September 2019 is the date of the “Reeferendum” on the Cannabis Legalisation and Control Bill.
While this bill is intended to legalise “Adult use” it also offers improved access for those seeking to use cannabis for therapeutic (medicinal) purposes.
But isn’t Medical Cannabis already legal?
Sort of, the Coalition government has legalized a liberal prescription regime, where any authorised prescriber can prescribe any product, for any condition. However coupled with this, is very high quality-standards, that have already seen casualties, with New Zealands only lozenge taken off the shelves. Rather than improving access in the short term, it has had the opposite effect on reducing choices available.
Why Cant patients just get it on prescription?
Unfortunately, Doctors are on the whole, unwilling to prescribe Medical Cannabis. In Canada and Australia, Expensive specialist Cannabis prescribers are the best way to gain access, further increasing the cost, and making it unreachable for sickness beneficiaries.
But isn’t Medical Cannabis Just Cannabidiol (CBD)?
No, Tetrahydrocannabinol (THC) is very therapeutic. Initially known for reducing eye pressure in glaucoma, its been most effective in studies for spasticity in MS, Chemotherapy-induced Nausea and Vomitting, forms of chronic pain, Treatment-resistant Tourrette’s syndrome Tics, and as a mild dissociative (think a “Ketamine lite”) for those experiencing severe bouts of pain that cant be treated with regular drugs.
Could the referendum make Medical Cannabis Cheaper?
Absolutely, if companies cultivate cannabis for both markets, they will be afforded economies of scale which could drive prices down. Additionally, some of the levies are intended to be reserved for Health purposes and while a long shot, MCANZ will be pushing for some of the tax take to subsidise Medical Cannabis for Genuine patients. Finally, retail cannabis is likely to be far cheaper than prescription products. In Australia, a Prescription ounce of Bedrocan would cost $650AUD while in California, a high-quality ounce of a medical variety costs $210USD on average. Converted to NZ, Prescription Cannabis is twice as expensive as similar Cannabis in over the counter markets.
Why is cost so important?
Due to the illegal nature of Cannabis, and its therapeutic use over thousands of years, few have been committed to spending tens of millions of dollars on gold standard clinical research. And because of this, there isn’t enough evidence for PHARMAC to consider funding Cannabis medicines. So while potentially dangerous drugs like Morphine and Fentanyl cost a patient $5 a month due to PHARMAC Subsidies, the most researched medical cannabis product, Sativex, typically costs $950 a month with no funding, and the severe MS patients who need it most are on sickness benefits. Furthermore, this product has only about $150 worth of cannabis as an ingredient at black market prices. Finally, the ability of patients to grow their own Cannabis for therapeutic use, further reducing their reliance on others.
Isn’t smoking bad for you?
Yes absolutely. There are devices called Vaporisers which reduce the risk from inhalation, by 90-95% for the good units. Unfortunately, in his infinite wisdom, David Clark only legalized the most expensive medically certified devices, again an issue for beneficiaries and pensioners. MCANZ sells vaporisers, breaking the law, and has even had customs seizures, despite the clear benefits these devices offer. Legalization will open up access to more affordable vaporisers, and with an education campaign and greater uptake, the public health burden from respiratory harm will be greatly reduced. This could be done now via Gazzette notice from David Clark, but he lacks the initiative to do so.
Is Homegrown Cannabis reliable enough for therapeutic uses?
Yes, while homegrown cannabis will not be a standardised dose like medicines, it is still safe to administer as a medicine. When dealing with THC, particularly inhaled via a vaporiser, patients adjust their serving size to the potency of the cannabis. While historically Cigarettes or “Blunts” were common, today most patients often get by with very small amounts, (less than 0.3grams) in chambers of pipes and preferably vaporisers. There is a well-known mantra that applies to all Cannabis users, “Start low, and go slow”