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Medicinal Cannabis MEDICINAL CANNABIS A SUBMISSION IN RESPONSE TO: VLRC ISSUES PAPER MARCH 2015 Prepared for: The Victorian Law Reform Commission Prepared by: Michelle O’Dea With the assistance of: A working group of the Cannabis Community of Victoria. INDEX PART ONE 1. Terms of Reference 10 2. The Cannabis Community of Victoria 13 3. The Need for a Medicinal Cannabis Scheme in Victoria 19 PART TWO 4. Cannabis as a Safe Food and Medicine 28 5. The Taxonomy, Pharmacology and Therapeutic Benefts of Cannabis: 33 a. Taxonomy b. Pharmacology c. Cannabinoids: i. Psychotropic Cannabinoid: THC ii. Non psychotropic Cannabinoids: • Tetrahydrocannabinolic Acid (THCA) • Cannabidiol (CBD) • Cannabigerol (CBG) • Cannabinol (CBN) • Cannabichromene (CBC) 6. Safe ad Effective Use of Cannabis 43 PART THREE Forms, Applications and Dosing of Cannabis 56 Forms and Applications Cold Extraction Process: Inactivated CannabisTherapeutics : Juicing Cannabis • submission for adoption as a part of a Medicinal Cannabis scheme ii. Cold Extracted Cannabis Tinctures • submission for adoption as a part of a Medicinal Cannabis scheme iii. Cold Extracted Cannabis Extracts • submission for adoption as a part of a Medicinal Cannabis scheme c. Extractions & Applications Using Heat: Activated Cannabis Therapeutics: i. Smoking • submission for adoption as a part of a Medicinal Cannabis scheme ii. Concentrates: • hash • hash oil & wax • submission for adoption as a part of a Medicinal Cannabis scheme iii. Edible Cannabis Products • submission for adoption as a part of a Medicinal Cannabis scheme iii. Vaporizing Cannabis Flowers • submission for adoption as a part of a Medicinal Cannabis scheme 8. Controlling Undesired Side Effects of Cannabis Medicine 86 9. Dosing of Medicinal Cannabis 86 • The Correct Dose of Medicinal Cannabis PART FOUR 10. Regulatory Framework of a Medicinal Cannabis Scheme 94 11. Regulatory Objectives For a Medicinal Cannabis Scheme 102 12. Comments on Regulatory Objectives For a Medicinal Cannabis Scheme and Terms of Reference 104 PART FIVE 13. Proposed Models For a Medicinal Cannabis Scheme 114 a. Providing a Defence for Medicinal Cannabis Use b. A Government Controlled Model c. A Government Regulated Model i. Supply Under a Government Regulated Model: • Cultivation ii. Processing and Distribution Under a Government Regulated Model: • A Medicinal Cannabis Dispensaries • Medicinal Cannabis Clinic / Dispensary & Compassion Club • Compassion Clubs / Co-Operatives • Manufacturers 14. An Overview of A Proposed Medicinal Cannabis Scheme For Victoria. 123 PART SIX 15. Comments on Features of A Proposed Medicinal Cannabis System: 136 a. A Defence For Medicinal Cannabis Use b. Government Control of Supply of Medicinal Cannabis c. Government Regulation of Supply of Medicinal Cannabis d. The Cost of Medicinal Cannabis e. Forms of Medicinal Cannabis PART SEVEN 16. Access To Medicinal Cannabis: 148 a. Access to Medicinal Cannabis b. Exceptional Circumstances Access Criteria c. Evidence Based Medicine e. Advantageous Outcome Without Unacceptable Downside f. Access Via a List of Symptoms & Medicinal Conditions 17. Authorising and Prescribing Medicinal Cannabis 161 PART EIGHT 18 Cultivation Processing and The Distribution of Medicinal Cannabis 16 Medicinal Cannabis Cards & Licenses Quantity of Medicinal Cannabis to Be Supplied & Possessed 19 Cultivation 203 Commercial Produc Personal Production Designated Production & Third Party Cannabis Producers 20 Processing and Distribution 243 Medicinal Cannabis Dispensaries Medicinal Cannabis Clinics Compassion Clubs/Co-Operatives Manufacturing Cannabis Products PART NINE 21. Operation and Implementation of a Legal Amnesty 284 I would like to thank the Victorian Law Reform Commission (“VLRC”) for the opportunity to make this submission. There is presently no formal association operating within Victoria that represents the views of the Cannabis Community of Victoria (“CCV”). Accordingly, this submission was requested and prepared with the assistance of Mr Fred Adnronikis together with contributions made by a small working group of individuals from within the Cannabis Community of Victoria (“CCV”). Further contributions and assistance were also received from many other sources including: Mr Paul Armentano of NORML in the USA; Ms Mara Gordon and founder of Aunt Zelda’s, USA; Mr Marcel Gignac of the Medicinal Cannabis Patients Alliance of Canada Inc; The British Columbia Compassion Club Society, Vancouver, British Columbia, Canada; Mr John Conroy Q.C, Constitutional and Human Rights Lawyer, Canada; Mr Ian Breakspear, Australian Clinical Herbalist, Naturopath, Lecturer and Author; Emeritus Professor, David Pennington, AC. Mr Adrian Columb is to be acknowledged for his tireless contributions and editorial assistance. I trust that the content of this submission will be beneficial to the VLRC in the discharge of it’s responsibilities in advising the Victorian Government on the operation of a Medicinal Cannabis Scheme in Victoria. DISCLAIMER: The information in this submission is presented for general information purposes only. The author has attempted to present the material to the best of her ability but makes no representations or warranties generally or otherwise, including but not limited to: the accuracy of the submissions content and or any materials relied upon and cited within it. The content of the submission is for education and information purposes and is not intended and should not be relied upon as advice in any capacity whether legal, medical or otherwise. Persons reading this submission should seek professional advice on any information presented therein and are reminded that cannabis possession and use is a scheduled poison and a substance prohibited by law attracting criminal prosecution. PART ONE TERMS OF REFERENCE The Cannabis Community of Victoria (‘’CCV”) acknowledges that: 1. The Victorian Government is committed to enabling Victorians to have lawful access to and use of cannabis for medicinal purposes in ‘’exceptional circumstances.’’ 2. On the 19th December, 2014 under S. 5(1)(a) of the Victorian Law Reform Commission Act 2000 (Vic) the Victorian Attorney General, the Hon. Martin Pakula, M.P., requested the Victorian Law Reform Commission (“VLRC” or ‘’the Commission’’) to review and report on changes to Victorian laws that would achieve this outcome. 3. The terms of reference provided to the Commission were: (a) to review and report on options for changes to the Drug Poisons and Controlled Substances Act 1981 (Vic) and associated regulations which would allow people to be treated with medicinal cannabis in ‘’exceptional circumstances.’’ (b) to make recommendations for amendments (if any) to the: ● Therapeutic Goods (Victoria) Act 2010 ● any other relevant legislation. (c) In conducting the review the Commission has been asked to consider: ● the operation of the laws referred to and how they interact with Commonwealth law, functions and any relevant international Conventions; ● medicinal use of cannabis in other jurisdictions. (d) The Commission is asked to appoint expert panels to assist in its review to examine specifically: ● prescribing practices, including eligibility criteria for access to medicinal cannabis and the role of doctors in managing its use by patients; ● regulating manufacture and distribution, including the forms of medicinal cannabis that should be permitted for use. 4. The Commission has established two advisory committees to comply with the terms of reference set out at 3 (d): (a) a medical advisory committee of experts in the therapeutic use of cannabis and current clinical research. (b) a regulatory advisory committee of experts in effective regulation and the 10 operation of current law and overseas reforms. 5. The terms of reference do not invite the Commission's views on this matter or on whether the prohibition on cultivation, production, supply and or use of cannabis should be fully removed. The Commission makes no comment on these matters. 6. On the 17th March 2015 the Commission issued a discussion paper: “Medicinal cannabis – Issues Paper’’ (‘’issues paper’’). This publication provides background information and raises questions identified as issues for further consideration. The publication of the paper, marks the beginning of the consultation process between the VLRC, stakeholders and the general community referred to as ‘’interested parties.” 7. The Commission is seeking written submissions from interested parties on the issue paper, terms of reference and/or anything arising out of such, to be received by 20th April, 2015, with follow up discussion to identify law reform options thereafter. 8. The Cannabis Community of Victoria (“CCV”) is a major stakeholder in this process. It desires and anticipates engaging with the VLRC, State Government and other relevant stakeholders in the formulation of a medicinal cannabis scheme for Victoria. 9. The Commission proceeds on the basis that the review undertaken should be evidence based, open and balanced. 11 12 THE CANNABIS COMMUNITY OF VICTORIA 13 THE CANNABIS COMMUNITY OF VICTORIA The Cannabis Community of Victoria, or ‘’CCV’’ has a long history. Cannabis arrived in Australia on the First Fleet at the request of Sir Joseph Banks in 17881 Consumption became widespread in the Victorian colony, and it was heavily used in the 19th and 20th centuries.2 Marcus Clarke, well known Melbourne based journalist and celebrated Australian novelist and poet, wrote on cannabis use in Victoria during the 19th century, including a short
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