DRUG FREE AUSTRALIA The ACT Medical Cannabis Conundrum Why legislate an inferior product? 1. The Greens Bill is premised on an ignorance of the currently legal status of medical cannabis 2. The Greens ‘medical’ Bill has not been requested by the medical establishment 3. The Greens Bill ignores 74% of addicted teens in Colorado sourcing cannabis from medical marijuana patients 4. The Greens Bill does not recognise that it is legislating trafficable quantities of cannabis 5. The Greens Bill, perhaps unwittingly, aligns with drug legalisation strategies worldwide 6. The Greens Bill ignores the heavily evidenced harms of crude cannabis to users and their community 7. The Greens Bill will proliferate recreational cannabis use, which most Australians condemn Central Issues & Compiled Evidence DRUG FREE AUSTRALIA Executive Summary - Seven Central Issues for ACT Legislators 1. The Greens Bill is premised on an ignorance of the currently legal status of medical cannabis ‘Medical Marijuana’, (which is a misnomer) has been legally used in Australia since the mid-1990s, when the THC capsule developed in the US called Marinol was imported into Australia under TGA Special Access for 100 patients. Marinol can be imported today under the same arrangement. Alternatively, the whole-leaf extract of cannabis, called Sativex, was approved by the Australian TGA in 2012 for MS spasticity. Both medications are pharmaceutically standardised in terms of dosage, strength and purity, which crude cannabis products are not. Both medications can be used for maladies where clinical trials have previously shown promise – nausea, AIDS wasting, chronic pain and MS spasticity. A third pharmaceutical medicine which is high in CBD, Epidiolex, is currently being tested in the US and could be tested here under similar arrangements – CBD is the element within cannabis believed to be responsible for the relief of severe seizures in epilepsy-like syndromes for some sufferers, including children. There is consequently no need to legalise crude cannabis grow-sites in Australia. Further, Greens’ concerns that patients will suffer stigma is nullified when accessing legally available medical cannabis, and patients have full rights to make their own decisions because of its legality. The only existing injustice for patients is the failure of the Australian media to inform them of current legally available options. The onus is on the Greens to demonstrate that raw cannabis oil or smoked cannabis is superior to these pharmaceutical medications – akin to demonstrating that raw opium is better than pharmaceutical morphine. Their submission fails to do this . nor could it. 2. The Greens ‘medical’ Bill has not been requested by the medical establishment It is not Australia’s medical establishment that is asking for crude cannabis to be used here as medicine. The push for smoked marijuana, which is particularly by drug legalisation lobbyists who first publicly supported NSW media-showcase Dan Haslam’s use of smoked cannabis for chemotherapy- induced nausea, militates against everything that calls itself ‘medical’. The harms of smoking as a delivery system are self- evident – no medicine is ever smoked. 1 Cannabinoids are not a first-line drug for any medical condition. Other legally available drugs are better for each of the few conditions which cannabinoids have been found to alleviate The cost of purchasing Marinol or Sativex via internet is precisely the same as purchasing cannabis from an Australian drug dealer, dose for dose – on average $500 per month. Alternatively, in the US the cost of purchasing commercially grown cannabis for patients is also $500 per month. Any thought of allowing patients to grow their own cannabis to cheapen costs must contend with the weighty issues of diversion of such cannabis for recreational use, as evidenced in those US States that have allowed home-grown cannabis In the most extensive scientific review of ‘medical marijuana’ to date by the US Academies of Science’s Institute of Medicine, 95% of ‘medical marijuana’ users in their US surveys were previously recreational cannabis users. Many of the patients who are brought along to parliamentary inquiries, and who offer public testimony of the wonderful effects of cannabis are actually speaking from a background of pre-existing cannabis dependency and addiction, where cannabis alleviates many of the very conditions it itself causes, often as part of a well- documented withdrawal syndrome. Further, many of the maladies cited by medical cannabis patients cannot be objectively verified by medical practitioners, relying only on the patient’s own subjective word, opening medical cannabis use to mischief-making and unverifiable claims as with the Disability Support Pension. Therefore, the Greens proposal to allow cannabinoid use for ‘Category 3’ maladies which in clinical trials have not been evidenced as alleviated by medical cannabis should not at all be countenanced even if pharmaceuticals only are used 3. The Greens Bill ignores 74% of addicted teens in Colorado sourcing cannabis from medical marijuana patients In one US State with ‘medical marijuana’ laws, 74% of young people entering treatment for cannabis addiction sourced their cannabis from people with ‘medical marijuana’ prescriptions, demonstrating that diversion to recreational users will always be a problem under such provisions. While it is unclear whether medical cannabis is the cause, US States that have legalised medical cannabis have higher rates of recreational use than other States. 2 4. The Greens Bill does not recognise that it is legislating trafficable quantities of cannabis Just one single cannabis plant, harvested up to five times a year, can yield 2,500 grams of cannabis per year, enough for 8,600 joints – far beyond the needs of any single patient. As such, even a single cannabis plant represents trafficable quantities of cannabis. 5. The Greens Bill, perhaps unwittingly, aligns with drug legalisation strategies worldwide Those working to legalise the recreational use of cannabis worldwide by seeking to destroy the United Nations’ International Drug Conventions use ‘medical marijuana’ as a Trojan horse to introduce the full legalisation of cannabis for recreational use. Richard Cowan, the Director of cannabis legalisation organisation, NORML, said in 1993 “medical marijuana is our strongest suit. It is our point of leverage which will move us toward the legalisation of marijuana for personal use . .” While it is unclear whether medical cannabis is the cause, US States that have legalised medical cannabis have higher rates of recreational use than other States. 6. The Greens Bill ignores the heavily evidenced harms of crude cannabis to users and their community The harms of recreational cannabis use are so substantial and substantiated that giving any leeway to Trojan horse strategies of the drug legalisation lobby should never be contemplated. The Greens Bill, simply by proposing the availability of crude cannabis in any form, clearly ignores the damage done by cannabis to users and their community. 7. The Greens Bill will proliferate recreational cannabis use, which most Australians condemn According to the 2013 National Drug Strategy Household Survey, a survey of more than 24,000 Australians, 90% of Australians did not approve the recreational use of cannabis. While 69% of Australians support ‘medical marijuana’ in the same survey, Drug Free Australia contends that very few of these Australians would be able to specify the handful of medical indications attributed to cannabis, and would likely disapprove anything which would proliferate recreational cannabis use. Colorado laws and surveys of teens demonstrates that crude medical cannabis proliferates recreational use. The evidence supporting each of the five central issues nominated here is found in the following pages. 3 Table of Contents EXECUTIVE SUMMARY - SEVEN CENTRAL ISSUES FOR ACT LEGISLATORS ....... 1 Compiled Evidence The Greens Bill is premised on an ignorance of the currently legal status of medical cannabis ......................................................................................................... 6 MARINOL (Dronabinol) legally used since mid-1990s ........................................................ 6 MARINOL still legal in 2015 – Advice from the Australian TGA .......................................... 7 SATIVEX TGA registered in 2012 ....................................................................................... 8 Greens proposal wrongly believes SATIVEX cannot be more generally used ................... 9 SATIVEX legal in 2015 – Advice from the Australian TGA ................................................. 9 EPIDIOLEX being trialled by US FDA for severe epilepsy seizures ................................. 11 Crude cannabis not medical .............................................................................................. 11 DFA gives qualified support to use of pharmaceutic cannabinoids ................................... 11 No stigma using legal pharmaceuticals ............................................................................. 12 ACT Legislative Assembly – suggested actions ................................................................ 12 The Greens ‘medical’ Bill has not been requested by the medical establishment . 13 Medical Associations not supportive of smoked marijuana ............................................... 14 Australian Medical Association not endorsing Greens’ approach ....................................