Medical Cannabis - Co-creating a Policy for Aotearoa

Thursday, 7 September 2017, 11:05 am
Article: HiveMind

Medical Cannabis - Co-creating a Policy for Aotearoa

Welcome to the fourth and final HiveMind for Scoop’s Opening the Election campaign for 2017. This HiveMind explores the question: what would a fair, humane and safe Medical Cannabis policy look like for Aotearoa, NZ in 2018?

There are many valuable opinions as to whether and under what terms Kiwis should be allowed to use Cannabis for medical purposes. This is an opportunity to put our heads together and co-design a new policy that takes into account the various issues and a diverse range of views.

Why Medical Cannabis?

In April, Scoop readers told us that health was one of the top 5 issues of concern this election and Medical Cannabis has emerged as a highly relevant health issue. A majority of New Zealanders now support legalising Medical Cannabis and evidence for the benefits continues to stack up.

While minor policy tweaks have been made over the past year, these appear to have done very little in substance to provide improved access to patients who wish to follow this path.

Viewpoints on this matter range from complete prohibition through to allowing a system of local Medical Cannabis producers and the right for patients to grow their own medicine. It may well be that the most publicly acceptable approach for now lies somewhere in the middle, however, public opinion is overwhelmingly in favour of law reform to some degree.

The fact that current policy is lagging so far behind public opinion is damaging to the integrity of the law, and the delicate social contract between representatives and citizens. A new approach is clearly needed. Help us advance that conversation.

How It Works

In the Pol.is window below you can vote on a series of statements representing a range of opinions commonly arising when considering Medical Cannabis policy. You can also to submit your own statements for others to vote on. The results will give good qualitative data on what type of policy respondents are prepared to accept and what areas of consensus emerge.

As usual we will open source this data for all to see and use.

How To Participate

You can vote on existing statements and share your own perspectives on the issue below.
To learn more about the various issues please check out our summary of the Medical Cannabis debate and list of resources below.

Learn - See the summary article and additional resources below; click here.
Vote - Statements are presented in random order in the interactive window below for you to decide to agree, disagree or pass on each.

Suggest - Add new statements to expand the debate. (HiveMind will select a limited number of new statements weekly to add according to our selection criteria)

Connect - Please sign up or return regularly before close off on Weds 20 September at 10.00 pm. HiveMind will present new statements and ones you haven’t voted on at each new session.

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Medical Cannabis in Aotearoa – HiveMind Background Article

Following is an outline of the various issues, viewpoints and areas of dispute as we see them in the New Zealand context. If you see them differently or have evidence we have not included, please feel free to let us know.

Historical Overview

Cannabis sativa is one of the world’s oldest cultivated plants and has a long history of use as a medicinal plant in various regions, likely dating back more than two millennia. Many 19th-century practitioners ascribed medicinal properties to cannabis after the drug found its way back to Europe during colonial expansion into Africa and Asia. In the early 1900s, prohibition of the drug began in the west but a resurgence of interest in the therapeutic effects of cannabis began 20 years ago. In 1996, Arizona and California first passed medical cannabis legislation to make it available as a medicine to patients with a variety of conditions. Many other US states and a growing list of countries now permit medical cannabis to varying degrees.

Cannabis and Public Good

The public-health implications of access to essential medicines are an important element of the public good. According to Michel Bauwens, ensuring such access provides clear benefits by allowing recipients to better contribute to the social fabric and economic productivity of their communities. Conversely, a lack of access causes enormous social problems in terms of economy-depressing illnesses.

For this reason, a human right to access essential medicines has found its way into many international treaties and national constitutions. The question then becomes whether cannabis is an essential medicine to some people? Many advocates clearly believe it is, but what does the science say?

The Science on Cannabis:

The human endocannabinoid system (ECS) is as yet quite a complex and unstudied area. It is a group of cannabinoid receptors located in the mammalian brain and throughout the central and peripheral nervous systems and is in fact named after the compounds that were first isolated by scientists in Cannabis. Known as "the body’s own cannabinoid system", the ECS is involved in a variety of physiological processes including appetite, pain-sensation, mood, and memory, and in mediating the psychoactive effects of cannabis.

Because cannabinoids are able to tap into human endocanabanoid receptors, the plant has a very unique ability to interact with important parts of the human brain and perhaps even interact with important brain chemicals such as serotonin. This complex relationship explains in part both the medical potential and the reasons for concern around the negative cognitive effects of cannabis. It may also explain why humans have had such a close relationship with this plant over the centuries and by all accounts many have enjoyed experimenting with it from time to time.

Tetrahydrocannabinol (9-THC), is the cannabinoid primarily responsible for the psychoactive effects of cannabis. The effects of THC, however, are believed to be moderated by the influence of the other components of the plant, most particularly the cannabinoids. The most abundant cannabinoid in the hemp plant is a non-psychoactive component called cannabidiol (CBD).

How Medical Cannabis Differs to Recreational Cannabis

CBD is found in higher quantities in most Medicinal Cannabis strains due to its anti-inflammatory, antioxidant, painkilling and neuroprotective qualities. Some Medical Cannabis products are even pure CBD, but amazingly are still illegal in New Zealand. According to the NAP review above there is evidence that CBD could potentially be exploited in the treatment and symptom relief of various neurological disorders such as epilepsy and seizures, psychosis, anxiety, movement disorders (e.g. Huntington’s disease and amyotrophic lateral sclerosis), and multiple sclerosis.

Advocates of Cannabis reform often point out that critics of Medical Cannabis seem to either be incapable or unwilling to comprehend the simple fact that THC and CBD are very different compounds, with significantly different effects. Judging Medical Cannabis by what we think we know about the side effects of highly psychoactive recreational Cannabis is a seriously flawed exercise. Note that CBD has even been shown to have potential in treating psychosis as well as other mental health issues, so it is an important element in ensuring the safety of Medical Cannabis.

According to Associate Professor Nadia Solowij, from the University of Wollongong’s School of Psychology, CBD is thought to counteract the short and long-term negative effects of THC. But it is concerning that CBD has largely been bred out of modern cannabis due to market demand for higher THC levels. She believes this has increased the negative association between cannabis use and psychosis.

New Zealand’s black market products have traditionally had some of the highest THC content of any cannabis in the world due to years of selective breeding and prime growing conditions. This is perfect if your business model is to suitably blow the customers’ brains, however, Medical Cannabis strains are far different. Black market cannabis for this reason offers significantly less medical benefits and higher risks and side effects than the more balanced THC and CBD of Medical products. There is an ever-developing knowledge, and respect for the various components of Cannabis and many high-CBD strains are now available which are suited to medical purposes.

There is a burgeoning black market in Medical Cannabis emerging in New Zealand due to the high demand and lack of a suitable legal alternatives. However, due to its unregulated nature there is currently little consistency, standardisation or transparency around origin, dosages or CBD ratio. This could in fact be putting many patients at risk. A more rational and responsible debate around Medical Cannabis needs to be clear about this important difference from the outset.

Efficacy of Medical Cannabis

There have been many studies about cannabis with varying degrees of quality, funding, bias and methods which, to date, makes certainty around claims difficult. However, a new and extensive review of scientific literature by the National Academies of Science, Engineering and Medicine has clarified the situation somewhat. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017) analysed more than 10,000 scientific studies on Cannabis. It basically summarises what evidence we have about Cannabis, what we think we know, and what needs more evidence.

This report suggests that:

- There is conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults, as antiemetics in the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids), and improving multiple sclerosis symptoms.
- There is moderate evidence that cannabis or cannabinoids are effective for improving obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis.
- There is limited evidence that cannabis or cannabinoids are effective for increasing appetite and decreasing weight loss associated with HIV/AIDS, multiple sclerosis, Tourette syndrome, social anxiety disorders and posttraumatic stress disorder

So, while the evidence of efficacy for some medical purposes is now proven conclusively, there is still uncertainty and debate over other claims of medical efficacy of cannabis.

Many of these other claims are, however, trending towards being proven as more high quality research is done but this is taking time. In policy circles, comprehensive evidence reviews such as this are the gold standard in scientific evidence as they look into the quality, reliability and accuracy of the claims of various other studies to give a balanced picture.

However, reports such as this can only review studies that have taken place. As the review states, there has not been enough high quality research on the potential medical benefits of cannabis. Most of the research in the past has been into the potential dangers of cannabis rather than the potential health benefits.

The report also points out that the difficulties of accessing clear data around medical cannabis is exacerbated by the fact that there are many legal and financial barriers in place making unbiased and accurate studies of the risks and benefits of Medical Cannabis virtually impossible.

The big take home recommendations from the report are that as a civilisation we need to: 1. address research gaps in cannabis knowledge; 2. improve research quality; 3. improve surveillance capacity at government level; and 4. address research barriers such as laws and funding.

Urgency or Precautionary approach

The main difference in opinion in policy circles appears to be around whether we continue to wait for conclusive scientific evidence of efficacy of all claims for Medical Cannabis or take a more permissive approach by legalising it and leaving it up to medical professionals discretion.

Advocates believe changes are necessary in order to provide immediate relief to patients in the absence of a medical industry in NZ. Critics, mostly on the conservative side of politics, however, favour a more precautionary approach, often citing public health, social costs and lack of conclusive evidence over benefits of reasons for such an approach.

Given the results of the evidence review above, however, it is becoming more and more difficult for opponents to argue that there is not a clear evidence base for at least some medical benefits of cannabis. The reality is that concrete and conclusive science is rare when it comes to the brain and complex medical interactions. Medical Cannabis advocates argue that waiting for conclusive evidence could mean legalisation never happens or at least takes a very long time.

Advocates also argue that this highly rational approach favouring scientific evidence over all other types of evidence is no longer valid. We have centuries of anecdotal evidence and traditional knowledge outside the western scientific tradition of medical benefits of cannabis. Many, including some Māori and indigenous peoples, are increasingly questioning the comprehensiveness of western medicine and scientific rationalist approaches as a system for understanding the complicated healing processes of the human body. There may well be a valid argument that there is a spiritual or ethereal element to cannabis’ effects that is impossible to quantify under current systems.

The fact is, evidence or no evidence, New Zealanders are already self-medicating with Medical Cannabis. Newshub’s The Nation reports some oncologists inform them that between 40 and 60 percent of their cancer patients use cannabis. As a result, many Kiwis now claim to have witnessed or experienced the powerful medical potential of cannabis firsthand either personally or through loved ones.

These people understandably may find it patronising to be told by politicians or medical professionals that there is no scientific proof or merit to Medical Cannabis. Waiting for science to prove what many already believe is hardly an appealing option for people with serious or even terminal health conditions and a situation that we cannot continue to take lightly.

Double Standards?

Advocates also argue that to impose barriers to access to Cannabis based on a lack of evidence of efficacy while taking a far more permissive approach to often risky and damaging pharmaceuticals is discriminatory, arbitrary and a legal double standard.

Many other medications are arguably not conclusively proved to do what they claim to do, yet are still readily available. There have been numerous examples of FDA and PHARMAC approved medications subsequently being proven as ineffective or even harmful to patients. The Medsafe.govt.nz publicly searchable database for example lists a total of 2147 medical products that have been recalled in New Zealand for various reasons since 2012 alone.

Barriers To Access

Affordability
The main significant barrier to access for patients in New Zealand is the sheer unaffordability of the pharmaceutical cannabis products approved for import. Only 5 Cannabis-based medications worldwide have managed to meet the rigorous and expensive requirements of pharmaceutical grade certification. Of these, only two, Sativex and Tilray, have been approved by the Government for use in New Zealand for MS patients but are not subsidised by PHARMAC.

The high costs of production and international shipping is passed on to consumers meaning Sativex costs $1200 per month to patients although it only contains perhaps $150 worth of cannabis at black market rates. Products such as Sativex are clearly priced far beyond the reach of most patients who need them, leaving the black market as the only option for most.

Non-Pharmaceutical or ‘Near Pharmaceutical’ Products

The reasoning for this continued cost barrier is the on-going insistence of the Government that only pharmaceutical quality products with proper evidence of testing in New Zealand are allowed. The reason, according to the Government, is the lack of safety and clinical trials on the efficacy of non-pharmaceutical cannabis products.

This may seem like a reasonable approach to many, however, to patients it amounts to a practical ban on all affordable Medical Cannabis products. Outside of the massively wealthy ‘big pharmaceutical industry’, few if any producers have the money or resources to meet the stringent requirements for pharmaceutical grade certification.

Lack of pharmaceutical quality does not, however, mean that products are inherently inferior. There are other recognised systems governing quality including ‘food grade’ safety requirements. The Ministry of Health already uses these guidelines regularly and has approved non-pharmaceutical cannabis products based on meeting these requirements for consistency, standardisation and dosage.

A More Affordable Approach is Possible

Canada has developed a more practical and effective policy approach that allows a vast range of affordable, locally manufactured, non-pharmaceutical cannabis-based products. Medical Cannabis Awareness New Zealand (MCANZ) describe these products as ‘near pharmaceutical’, meaning they are standardised and safe with rigorous independent testing. They simply have not gone through the expensive process required to achieve pharmaceutical status.

MCANZ argues that there are ‘near pharmaceutical’ products on the market in Canada with just as much efficacy and safety as pharmaceutical products. That range includes balanced cannabis oils/tinctures that are functionally equivalent to Sativex – but 80% cheaper.

MCANZ report they have helped a number of patients access these more affordable medicines from Canada in 2016 and 2017 with not a single case of denial of approval from the Ministry of Health. Without this advocacy, financial support and savings on bulk shipping these patients would not have been able to afford these products at all.

Solving this affordability problem, according to MCANZ, will likely require a compromise between the most affordable approach for patients and the ‘only pharmaceutical quality’ line of the Government. The Canadian model appears to offer just that compromise and could presumably be easily copied by New Zealand since Canada has a similar ‘common law’ based legal system.

Costs to taxpayers

There is also a valid concern around the potential costs of this current system to taxpayers. The question is essentially whether taxes should be subsidising expensive pharmaceutical products through Pharmac when there are more affordable options available.

Shane Le Brun of advocacy group MCAN points out that under the current system, ACC and WINZ could potentially face huge future costs as a result of their obligation to subsidise expensive cannabis-based medicines. It seems then that it is in everyone’s interest to find a more cost effective solution fast.

Developing a Local industry

The requirement of pharmaceutical quality placed on products wishing to enter the market is also holding up the development of a local industry in New Zealand. Costs involved with bringing a pharmaceutical grade cannabis product to market in New Zealand under the current system are estimated to be well over $20 million. This is hardly encouraging to prospective businesses, especially given that under the current law there would still be no ability to sell the finished, trialled product.

Medical Cannabis advocates state, however that by copying the Canadian model of licensed producers, on the other hand, we can have businesses quickly providing products for access at affordable rates. Gradually forcing these producers to pharmaceutical grade quality over time would then bring those products up to the highest standards to allow a potentially lucrative export industry to develop. Other countries such as Canada and even Australia already have a head start in this industry, so it seems action is needed soon if we are not to miss the boat.

To Grow or Not to Grow?

Many proponents have suggested that a system allowing approved patients to grow their own Cannabis at home for personal use will be the quickest way to achieve more affordable access to Medical Cannabis in New Zealand. The Green Party’s Julie Anne Genter has a Member’s Bill before Parliament which will likely be debated in early 2018. In its current form, The Misuse of Drugs Amendment Bill amends the current Misuse of Drugs Act to allow for this approach.

Critics, including outgoing Associate Minister of Health Peter Dunne and PM Bill English, claim that allowing this approach will be unworkable, however, none of the critics of this policy have provided solid evidence to support these claims.

There is a strong argument on human rights grounds that patients should be able to grow their own cannabis or other plants for personal medicinal use. This right has been affirmed by the courts in Canada and in the Berlin region of Germany.

There are already examples overseas of a ‘grow your own’ provision working so this is certainly no utopian idea. Such a system could be designed with checks and balances in place to ensure safety and prevent abuse of the system. Like any other policy, this simply requires consideration of potential risks and investment in measures to mitigate those risks.

Safety of Medicinal Cannabis

There are many safety issues to consider as part of any discussion around cannabis as with any other health related policy. However, we must ensure this conversation is balanced and evidence-based rather than rely on populism or misrepresentation of science.

Double Safety Standards?

Critics of Medicinal Cannabis argue that Cannabis products should be shown to have no adverse effects and cause no harm in order to be approved. They often site a lack of evidence that Medical Cannabis has no side effects in support.

Proponents, however argue that there is a double standard at play here as many other pharmaceutical medicines cannot be said to meet this standard of ‘do no harm’. Prescription opioids or painkillers for example have lower safety profiles than cannabis and have a number of known serious harmful side effects including a propensity to lead to addiction or dependence.

New Zealand is according to many in the medical profession on the verge of an epidemic of painkiller dependence similar to the one already experienced in the US due to overprescription and ease of access of these drugs. Pharmac figures obtained under the Official Information Act show that since 2011, the number of prescriptions for pain medication increased from 6.15 million to 7.18 million in 2016. During this period, the number of scripts for opioid painkillers skyrocketed by almost 20 per cent, from 1.56 million to 1.85 million.

A recent USA-based study even suggested that Medical Cannabis may even have a place in curbing the opioid epidemic. Such results no doubt have the powerful pharmaceutical companies behind these drugs concerned about the potential of Medical Cannabis to replace their products. In this context it is hardly surprising that many frustrated patients and advocates have formed the opinion that lack of progress of the Medical Cannabis laws may be in part due to a cosy relationship between the current Government and the pharmaceutical industry.

Furthermore, advocates point out that we already allow such socially and physically destructive drugs as alcohol and tobacco with no health benefits and effectively all subsidise the public cleanup of the harm they cause through the health and prison systems.

Is a Lack of Accessibility and Information Damaging Safety?

Advocates also claim the current laws unnecessarily and unjustly force otherwise law abiding citizens into contact with the criminal world and risk their safety and freedom.

It is also claimed that the current law is holding back the ability of the government and health professionals to provide clear and accurate safety information about responsible medical use. Patients have turned to advocacy networks such as MCAN for support to access appropriate products at affordable rates.

Safety of self-cultivation
There is debate over whether it is safe to allow patients to grow their own as proposed in Julie Anne Genter’s Members Bill.

Most advocates appear to think this system could be safe if done correctly. There are robust systems in place already around the world that could be copied for a model NZ Law.

Such a policy could require people to hold a license and ensure they get a safety course and only use safe equipment to reduce risk of fire or explosion. Plant quantities would be strictly limited under this system in order to ensure they are only for personal use.

Safety of Non-pharmaceuticals

There is also a safety consideration in the above-mentioned debate over whether to allow non-pharmaceutical cannabis products. The Government’s line is that it is only safe to allow pharmaceutical products that have been through rigorous trials to a pharmaceutical standard.

There are however, entirely safe non-pharmaceutical products available on the market overseas which have already been accepted by our Ministry of Health. Canada has already demonstrated that it is feasible to safely produce such products ourselves in New Zealand with the appropriate controls and independent testing in place.

Mental Health

Mental health risks are a very real consideration in any Medical Cannabis policy discussion. New Zealand has some of the highest rates of depression and suicide in the world, especially among youth. Clearly nobody wants to do anything to make this worse.

There has been a lot of negative press over the years linking cannabis to mental health issues, however evidence on the causal nature of cannabis in negative mental health and cognitive outcomes is far from conclusive. There is in fact evidence of both negative and positive effects of Medical Cannabis on mental health.

The NAP review of evidence findings do suggest that THC presents a risk factor in people with a predisposition to certain mental health issues such as schizophrenia. The review also found, however, that cannabis does not appear to increase the likelihood of developing depression, anxiety or posttraumatic stress disorder and shows promising potential in treatment of some mental health areas (with further study needed to better understand).

Another evidence review recently published in the journal Clinical Psychology Review, in fact found evidence that cannabis can likely benefit people dealing with depression, social anxiety and PTSD. However, evidence also suggests it may not be ideal for people with bipolar disorder, for which there appears to be more negative side effects than positive ones.

Another study by a Harvard Medical School Affiliate suggests that medical marijuana may not impair, and in many cases, may actually improve executive functioning in adults.

Protecting Developing Brains

There is certainly reason to be cautious about the effects of high dosage recreational cannabis on children and teenagers. Some studies certainly suggests a correlation between the THC cannabis and cognitive issues among child and teenage brains. However, the correlation between cannabis and cognitive development issues is not proven causally, meaning a range of other factors could play a part including alcohol abuse and the fact that risk takers or those with certain cognitive traits are attracted to cannabis. More studies are needed to better understand the full mental health impacts of cannabis on the developing brain.

On the other hand, many children and youth overseas and in New Zealand have found Medical Cannabis products extremely helpful. Overseas, many children with Autism, Dravets, Cancer and other conditions have been using Medicinal Cannabis under parental and health professional supervision. There is no evidence of mental health or cognitive development issues and many parents appear to think the benefits of seeing their children free of pain and symptoms outweigh any potential side effects. Who can judge them for that?

Education and transparency.

Advocates argue that legalising will improve overall safety for Medical Cannabis patients by allowing more open and transparent discussion of the various physical and mental health benefits and risks. GPs would be more educated under a robust system so that they are able to prescribe correct dosages in individual cases following well-established international best practice.

In a robust Medical Cannabis system appropriate information and education to ensure GPs or specialists are educated on the various issues around mental health and cannabis. This would involve increasing their awareness of the CBD v THC dosage issues and the risks and benefits of different cannabis medications for children or cases where mental health may be a factor.

Safety Issues Recap

There are genuine safety concerns around Medical Cannabis. However, it is clear the current prohibition approach is not making this better.

The evidence from other countries with Medicinal Cannabis regimes does not support the claims that there would be any increased social harm from legalising Medical Cannabis. For example, evidence from Colorado (where cannabis is now fully legalised) shows that crime and driving offences have dropped and underage use is in fact stable or falling.

An appropriate Medical Cannabis policy would, however, need to have safeguards in place to prevent harm and enable access of suitable products. It would also need to take special care to prevent harm to children or those with mental health risks.

Legality of Doing Nothing

The big question yet to be discussed in depth in the Medical Cannabis debate in New Zealand is the legality of the current situation. There is a strong argument that current laws breach patients’ human rights to access essential medicine. Scientific evidence is mounting and many agree there are far more harmful substances and less effective pharmaceuticals already legal. If that is true then it could be argued that the current situation is arbitrary, discriminatory and a double standard. If so, this would represent a failure to uphold the integrity of the law which could damage its standing in the eyes of many citizens. There is definitely a legal question that needs consideration in further discussions on the issue.

Conclusion

Public opinion is also now overwhelmingly supportive of reform to Medical Cannabis Laws. If politicians disregard this public opinion and evidence and take a head in the sand approach on the Medical Cannabis issue this could be damaging to the delicate social contract between voters and their representatives. This is arguably not a good situation as some feel it calls into question the ability of politicians to represent our interests. What we need now is an urgent, open and transparent discussion of the various policy options with genuine involvement of the public. This should not be a talk-fest but a genuine collaborative approach with an aim to solving the problems of affordability, safety and access quickly.

FURTHER RESOURCES

- Public Opinion
- Political Will
- Current Policy Proposals
- Alternative Options
- Further reading list

Public Opinion

There is clear evidence of overwhelming support among New Zealanders for legalisation of Medical Cannabis. An ongoing 2017 Newshub poll of over 8000 Kiwis now shows that 97% of voters support legalisation for medical purposes. Another Newshub survey earlier in 2017 found 78% of Kiwis support either legalising or decriminalising Cannabis for pain relief and 81% support it for Terminal pain relief and even 55% support personal growing.

Political Will

Just what mandate for change there is next year will depend to a large extent on the outcome of the 2017 general election. The political parties stances on the matter are now pretty clear.

All parties except National and NZ First are in support of legalisation of Medical Cannabis according to Newshub.

Current Policy Proposals

Green Party
The issue will most likely be debated in 2018 through the mechanism of a Members Bill tabled by Greens MP Julie Anne Genter. Genter’s Misuse of Drugs (Medicinal Cannabis and Other Matters) Amendment Bill proposes to create a specific exemption for any person with a qualifying medical condition (or their nominated supporter) to cultivate, possess or use the cannabis plant and/or cannabis products for therapeutic purposes, provided they have the support of a registered medical practitioner.

The Bill also ensures that non-psychoactive cannabis plants and products are not controlled substances under the Misuse of Drugs Act. It clarifies that a non-psychoactive compound, Cannabidiol (CBD), is excluded from the definition of cannabis, and therefore exempt.

National

The Prime Minister and outgoing Health Minister Peter Dunne, have declared that they are completely against the provision allowing patients to grow their own.

They state that they prefer a ‘pharmaceutical-based Medical Cannabis approach similar to the current situation where only approved pharmaceutical grade products are allowed.

Labour
New leader Jacinda Ardern, has stated unequivocally that she supports legalization of Medical Cannabis. However, as Russell Brown correctly points out, Labour has not made public an effective policy on the issue.

TOP
The Opportunities Party Cannabis Policy calls for full legalisation of Cannabis in New Zealand.

This policy would license suppliers and manufacturers to encourage small scale regional supply, regulate the potency of supply and allow home growing of up to 2 plants.

TOP propose to set up a regulated government and non-profit retail market for those over 20 and use the revenue generated for education, after school projects for youth, treatment of addiction and regulation to control demand.

NZ First

New Zealand First have not yet committed to support legalisation of medical cannabis. However, propose to launch a Citizens Initiated Referendum on the full legalization of cannabis after eighteen months of debate in 2018.

ACT

ACT is supportive of medical cannabis from a personal freedoms perspective like any self-respecting libertarian party should be.

Alternative Proposals From The Community

Advocacy Group Medical Cannabis Awareness Network (MCANZ) has outlined the 4 options they see for a Medical Cannabis policy in New Zealand moving forward. These options are:

1. Do nothing. Continue to allow pharmaceutically-trialled products only.
2. Minor tweak to allow trials and commercial development of 100% GMP- trialled products.
3. Canadian-style licensed producers of ‘near pharmaceutical’ products.
4. Home grow and licensed producers.

Option 4, they state, is the preferred option of most patients.

FURTHER READING

Science on Cannabis
The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017)
Splendor in the Grass? A Pilot Study Assessing the Impact of Medical Marijuana on Executive Function
Medical cannabis and mental health: A guided systematic review

Access and Affordability

http://mcawarenessnz.org/2016/01/26/family-struggles-to-afford-medicinal-cannabis/
http://mcawarenessnz.org/2017/05/07/costs-cannabis-food-vs-pharmaceutical-grade/

NZ Cannabis Politics

https://www.greens.org.nz/policy/fairer-society/cannabis
http://www.top.org.nz/top8
https://publicaddress.net/hardnews/about-last-nights-medical-cannabis-question/
http://www.newshub.co.nz/home/shows/2017/03/debate-over-dope.html
https://www.drugfoundation.org.nz/news-media-and-events/medical-cannabis-report-disappointing/
http://www.newshub.co.nz/home/shows/2017/04/poll-do-you-think-it-s-time-to-legalise-cannabis-for-medicinal-purposes.html#.WORKdJ8_2S4.facebook
http://www.newshub.co.nz/home/election/2017/08/who-should-i-vote-for-drug-policy-at-a-glance.html
http://www.scoop.co.nz/stories/PO1702/S00071/medical-cannabis.htm
http://www.scoop.co.nz/stories/PO1706/S00061/cannabis-party-president-defects-to-top.htm
http://www.scoop.co.nz/stories/SC1702/S00032/change-to-cannabis-approval.htm
http://www.scoop.co.nz/stories/PA1707/S00098/access-to-cannabis-based-products-improving.htm
http://www.scoop.co.nz/stories/PO1706/S00288/how-legalising-cannabis-can-help-society.htm
http://www.scoop.co.nz/stories/PA1706/S00134/medicinal-cannabis-finally-on-parliaments-agenda.htm
http://www.scoop.co.nz/stories/PO1708/S00089/jacinda-over-bill-say-organisers-of-medical-cannabis-rally.htm ">">http://www.scoop.co.nz/stories/PO1708/S00089/jacinda-over-bill-say-organisers-of-medical-cannabis-rally.htm
http://www.scoop.co.nz/stories/PO1702/S00061/medical-cannabis-products-are-pharmaceutical-cannabinoids.htm
http://www.scoop.co.nz/stories/PO1705/S00245/the-opportunities-party-releases-cannabis-reform-policy.htm
http://www.scoop.co.nz/stories/PO1607/S00219/treasury-vindicates-cannabis-party.htm
http://www.scoop.co.nz/stories/GE1702/S00034/medicinal-cannabis-changes-will-make-little-difference.htm
http://www.scoop.co.nz/stories/PO1608/S00163/majority-backs-cannabis-law-change.htm
http://www.scoop.co.nz/stories/PO1606/S00010/medical-cannabis-users-go-public-to-denounce-review.htm
http://www.scoop.co.nz/stories/PO1605/S00264/medical-cannabis-review-has-failed-to-protect-patients.htm
http://www.scoop.co.nz/stories/PO1707/S00104/the-nation-lisa-owen-interviews-alison-holcomb.htm

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HiveMind

What is HiveMind?

Welcome to HiveMind - Scoop's new public engagement platform. HiveMind is an experiment including our readers in co-creating a more participatory and interactive public media conversation.

We believe online public engagement tools can help groups of people interested in an issue to find new points of commonality and novel solutions to complex societal problems. Such problems require broad-based and inclusive debate and decision making.

It's all too easy for us to remain stuck in polarised worldviews or our social media bubbles. HiveMind seeks to get beyond these echo chambers and to allow people to:

- Engage in a meaningful process
- Learn from other perspectives
- Identify common ground in disparate viewpoints
- Create potentially innovative and practical solutions to real world issues

HiveMind uses Pol.is - an online tool for collecting open-ended feedback from large groups of people. Through a HiveMind exploration you can voice your opinion about a story or issue, and can also agree and disagree with what others are saying, one statement at a time. New statements go through a moderation process and then are added so that participants can vote on them.

Pol.is runs statistical analysis on these voting patterns in real-time. It produces opinion groups and surfaces the comments that brought each group together. It also identifies comments that found broad consensus among participants.

Read more about HiveMind here.

Contact HiveMind

• Email - Joe Cederwall - joe@scoop.co.nz