On Newshub Nation: Simon Shepherd interviews Green MP Chloe Swarbrick

Simon Shepherd: Green MP Chloe Swarbrick’s name has become synonymous with drug reform, so following years of campaigning for safe, public access to medicinal cannabis, what does she think of the government’s new plan? Well, Chloe Swarbrick joins me now. Thanks for your time this morning.

Chloe Swarbrick: Thank you. Good to know, about my name.

Yes, well, that’s the association that maybe you’ve got. You’ve campaigned for a long time for drug reform, so have you been happy with what’s been proposed this week?

Yes, so, this was something which was part of the government’s 100-day plan to introduce a medicinal cannabis regime. I was part of actively negotiating with Dr David Clark, the minister of health, the regime which is now— well, the legislation which has led to the regime. And one of the really key components that the Greens negotiated is that we would have this regime, the concrete principles in place, by the end of this year so there’s certainty for patients.

Great. Are you happy with it?

We are largely happy with it, yeah, absolutely. I mean, two of the key things for patients are the issues of access and affordability. And what’s really fascinating about cannabis and medicinal cannabis as a product for those who are in pain or in suffering presently is that hasn’t come on to the market or become an issue as a result of this real top-down, medicalised approach, whereby it’s come in a pill bottle and then been supplied to patients. Instead it has largely been an issue driven by patients and their whanau looking for an alternative to a cocktail of opiates that come with a raft of awful side-effects.

Okay. You seem quite passionate about this. Why? Why is that?

I didn’t come into Parliament to advocate for drug law reform. So, I received the medicinal cannabis member’s bill from Julie Anne Genter when we negotiated to form a government and she became a minister. A minister can’t progress a member’s bill, so we were looking around our caucus. We are on record at the time as saying that we were unhappy with the proposals in the government’s legislation for medicinal cannabis. We wanted it to go further, particularly because we were listening to the voices of patients. But what we always recognised is that in the potential for the regime to be developed to allow for licencing of domestic products, there is massive opportunity for New Zealanders to produce affordable, accessible products in medicinal cannabis.

So, if we back the truck up a little bit, in your private member’s bill that you took on, it proposed people being able to cultivate and grow their own after prescription from their GP. So would you still support that? Because that’s not allowed in this current regime.

Yeah, so, personal cultivation is one of those major differences between what was proposed in the government’s legislation and in ours. Notably, we have worked with the government to detail three major changes to the government’s legislation, but we can get to that later. So—

This is not one of them, though, is it?

No, it’s not. And this, we found that my member’s bill was voted down. There was not a majority in parliament in support of that, so now we’re actually dealing with the issue of personal cultivation in the referendum. And that, I think, is actually a really important distinction, because in the referendum, we are going to be talking about the broader issue of cannabis and whether we want to see it treated as a criminal issue, instead of what I think it should be, which is a health issue, which is the path that New Zealand is now currently on. There are greater oversights in what’s being proposed in this medicinal cannabis regime, and I think it strikes the balance between efficacy and safety of products, and accessibility and affordability for patients.

Okay, well, let’s talk about that, then. There are two manufacturing standards being considered in this framework. One would place it as a medicinal standard. But that would make it slower to get to market and more expensive. So which one do you favour? That one or a lesser one?

Yeah, so there are two proposals — there’s GMP, which is governed by the Medicines Act, and there’s GPP, which is governed by the Misuse of Drugs Act. And what’s actually proposed is that we have a dual track there. So, the GMP line would allow us to export products, which obviously offers a massive opportunity for domestic producers to get into what is a billion-dollar industry. But in terms of getting products to market – that are certain in their potency and that there is consistency of supply for patients and their whanau — I do think that we also need to make sure that there are those products that meet those GPP, Good Production Practices.

So you’re favouring a two-track approach to this. But what about the quality assurance for that lesser manufacturing process? How can you be assured that you’re actually getting something which is being advertised as a medicine, and the quality that it needs?

Well, it’s not going to be advertised at all, which is one of the things which is in the legislation for medicinal cannabis.

Okay, put forward as a medicine, then. That’s a different issue – but put forward as a medicine.

Yeah, yeah. So, it is still meeting a really high threshold of quality with those GPP standards. And what we will know is that there is going to be certainty of the balance of THC and CBD in those products. I think there’s perhaps a little bit of misinformation around CBD and THC. As the evidence is developing, it’s becoming common knowledge amongst practitioners that you actually, in certain circumstances when prescribing this product to people, do need that THC, which is commonly associated with psychoactive properties. But that actually also helps with pain relief. So if you get that balance right between CBD and THC, then you do get the best possible medicine available for people.

Let’s talk about THC, then. I mean, because there is evidence that THC does affect young people’s brains, okay? And there is no prescription in these regimes for the amount of THC that can be in these products. So is that a dangerous path to tread?

There is, actually.

Well, it doesn’t say the potency.

It does say that. It says that there’s a 2 per cent limit of THC when you are looking at prescription through the Medsafe model. So that is for different types of products that are going to be produced. And this is the whole point of going out to public consultation, because these medicines, you know, as I said at the beginning – whether you have a drug that is accessed through a pharmaceutical prescription, or you have a drug that is accessed through the black market under prohibition, these drugs are going to be used, and they’re potentially going to be misused. The best way to reduce harm and ensure the well-being of communities and of patients is to make sure that we have sensible, evidence-based legal regulation.

Okay. So, you just talked about the black market then. So if we’re going to be developing a market which is medicine-grade, it’s going to take a long time, and it’s going to be expensive for that to actually mature. So for those people who need it in the short-term and they don’t have an exemption under the law, what’s going to happen to them? They’re still going to be prosecuted, aren’t they?

Well, notably, the Greens advocated for a criminal defence for all people who are using for medicinal purposes, and that is a large proportion of New Zealanders. Per our Ministry of Health stats, 11 per cent of New Zealanders are using cannabis.

But that doesn’t exist under this regime, though, does it?

It does exist for those with terminal illnesses, yes.

That’s right. But there’s other people who have chronic pain who want to be able to use this; they won’t be able to afford it; they’ll go to the black market, and they’re going to get prosecuted. Is that correct?

Not necessarily, because there’s also a raft of other changes that are occurring within this space, particularly around the Misuse of Drugs Act amendment that’s currently just being reported back from the Health Select Committee. But importantly, with regard to the development of the market, you’ve hit the nail on the head. It is going to take a long time, or a substantial amount of time, to develop a mature market, which is why it’s important that we have this dual track for both GMP – really high-standard, medicinal, pharmaceutical-grade products – and GPP, because people are currently already accessing medicinal cannabis products.

Under the current proposal, specialists are going to have to sign off the bulk of these prescriptions, because these medicines aren’t on the market yet. Is that too prescriptive? Or too restrictive?

I think what we know – and I know this speaking to a number of GPs out there – is that there is a little bit of hesitancy, because, again, the way that medicinal cannabis has evolved and developed as an issue hasn’t been this top-down approach that has come through med schools or been advocated necessarily by pharmaceutical guilds otherwise.

So you’re saying they’re uneasy with it?

I’m saying that it’s new, and newness proposes novelty, and it proposes challenge, and it proposes risk, and what that means is that GPs are going to have to learn a little bit more about what medicinal cannabis means. And the evidence base is developing, because it has been – cannabis and medicinal cannabis – have been subject to ‘reefer madness’ and the war on drugs for 40-plus years, and it’s going to take some time to unpick that. But I’ve also spoken to GPs who are incredibly keen to actually get the best outcomes for their patients.

Which is what they sign up to in the first place.

Absolutely.

Let’s just move on to something – last thing – you’re on this cannabis referendum roadshow. I mean, you had your first one in Invercargill this week. Do you see medicinal cannabis as sort of a stepping stone to introducing recreational use?

They’re two different issues completely. So, the issue of cannabis as a whole is about how we actually deal with the problem that cannabis exists in this country, and it is being used regardless of prohibition. So we actually want to look at reducing harm, because we know that people are presently accessing it. Medicinal cannabis is for people who are currently in pain and suffering and are being turned into criminals for accessing the only medicine that works for them.

Do you think that that blurred line that people see can ever be pulled apart? Do you think people will see the two different arguments?

I think that the very proposal that’s currently on the table from the Ministry of Health and the Expert Advisory Panel, which is now out to the general public to give their submissions in by the 7th of August, is demonstrative of that. We’re looking here at producing a product that meets health standards, that meets medical standards and that has medical oversight.

Green MP Chloe Swarbrick, thank you for your time.

Kia ora.

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