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  4. 13 November 1995

Medical Use Of Cannabis

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SpeakersSymonds The Hon Ann
BusinessAdjournment

MEDICAL USE OF CANNABIS

The Hon. ANN SYMONDS [6.30]: I wish to express support for the doctors and health workers who this morning in the Sydney Morning Herald called for marijuana to be used for medical purposes. It is unfortunate that a valuable therapeutic substance is being withheld from patients with a variety of medical conditions which respond favourably to its administration. There is a growing body of evidence that cannabis has a beneficial effect on a number of chronic conditions. Conditions such as glaucoma, multiple sclerosis, depression, epilepsy, paraplegia, quadriplegia, and chronic pain all respond to marijuana. In addition to being beneficial in the treatment of such chronic conditions, cannabis also assists to control the nausea and vomiting that result from chemotherapy when all other remedies have failed. This has been known for more than 20 years. In the United States Dr Lester Grinspoon encouraged some of his medical colleagues to conduct a scientific study on the use of cannabis, and their results were published in the prestigious New England Journal of Medicine in 1975.

Cannabis also can help patients with advanced AIDS to gain weight. Cannabis was first used as a medicine more than 5,000 years ago. Nicholas Culpeper in his work listed all the conditions in which the use of cannabis was indicated. Its use was once respectable, and even Queen Victoria was given cannabis by her court physician. The invention of the hypodermic syringe in the 1950s increased the use of opiates for fast pain relief. As cannabis is not water soluble it is difficult to inject and so its use as an analgesic was bypassed. The late nineteenth century saw the development of synthetic drugs like aspirin, chloral hydrate and barbiturates, and this further diminished the use of cannabis.

Because of the desire to stop the recreational use of cannabis a number of laws have been introduced throughout the world that have adversely impacted on people with medical problems. The 1938 Marijuana Tax Act in the United States was one of the first of these laws. The American Medical Association led a campaign against that legislation because it believed
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cannabis use had to be retained for its medical properties. However, that campaign failed. Prohibition has meant the withdrawal of cannabis use for medical purposes. I admit that many drugs have adverse side effects. For instance, it is estimated that in the United States each year 500 to 1,000 people die of aspirin-induced bleeds, yet aspirin has a benign reputation. Any adverse side effects of cannabis must be balanced against the benefits it can give.

Severe glaucoma, which does not respond to usual drug treatment such as pilocarpine drops, has been shown to respond to cannabis, which restores intraocular pressure to normal. Cannabis offers people with severe glaucoma who are facing the onset of blindness an alternative treatment that may well benefit them. I have spoken to a young woman suffering severe glaucoma whose ophthalmologist confirmed for her the benefits of cannabis but nevertheless counselled her not to use the cannabis, which could have assisted her, because its use was illegal. There is now a synthetic tetrahydrocannabinol available - dronabinol - which is given orally. The use of dronabinol medically is controlled by both State and Federal legislation and by regulations in New South Wales. These controls are impeding the use of what is increasingly acknowledged to be a beneficial substance.

The procedure for prescribing dronabinol is convoluted. Doctors - and only some doctors - are allowed to prescribe dronabinol, and they must first apply for permission under the Federal Therapeutic Goods Act to use a cannabis derivative. After that approval is obtained the doctor must apply to the Chief Pharmacist in the Pharmaceutical Services Branch of the Department of Health for permission to treat each individual patient under section 29 of the New South Wales Poisons Act 1966. A proposal is before the New South Wales Minister for Health to dispense with this provision, to speed up the process. I urge the Minister for Health to adopt this proposal as an interim measure. However, my concern is that dronabinol is not the ideal form of administering cannabis because its absorption rate is too variable. Too little absorption and the patient gets no relief; too much absorption and the patient becomes intoxicated. This latter condition distresses some people. The personal use of cannabis leaf provides a more predictable effect, and for this reason many people prefer to use the natural product.

Recently I had lengthy discussions with a woman who suffers from bouts of severe back pain that are the result of a serious car accident in 1971. She can use only cannabis to relieve her pain; she is allergic to legally available pain-killers. A few months ago her next-door neighbour reported her to the police and she was charged, convicted and fined. She should be able to use a small quantity of cannabis to relieve her pain without fear of prosecution. Why should she be denied that relief? Someone suffering from multiple sclerosis who will probably live for 40 years should be able to self-administer cannabis. Unfortunately, frequently people who attempt to do this are harassed by the police. In Western Australia a man has been reported, fined and convicted nine times in this regard. The natural product is certainly cheaper and more effective than synthetic forms of cannabis. It is difficult to justify forcing people to pay for pharmaceutically prepared substances when they can grow their own cannabis at a fraction of the cost. I urge the Government to introduce medical necessity as a ground for the use of marijuana.




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