabis, for a patient under their care.

A 2002 Health Ministry briefing paper stated that between 1994 and 2002, 12 applications were made by doctors, on behalf of seven patients, for exemption to prescribe cannabis for medicinal use. Among these were two applications for unnamed patients, and two patients who had more than one doctor apply for them. None were successful.

But the Health Ministry told The Dominion Post last week that no medical practitioners had ever applied for the exemption - only patients, who had all been turned down.

Health Canada has approved the cannabis nasal spray Sativex for relief of neuropathic pain in multiple sclerosis sufferers.

Spanish authorities are also believed to be approving the use of cannabis capsules in specific cases and under medical supervision. Sativex trials in Britain are ongoing, focused on seeing what benefit the medicine could have beyond its most common use, for pain relief in multiple sclerosis sufferers. Preliminary results from manufacturer GW Pharmaceuticals in January showed what the company said were "substantial improvements" in pain among those suffering painful diabetic neuropathy.

Cannabis has been the subject of three previous health select committee inquiries, in 1995, 1998 and 2003.

What does the new bill propose?Green MP Metiria Turei has lodged a member's bill proposing an amendment to the Misuse of Drugs Act 1975 to decriminalise use of cannabis for medicinal purposes.

The bill would allow cardholders to consume, smoke and possess a certain amount of cannabis, quantity not specified. A register of cardholders and their designated agents would be created.

Applications for a card would require evidence that the person suffered from a list of conditions, some of which were recognised as benefiting from medicinal cannabis use, including Aids wasting syndrome, glaucoma and epilepsy. The bill was awaiting information and Ms Turei said this week that she had no undertaking from any party to back the bill. But it's likely a 3000-signature petition could build the profile of her cause. Norml, a group pushing for reform of cannabis laws, has handed the petition calling for legalised medical use to Parliament.What does the Health Ministry say about that?Health Ministry documentation released to The Dominion Post this month under the Official Information Act dated back toMay 2000, and included briefing papers to former health minister Annette King and current Health Minister Pete Hodgson. The most recent correspondence was an October 2006 briefing paper for Mr Hodgson on the bill.

The papers show a level of support within the ministry for medicinal cannabis use. "The scientific and clinical evidence, while not yet overwhelming, indicates that the use of cannabis has therapeutic value in treating serious conditions, including multiple sclerosis, HIV and cancer-related wasting and chronic pain where other medications have proved less effective."

The ministry listed three concerns: potential physical and mental harm from smoking the drug, the difficulties in assuring quality and control of the dose, and problems of legitimate supply of what is primarily an illegal drug.

"Despite these concerns about the use of cannabis leaf as a medicine, the ministry believes that there is now sufficient evidence of safety and efficacy of cannabis in some medical conditions to support consideration of compassionate use under tightly controlled circumstances."

Ms Turei says: "It is a health issue to some extent, but for patients who are likely to die ... really the risk of smoking is completely irrelevant."

Finally, because of the provisions in existing legislation, allowing the health minister to approve a product as a medicine, or an individual's request for consent to use medicinal cannabis, the ministry does not believe the bill is necessary.What else do the

briefing papers say?On one paper, Ms King added a third handwritten recommendation to a health report regarding approvals for the supply of cannabis products. It read: "Please note: I have said no approvals will be given until the results of the UK trials are known 2002-2003."

Other documentation showed that Labour MP Tim Barnett pressured his colleagues, writing to Mr Hodgson in March 2006 to request an update on progress setting up a system to allow access to medical cannabis-related products.

Mr Barnett asked about the same clinical trials, and Mr Hodgson's response made the point that, regardless of the trial outcomes, there had not been any applications to register medicinal cannabis products in New Zealand. Until such applications were made to Medsafe, the Health Ministry's drug regulator, they could not be considered.

If Medsafe were convinced, it would recommend that the minister consent to distribution in New Zealand. So, if leaf cannabis was not an acceptable form of medicine and Ms Turei's bill failed, it would then require a company with a relevant product to make the issue less about the theory and more about the practicalities.

The ministry believes pharmaceutical forms of cannabis are more appropriate as a treatment than smoking leaf cannabis.

GW Pharmaceuticals in Britain is one of the leading manufacturers and distributors of medicinal cannabis worldwide. In 2003, it indicated it would supply its pharmaceutical cannabis product, a nasal spray called Sativex, for a clinical trial in New Zealand.

A briefing from October last year said: "To date, the Ministry of Health has not received an application for approval of this or other pharmaceutical forms of cannabis."

A GW Pharmaceuticals spokesman said he would not have time to respond to questions from The Dominion Post this week regarding any future approaches to supply Sativex in New Zealand.

Prime Minister Helen Clark said this week that the Health Ministry's advice should not be read as a "major endorsement" of medicinal cannabis use, and that no application had been made to introduce Sativex to New Zealand.

Source: The Dominion Post (NZ)
Copyright: Fairfax New Zealand Limited 2007
Website: Latest breaking news NZ | Stuff.co.nz
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