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Medicinal Cannabis - Health Select Committee Support

Published: Mon 26 Aug 2013 11:15 AM
Medicinal Cannabis - Health Select Committee Support
Facebook Event Link: https://www.facebook.com/events/159534524236993/
Wednesday, 28 August 2013 10:00am until 10:40am at Parliament Buildings
Dr Geoff Noller (www.geoffnoller.com) will be making an oral submission on behalf of The Petition of William Joseph Rea - Requesting that the House give urgent attention to the Law Commission's recommendations regarding medical cannabis use and legislate to decriminalise cannabis use for pain relief or managing symptoms of chronic illness, allow doctors to prescribe cannabis, and allow clinical trials, and note that 2,765 people have signed a petition supporting this request. http://www.parliament.nz/en-nz/pb/presented/petitions/50DBHOH_PET3133_1/petition-of-william-joseph-rea-requesting-that-the-house
Petition number: 2011/41 Presented by: Kevin Hague Date presented: 27 November 2012 Referred to: Health Committee
COPY OF MY WRITTEN SUBMISSION
Written submission to the Health Select Committee my petition 2011/41
‘that the House give urgent attention to the Law Commission's recommendations regarding medical cannabis use and legislate to decriminalise cannabis use for pain relief or managing symptoms of chronic illness; allow doctors to prescribe cannabis; and allow clinical trials, and note that 2,765 people have signed a petition supporting this request.’
Dear Chairperson,
Thank you for your letter requesting clarification of the issues raised in the above petition. I outline the major issues below, and would welcome the opportunity to appear before the committee should you require that I speak to the submission or if you would like to ask further questions.
Law Commission Report
In 2011 the New Zealand Law Commission released a report NZLC R122 Controlling and Regulating Drugs - A Review of the Misuse of Drugs Act 1975 which states;
"Given the strong belief of those who already use cannabis for medicinal purposes that it is an effective form of pain relief with fewer harmful side effects than other legally available drugs, we think that the proper moral position is to promote clinical trials as soon as practicable. We recommend that the Government consider doing this. In the meantime, while trials are being conducted, we think that it would be appropriate for the police to adopt a policy of not prosecuting in cases where they are satisfied that cannabis use is directed towards pain relief or managing the symptoms of chronic or debilitating illness."
Benefits of Cannabis As a Medicine
Cannabis and cannabis-based products have historically been used for medicinal purposes. Hundreds of recent studies validate the therapeutic use of raw cannabis and cannabinoids. Of all the negative consequences of cannabis prohibition, none is as tragic as the denial of medicinal cannabis to the tens of thousands of patients who could benefit from its therapeutic use.
Modern research suggests that cannabis is a valuable aid in the treatment of a wide range of clinical applications. These include pain relief — particularly of neuropathic pain (pain from nerve damage) — nausea, spasticity, glaucoma, and movement disorders. Cannabis is also a powerful appetite stimulant, specifically for patients suffering from HIV, the AIDS wasting syndrome, or dementia. Emerging research suggests that cannabinoids found in cannabis may protect the body against some types of malignant tumours and are neuroprotective.
Support For Cannabis As a Medicine
Currently, more than 60 international health organizations support granting patients immediate legal access to medicinal cannabis under a doctor’s supervision. The use of cannabis as a medicine is well documented in research from the UK, Israel, Germany, Canada, and the USA. The American Medical Association, the Institute of Medicine in the US, the Federation of American Scientists, the World Health Organization, and the Royal College of Physicians in the UK all support medicinal cannabis. In New Zealand the New Zealand Medical Association supports research into the benefits of cannabis for medicinal use, and the Pharmacy Guild of New Zealand told the 2001 cannabis inquiry that it considers it perfectly possible to distribute medicinal cannabis if it were to be legal to do so.
The medicinal use of cannabis is legal in 18 states of the USA including California and Washington DC, the Netherlands, Germany, Spain, Canada and Israel. Research shows allowing medicinal cannabis will not affect overall use rates or teenager’s attitudes towards drug use. One million Californians can legally purchase medical cannabis at dispensaries or they may grow their own. In fact, research shows medicinal cannabis law reform in the USA is associated with reduced teen use rates.
Current New Zealand Situation
Although The UK-made cannabis extract Sativex has been made available on prescription from a GP, funding remains an issue and Ministerial approval is still required. I remain concerned that without any subsidy from Pharmac, Sativex will remain out of reach of most patients. Special Ministerial approval is still required for the imported alcohol-based cannabis extract. It contains a particular cannabinoid profile that will work for many but not all, and depending on the dosage rates of the individual patient it could last anywhere from one week to a month. It costs about $300 which can really add up, some patients find they can buy illicit cannabis at a far lower cost but growing their own or buying it illegally brings significant risks. There should be more options including giving patients or caregivers the ability to grow their own.
The New Zealand Misuse of Drugs Act 1975 prohibits any use of cannabis, including medicinal use by seriously ill patients; however the Minister of Health has the power under section 14 of the Misuse of Drugs Act and associated regulations to issue licenses permitting medicinal cannabis use.
Misuse of Drugs Act regulations allow a patient’s doctor to apply for special permission to import and prescribe a cannabis-based medication that has been approved in another country, or to run an experimental clinical trial (Sativex is one of several options. Theoretically, these should include the medicinal cannabis found in dispensaries in California and other US states). Your GP must also have the written backing of a relevant specialist, and they must have tried all other available medicines and found that they don’t work. Despite these high hurdles, several applications have been made to various Ministers of Health for patients to be able to consume whole herbal cannabis – which could be imported from authorised suppliers in Canada, the US, Netherlands, Germany or Israel – but so far all applications have been rejected.
Processed Versus Unprocessed Cannabis
Any potential harm from smoking cannabis is far from proven, and can be minimised by changing the delivery mechanism- see vaportization below. Seriously ill patients and their doctors are more concerned about current suffering than potential future lung damage – especially for terminal patients.
Smoked cannabis for chronic neuropathic pain: a randomized controlled trial http://www.ncbi.nlm.nih.gov/pubmed/20805210)
Vaporization as a "Smokeless" Cannabis Delivery System http://www.cmcr.ucsd.edu/index.php?option=com_content=article=149%3Avaporization-as-a-qsmokelessq-cannabis-delivery-system=41%3Aresearch-studies=135)
In 1986, a synthetic delta-9-THC capsule (Marinol) was marketed in the United States and labelled for use as an anti-emetic. Despite some utility, this product has serious drawbacks including its cost. For example, a patient taking three five-milligram capsules a day would spend over US$5,000 to use Marinol for one year.
In comparison to the natural, smokeable product, Marinol also has some pharmacological shortcomings. Because THC delivered in oral capsules enters the bloodstream slowly, it yields lower scrum concentrations per dose. Oral THC circulates in the body longer at effective concentrations, and more of it is metabolised to an active compound; thus, it more frequently yields unwanted psychoactive effects. In patients suffering from nausea, the swallowing of capsules may itself provoke vomiting. In short, the smoking of whole cannabis is more efficient in delivering THC and, in some cases, it may be more effective.
Conclusion
Our communities are choosing patients over politics and compassion over cruelty. We would ask you to do the same. There are people who are in serious, daily pain that prevents them from living any kind of decent life. The only thing that prevents them from having access to relief from that pain and suffering is this outdated and cruel law, I ask that the committee take urgent and serious consideration of this petition.
Sincerely,
William Joseph Rea
ADDITIONAL REFERENCES
Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. - http://www.ncbi.nlm.nih.gov/pubmed/18688212
A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. - http://www.ncbi.nlm.nih.gov/pubmed/18688212
In the media http://www.stuff.co.nz/national/3317457/Cannabis-ok-for-medicinal-use-Law-Commission . The report says there is "no reason why cannabis should not be able to be used for medicinal purposes in limited circumstances" - under a proposed scheme, people suffering from chronic or debilitating illnesses would be able to use cannabis under medical supervision, particularly where conventional treatment options had proven ineffective.- Cannabis cultivators would be licensed to provide medicinal marijuana in the same way as other legitimate dealers in controlled drugs, the report said. I was unable to find these stated things in the Law Commission report but wanted to add them to the submission if they exist.
Recent case where medical cannabis user was discharged without conviction on charges of cultivating cannabis because judge heard medical evidence, backed by doctor - http://www.stuff.co.nz/waikato-times/news/7992098/Cannabis-stops-the-pain
ENDS

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