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Prohibiting medicinal cannabis is a risk in itself

Every Friday The New Zealand Initiative puts out a newsletter (if you haven’t already, you can sign up here) where we write opinion pieces on current issues. Early in the week, I decided to write on medical marijuana, assuming that Helen Kelly’s excellent weekend interview on The Nation wouldn’t get the attention it deserves.

I was wrong. Over the past week, the issue has blown up. Really, I should have known better. First, because it is an understandably emotional issue, and like euthanasia, involves the government getting in the way of the alleviation of pain and suffering.

And second, because it’s just one of those topics that people are often weirdly coy about. Especially as a public figure. It’s like the question “have you ever inhaled?” Everyone knows someone who has smoked pot, but admitting to it as a public figure still seems like a bit of a social taboo. (Either that or I’m just really conservative and out of touch with what is now considered socially acceptable).

Anyway, our Insights pieces generally have a limit of 400 words. So here are some things I would have liked to add if I could:

  1. We’re a country of stoners, so why are we getting so precious? A 2014 United Nations World Drug Report places New Zealand third in the world for marijuana consumption per head. And yes, I know medical and recreational marijuana require two separate conversations, but you also can’t discount facts about the kind of society we are living in.
  2. Though I allude to it in my piece, I’d like to emphasise again how damn hard it is finding ANY reliable information on the current process, previous applications, or what reliable evidence has been derived. The Ministry of Health’s website does include information about the current process, though it did not show up using normal search terms (it’s here, by the way). The Drug Foundation has done some great work, though it’s getting a bit dated.
  3. I actually feel sorry for Peter Dunne. He’s copping a lot of flak for this issue, when it’s “the process” and National party policy equally at fault. Dunne himself will know he’s not a medical professional, so the personal attacks towards him are unwarranted.
  4. I find it interesting that in Colorado, where marijuana has been legalised, they are having the conversation about how to regulate for safety. Should it be treated just like any other food and beverage? Could it be that in the future, countries with legalised weed will have a much more consistent, safe an quality product? Colorado’s going to be an interesting case to watch for regulatory standards.
  5. One of the arguments against recreational/medicinal use is that consumption can result in heavy social costs. This is an area I’m working on for The Initiative’s health report: what are social costs (economics definition vs how the term is now widely used)? What should be counted as social costs? I’d discuss more, but I’m still in the middle of this research. I know this much so far, though: “social costs” is an oversued and abused term.
  6. “Increasing the risk of already risky behaviour” is just one argument against prohibition. Other arguments against prohibition include: it can divert law enforcement resources from more pressing crimes, it criminalises people who wouldn’t otherwise be criminals, and lets the black market (unsafe and unregulated) dominate the market for the product. People often think legalisation/decriminalisation involves proving the product is safe and effective. But harm-minimisation ought to look at the costs and risks of the current regime (prohibition) too.
  7. I’ve probably forgotten stuff still. The above is just what’s still at the forefront of my mind.

ICYMI: My original Insights piece

I agree with Helen Kelly

Helen Kelly has not always agreed with The New Zealand Initiative on regulatory issues, but on the issue of medical marijuana, we certainly agree with her.

The outgoing Council of Trade Unions president is wanting to use medical marijuana for her own terminal illness. In the absence of medical approval, Kelly has used the black market to obtain the drug.

She acknowledges the therapeutic properties, but also the risks: “It just seems absolutely insane that I’ve got no idea what I’m taking, how much I should take or how it’s manufactured – it’s crazy.”

Kelly is not wrong. Because the drug is outside the realm of government safety and regulation, the quality and potency will be unpredictable.

Another less acknowledged consequence of prohibition is that the evidence-base is equally inconsistent.

A simple Google search will tell you there is not a lot of credible or accessible information out there. There is even less if you confine your search to neutral sources.

If I was a desperate mother wanting to know whether medical marijuana would be an option for my sick child, I would not know what sources to trust. Or even how to apply.

The evidence of effectiveness is mixed, and only one patient’s application so far – Alex Renton’s – followed the correct process.

Effective or not, prohibition does the evidence base no favours, by limiting the research and evidence required to support safe consumption.

Clinical trials have been illegal in many of the countries New Zealand would look to for regulatory guidance (though random-control trials are now underway in Israel and the United States). Anecdotal evidence and case studies would be equally thin in this context.

The current case-by-case process may also hide medical professionals’ support for the product, who must apply on behalf of their patient. It is certainly conceivable that doctors would be unwilling to recommend a medication without robust evidence.

Additionally, it is also possible that medical professionals would want to avoid the reputational effects of being the only doctor in town associated with a controversial substance. Not all doctors want to be thrust into the political sphere.

Sometimes though, banning risky behaviour just makes the risk even more risky. So in a rare move of supporting more regulation, I say lift the prohibition and apply the appropriate safety rules.

About Jenesa Jeram (23 Articles)
I'm a researcher at the Initiative, currently working on social issues and public health. I have Twitter but I'm not very good at it: @JenesaJeram (I'm also super creative).

5 Comments on Prohibiting medicinal cannabis is a risk in itself

  1. On Twitter and in my blog I get ‘stuck into Dunne’ over this. I also see people deriding Helen Kelly currently for ‘getting personal’ over this issue with John Key.

    On both accounts what’s wrong with that? There’s little more personal than pain and one’s death. At the moment National, certainly, but also Peter Dunne, who remains idiotically prohibitive on anything to do with (non-toxic) cannabis, either medicinally or for recreation, is thus doing nothing to change this – that’s not good enough. Why can’t he say there is so much anecdotal evidence for cannabis oil as a pain reliever that he will argue with the government for it to be used on prescription (at the very least) – Helen Kelly was forthright on how good it is for her compared to morphine on Radiolive today; and over last four years I could wheel out three cancer sufferers for the same (although one of them has died, so could not literary give testimony). Dunne is doing no such thing. As this is extending unnecessary pain for many people, I will continue to attack him peacefully but personally, until we get a change. Also because 50 years has taught me you get no where with politicians by being nice.

    The archaic and nonsensical religious conservatism of this National government, is their Achilles Heel, and people are suffering needlessly because of it. They’re not nice. I’m not nice back anymore.

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    • Jenesa Jeram // October 16, 2015 at 2:43 pm // Reply

      Hi Mark,

      I think we’re largely in agreement (?) on both medical marijuana and euthanasia. My point about Dunne was aimed at the thought that for real change to happen, there needs to be much more pressure on the National Party as a whole. Dunne’s just performing a job he was assigned as best he can without rocking the boat. While it would be nice if he did so, I think pressure really needs to be focussed on overturning the legislative process as a whole.

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  2. And ditto above for the euthanasia debate. John Key has put as chair of the select committee on euthanasia the only seminary trained MP (who thus cannot change his mind against euthanasia, no matter what the evidence, because he holds an a priori faith-based position on it as a sin). Of all MPs, Key chose seminarian Simon O’Connor. That’s not honest inquiry: that’s a fob off and the middle finger to we humanists who want this basic right (via choice).

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  3. NZ is a backward religious place run by crazy fundies. Racist ideologies as well as unscientific dogma prevail here.

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