Issue 20 / 30 May 2016

THE importance of building a solid evidence base for the role of medicinal cannabis products must not be lost in moves to make the drug more widely available, say researchers.

In a Perspective published online by the MJA today, researchers have called for “considered management” in the wake of federal reforms to enable the cultivation of cannabis for medicinal and scientific purposes in Australia.

Sussan Ley, federal Minister for Health, described the federal legislation as the “missing piece” in the supply of cannabis to patients.

However, the MJA authors said many questions were yet to be answered, including efficacy, safety, dose, storage, and the bioavailability of the various cannabinoids via different administration routes.

Lead author Professor Jennifer Martin, chair of Clinical Pharmacology at the University of Newcastle, said that there was a general perception of medicinal cannabis as a panacea for a whole range of ills.

“The overriding desire to have cannabis available has meant that this has gone much more quickly than it would for other therapies,” said Professor Martin, who is involved in the New South Wales Health-funded medicinal cannabis trials.

“The enthusiasm for a new drug needs to be tempered with a bit of evidence and a bit of reality. We probably just need to go slowly until we learn how to use it.”

Writing in the MJA, the authors said that the legislation was a significant move for medicinal cannabis users – who can gain access to an unapproved product via schemes such as the Therapeutic Goods Administration (TGA) Special Access Scheme or under the Authorised Prescriber Scheme – without cultivating the drug or importing it illegally. The reforms would also streamline access to cannabis for researchers, they said.

In February, federal Parliament passed amendments to the Narcotic Drugs Act 1967 to allow controlled cultivation of cannabis for medicinal or scientific purposes through a single national licensing scheme. Alongside this move, an interim decision was made in April to down-schedule medicinal cannabis to Schedule 8 (controlled drugs) from Schedule 9 (prohibited drug).

A spokesperson for the federal Department of Health said: “This scheduling interim decision complements the amendments to the Narcotic Drugs Act … and aims to simplify access for those qualified for such access, while keeping appropriate controls in place to prevent these products from being diverted to illicit uses.”

Professor David Penington, former head of the University of Melbourne medical school and university vice-chancellor, said that the MJA article brought the issue into the consciousness of the medical profession, but failed to acknowledge Commonwealth and state efforts to put in place a path for these “checks and balances” to occur.

He said that the reforms were necessary measures for further evaluation to be undertaken in consultation with the medical profession.

“The medical profession has to be satisfied that the necessary steps are in place to use the products as they come through with all the necessary checks and balances, which would ordinarily be handled by the TGA, but are now allowed to be handled through the clinical trials framework and authorised prescriber framework, as agreed by the Commonwealth, as a way to bring all those necessary further steps into play,” Professor Penington told MJA InSight.

He said that Australia had a chance to rollout medicinal cannabis “rather better than many other countries have”, but it was crucial to take a step-by-step approach.

He added that it was important to take into account community demand – particularly among patients with painful, inoperable cancer – but that had to be balanced against the concern of the medical community that medicinal cannabis products were safe and effective.

“The medical profession doesn’t want to be steamrolled and asked to prescribe something they cannot be sure is safe to use,” Professor Penington told MJA InSight.

Professor Martin said that there was also a sense in the community that medicinal cannabis was safe because it had been used for more than 2000 years.

“The people who will be using it for medicinal purposes are pretty sick, they are often older, and they are usually not tolerant to cannabis.”

Professor Martin said that she was conscious of not being paternalistic and did not wish to diminish the hope of patients who were desperately seeking therapies for children with intractable epilepsy or for patients with terminal cancer.

“We want to keep that hope alive, and get excited that this might be helpful. But the reality is we don’t have that evidence yet that it will be helpful,” Professor Martin told MJA InSight.

“Our main issue is that we feel that there is a big groundswell of people trying to get this drug available and there may be a lack of understanding about the rigorous process that drug development goes through.”

Professor Martin said that if they were able to demonstrate a benefit in reducing seizures in children, this would need to be balanced against potential long-term risks to the developing brain. “It might all turn out to be safe, but … we don’t have the evidence of safety and effectiveness yet.”

Professor Wayne Hall, Director of the Centre for Youth Substance Abuse Research at the University of Queensland, said that the MJA article was “long overdue”.

“There has been a lot of uncritical attention in the media, which has created the impression that there is abundant evidence of the effectiveness of medicinal cannabinoids and cannabis in the treatment of various disorders,” he said. “In fact, as [the authors] point out, most of the evidence is anecdotal.”

He added that it was understandable that the community wanted to see action on medicinal cannabis because for some of these conditions, particularly the intractable forms of epilepsy, there was no effective alternative treatment.

“But it’s important that we’re doing trials to evaluate these claims.”

Professor Jan Copeland, Director of the National Cannabis Prevention and Information Centre at the University of NSW, said that the availability of medicines should be informed by science, and cautioned Australia from following the lead of the US.

“In the US, the medicinal marijuana legislation was through a citizen-initiated referendum. It was not based on any scientific or medical evidence at all, and the medical profession has not been involved in the dispensing and supervision of medicinal cannabis in the US,” Professor Copeland told MJA InSight.

She said that the US also failed to adhere to promises to fund public health information to counter the “weed is good for you and non-addictive and cures cancer” messaging.

Editor’s note: We have received complaints that the poll previously attached to this story was badly worded and therefore did not accurately reflect the full range of opinions. We agree. We have closed that poll, and replaced it with the one below.


Poll

The medicinal cannabis process is moving too quickly
  • Strongly disagree (84%, 1,168 Votes)
  • Disagree (12%, 164 Votes)
  • Strongly agree (2%, 31 Votes)
  • Neutral (1%, 17 Votes)
  • Agree (1%, 12 Votes)

Total Voters: 1,392

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62 thoughts on “Slow and steady on medicinal cannabis

  1. David Lindholm says:

    It strikes me as completely daft to introduce cannibis in this way. Surely it  should fly (or or more likely crash) on the basis of merrit if put through the existing drug regulatory processes. It should not be treated as a special case with its own legislation driven by pseudoscience. American pain specialists are finding it to be a real pain in the neck. Our track record of regulating opioids is appallingly bad and it would be magical thinking to expect we will do any better with cannibis. I for one wont be prescribing in our pain clinic. 

  2. strayan says:

    Things are moving too fast? Too fast!? Are you kidding me?

    No progress has been made (in Australia at least) for decades. The idea we still need to wait for “more research” before we take any action whatsoever is ludicrous. How much research? How much do you want? The truth is that no amount of research will satisfy some people. The first time I heard a medico call for “more research” into medicinal cannabis was an article in TIME magazine published in the1970’s.

    There has been ample time to carry out ‘more research’ and it has been, if you look. Do we know everything about cannabis? Of course not! We don’t know everything about anything. Take the drug paracetamol for example. A few years ago I learned that “Children exposed to long-term use of paracetamol during pregnancy had substantially adverse developmental outcomes at 3 years of age.” Wow, I didn’t know that before! Does that mean I’m going to stop recommending paracetamol to pregnant women? Nope! Does that mean paracetamol should be taken off the market because we still don’t know EVERTYTHING!? Nope. It doesn’t mean anything except we learned something new, congratulations people!

    I can’t for the life of me figure out why people are so apprenhensive about medicinal cannabis. We already prescribe drugs that are far more dangerous, drugs that kill, drugs that are more addictive, and drugs that lead to serious psychiatric problems. One of my patients had an adverse reaction to pegylated inteferon and went psychotic on me and that’s just one example.

    We need to get a move on with cannabis people!

  3. Dr Paul Dunne says:

    As a palliative care specialist I have seen many people try marijuana in various forms and have not been impressed with symptom control benefits but have seen a few quite severe confusional states as a result of its use. More research is needed and having a more open approach so that people are happy to report use would assist our understanding of the drug. Currently we have a lot of positive anecdotal comments but no negative comments which makes me think there is a lot of underreporting of use.

  4. Michael Kennedy says:

    Prof Martin is correct.

    In relation to unusual uses one only needs to look at its use by sportspeople.

    True it was a component  of  the “olympic vitctors dark ointment” used in the Classic Olympics but is now touted as being of benefit in some sports.

    I have looked at all the published data on it’s effect on strength and endurance (there is VERY LITTLE) and what there is shows a negative effect and indeed a lowering of the threshold whee angina will occur.

    One can find a case report for almost any cardiac condition associated with cannabis but the cardiotoxicity of cannabis (usually considering THC) not analogs remains a question to be resolved.

    Unfortunately the media and vested interests are trying to run the show so the medical profession needs to take the lead. 

     

     

     

     

  5. Michael Oakley says:

    The evidence is long in, while i will agree they need to study more they also need to get Medicinal Cannabis out to the public so they can study it the way WE need it. People are suffering and dying without legal access to the one thing that actually works! Big Pharma are terrified because they can’t control it, it makes people well and that is not good for business.

  6. Christopher Kennedy says:

    When I was diagnosed with Hodgkinsons Lymphoma I was offered opiods to control the pain of chemo. I didn’t take them, preferring to use dope. It worked. I am alive and not an opiod addict. I am also schizoaffective. Dope works with anxiety and depression. Want any more evidence?

     

  7. George Pouki says:

    Any faster and we will be going backwards.

  8. Kevin Pinch says:

    Try telling people with Chiari Malformation/Syringomyelia or Chronic Pain that the introduction of Medicinal Cannabis is moving to fast,
    On the contrary they will all say that it’s moving too slow.
    While the researchers have called for “Considered Management” people are suffering.
    While researchers are working during the day on “Considered Management” people are suffering.
    While researchers go home to the family and friends at the end of each day, people are suffering.
    While researchers sleep at night the same people are laying awake suffering,.

    If researchers could walk one day in the lives of these people they would begin to appreciate that the introduction of Medicinal Cannabis is moving too slow.

    Why do I know this ….because my wife is one of a very rare few that suffers severe Chronic Pain frrom Chiari Malformation and Syringomyelia.
     

     

  9. Emma Anderson says:

    I don’t think anecdotal evidence is enough but selected that option because there are other countries that have done rigorous scientific testing for decades.

    I would like to see marijuana legalised 1. For hemp products 2. It allows freedom for more research 3. We really shouldnt be giving someone a criminal record for a spliff when we know its actually less addictive than tobacco and less harmful than booze 4. This is the clincher for me PATIENT CHOICE

    I am tired of no choice in strain or dose and irregular supply. Dispensaries of herb and the right to grow matter. Not everyone can take oils or afford them and this will be more expensive if commercialised. It is already too expensive to get oils and the extraction chemicals such as ethanol are dangerous. Edibles are the safest and you need LEAF. Plus I have food allergies so I need to prepare myself.

    So we ARE moving way way too slow in Australia but NOT because anecdotes are enough. Gosh no. The science is in. Its just not Australian.

  10. Damian Flower says:

    I am using cannabis to treat the side effects of chemotherapy drugs. It’s more effective than the prescribed anti-nausea pills that come with their own side effects. I agree that more research is required but everything I have seen online so far appears to be related to how the big pharmaceutical companies can ‘package or synthesise’ a drug. It works perfectly well in its natural form. Just make it available to people that need it.

  11. Deborah Howe says:

    I was injured 4 years ago. I will need pain management for the rest of my life. Whilst I only required lower dose opioids and Lyrica, I did not function well on the meds.  Depression followed and then a friend asked if I had tried cannabis. Never looked back. Off centrelink, I have my life back. I get relief from any cannabis I buy on the blackmarket, obviously some strains work better than others but relief is always derived from vaping it. I understand the hesitancy and yes more research is required but those that have used it for decades have the information on dosing and use of whole plant cannabis. Please stop ignoring them and start listening. This is not about getting stoned or recreational use,  if all I wanted is to be stoned, I would of been happy on the opioids. Please move more quickly and start looking st whole plant as well as pharma derived. There is an organisation in the US called Doctors for Cannabis Regulation ( DFCR) the group includes a former Surgeon General. After having access to medical whole plant cannabis for over 20 years, they say legalise even for recreational use. If cannabis was a threat to public health, why would they recommend such a thing? Stop stalling, people are suffering needlessly.

  12. Lyn Cleaver says:

    “The medical profession doesn’t want to be steamrolled and asked to prescribe something they cannot be sure is safe to use,” Professor Penington said. In our experience, over eighteen years now, we have never once used a medication that is totally safe. All of them have come with unwanted side effects, some very serious such as compromised respiratory function. Even our specialist who is a leader in his field (Epilepsy) was very forthright in saying “I don’t know if this will work, and considering how medication sensitive Jeremy is I cannot promise it will be safe for him either” Needless to say we arrived at cannabis because everything else had failed. We were unsure if cannabis would help, and we were incredibly nervous about trying it. No less nervous than trying the last anticonvulsant we were offered however which saw our son trying to jump out of moving vehicles, which saw him locked in his own home because he was a danger to himself and others. A drug which saw him injure one of his support workers so badly she was hospitalised. A drug which caused him so much harm we could not even dress him or brush his teeth some days. He was a prisoner to this drug. Now, I know this drug has been tested and trialled, just the same as every other drug he had been prescribed over the years. His specialist knows, his paharmacist knows and Professor Penington knows that not all drugs are safe to use just because they have been trialled and tested. Jeremy is living proof of this. We home grow his cannabis and no steamrolling from any specialist or law maker will change that fact. He doesn’t have time to wait. 

     

  13. Juanita Kammholz says:

    Let me ask you this: what can a patient do, when they live with chronic pain and are allergic to ‘normal’ pain relief? That means, no opiates, no morphine, none of the usually prescribed medication and paracetamol is the only ‘drug’ that they can take, so what are they supposed to do? Doctors said that there is nothing that they can do to help. So, your choice becomes simple, end your life or take medical cannabis? Which would you choose? Medical Cannabis should be available NOW! After all, if one of the most prestigious hospitals in the world, The Mayo Clinic, prescribes it for patients and continues to research how it affects other diseases as well, then THE RESEARCH HAS ALREADY BEEN DONE!! 

  14. Junky Junk Mail says:

    42 years I’ve been having on average 15 epileptic seizures every day.

    I find out that medicinal canabis or CBD oil can significantly reduce these seizures and perhaps reduce the 112 pills per week that I take.

    You better believe I’ll try that, proven or not.

    The only reason the pharmaceutical companies are dragging their heels is because they can’t find a way to monopolise it and the government can’t find a way to regulate and tax the hell out of it.

  15. Anne Krestensen says:

    The Medical Cannabis users Inc. has a membership of 10,500 rejects from a broken health care system who use full plant cannabis extracts to treat and relieve a host of symptoms from a plathora of illnesses. Our members have undeniable results from self initiated trials as seen by their GP, Specialist, who tell their client behind their hand to keep doing what your doing. I am one of these people.
    These clients prefer cannabis to pharmaceutical proxucts which neither control nor relieve these symptoms but have been prescribed followed by vigorous testing by TGA. Many of these drugs have side effects that r3quire more pharmaceutical drugs to counteract them_ but they are prescribed without an ounce of concern for the client.
    Cannabis is a Botanical substance which can be eaten raw without any phycoactive effect and should be classified by TGA as Herbal ingredient in complementary medicine.
    Authorities should be consulting with the real experts out in the community_ those who have made it their lifes research. Manufacture and provide herbal cannabis to the thousands of individuals who are seeking it out daily AND are getting results.
    The MIDDLE CLASS MAN…
    The unemployed, the disable, the farmer, the healer, the manufacturer, the carers.

  16. Rangi Faulder says:

    Are we kidding? Cannabis has a long history in medicine but was removed for a number of decades for non medical and non scientific reasons. It’s interesting to know that under the single convention on drugs that only isolates are required to be trialled for safety and efficacy but not the raw oils. Raw oils are to be allowed without the wait yet forward to the reign of the Australian governments and the TGA and they classed it incorrectly where it could barely be accessed let alone grown or studied. Could it be that the adults living sixty years back has eyes and ears and could see that the raw oils were bottled up and dispensed and prescribed and there was uncertainty about manufacturing isolated compounds for medicine? Researchers should take the time if companies plan to release isolates as medicine. For cancer and chronic pain and epilepsy the patients are telling us it is helpful. The amount of cannabis consumed worldwide should speak volumes as should the volumes dispensed in USA and Canada to the sick. We are talking thousands of tonnes and hundreds of thousands of patients that are not complaining. While some elderly might not like the high effects and in Australia are obviously not getting a measured dose to begin with, it won’t kill them. Anyone would think we still can’t count how much THC constitutes too high a dose. Read up or maybe ask a mystic shaman from Jamaica, a recreational user from one of the local high schools, pubs, retirement home or try asking another medical professional with experience in toking or dispensing. You can find them everywhere over the seas outside of Australia. They somehow are allowed to dispense before waiting for Australia to sort itself out. 

  17. Ben mostyn says:

    This poll is unscientific. Much more than ” anecdotal” evidence for medical marijuana. What about the data on sending sick patients to jail for marijuana?

  18. Department of Health and Human Services Tasmania says:

    As with law, so with medicine. Extraordinary cases make for poor policy.  Anecdote, while no doubt satisfying to those involved, is not evidence of efficacy in the wider population.  The positive reporting bias surrounding such issues as “miracle” cures, including medicinal marijuana, is likely to be much more prevalent than that in the medical scientific literature, where it is already acknowledged as a significant limitation in understanding cause and effect.  While it would certainly be cruel to deprive the ill of a proven therapy, it would also be wrong of the medical profession to endorse a therapy without having a good handle on what it is likely to do, positive and negative.  Perhaps the answer is to provide a legislative framework in which those who want to try marijuana for symptom control may do so at their own risk, while the medical profession continues to tease out what benefits and/or harms may result and who is likely to benefit or be harmed.

  19. Karmel Solair says:

    I’m in a Rheumatoid Arthritis forum members from Australia, USA, Canada, Israel, Spain, Germany.    Suppressing the Imune system is NOT progress.  Cannabis does not suppress the immune system rather it modulates i.e. brings the immune system back to something like normal as it stops the inflammation process.  Will spent  cartilege will regrow once the inflammation ceases.  It certainly does (Germany) in those who also get Stem  Cell transplants $8,000 for 2 injections in conjunction with the medicinal cannabis, no hospital stay needed.  A knee replacement would cost $60,000+.    Cartilege does re- grow where there is some left .  The human body has cannabis receptors many find that once supplementing with Cannabis oil or whole plant juice these receptors return – like a flood gate re-opening, the immune system comes out of suppression to flow again.

    Israel findings are Medicinal Cannabis fights all the deadly infections of MRSA, Golden Staff, Fungus.

    In Far and Middle  East Herbal Medicinal Cannabis was and still is the healing medicine for millions as they cannot afford Pharmaceuticals.  Kaneh Bosm is mentioned in the Bible Moses/Christ.  Olive oil as the carrier oil.

     l/3 of people on forum have access to herbal Cannabis in their countries most finding healing with  mix of 2 cannabinoids THC & CBD  –  8% THC  !!

    Rheumatoid TRIAL  – THC 8% – RA sufferers happy to fund $100 each.   It is our  Human Right.  A case was just won in Brazil High Court on this basis.   So, naysayers don’t be left behind or behonden to practices of yesteryear.

  20. James Vosper says:

    It is ironic that a piece promoting scinece should use a poll so biased and unscientific. It is a further irony that the results are so overwhelmingly in favour of moving faster. 

    The fact is that there have been scientific studies carried out overseas and the evidence is positive. The fact is that Austrlalia has lagged behind other countries. 

    I have a question for the proponents of a “slow and steady” approach. How would they explain to the parents of a child, with intractable epilepsy, that he/she is better off having 80 seizures per day, rather than use a product that could stop them altogether?

    James

  21. Elena says:

    As a health educator I have read extensviely about reserach demonstrating the health benefits of medicinal cannabis (MC).  There are many doctors using MC in the USA, Canada, Israel, Spain, etc and results are documented. I’ve also met many people who are treating their pain, tumours, epilepsy, etc. with medicincal cannabis.  It is an excellent treatment for many for chronic pain.  MC was utilised by many doctors in the 20th century and it was favored by the AMA in the USA before prohibition, as “the best treatment for migraine, period pain and a number of other ailments.”  Health professionals and others in Australia need to become informed before they advocate not allowing patients access to tinctures, oils, edibles and other forms of this medicine. Check out this website where one can learn about what is happening in other countries with MC: http://www.unitedincompassion.com.au

  22. Michelle Sheridan says:

    Too fast? Ask those who are in chronic pain if the cannabis movement is proceeding too quickly. Ask those who are watching their children suffer, those who are risking imprisonment trying to treat an illness, those who are helping families live a better life and breaking the law to do so. Medicinal marijuana is already being used in this country, but the government would rather see us fill our homes with pills that can kill.  I’m tempted to say that it is FACT that medicinal marijuana will be legalised one day (where it’s actually just my opinion). How many more lives should suffer? How many more lives should be lost? How many more people should just sit back and painfully wait while the government plays the game? It’s about giving people the right to choose this as a treatment option if they want to. Not everybody will make that choice, and that’s ok, but the choice to do it legally needs to be there. 

    This is moving too slow if you ask me. 

  23. Shane Winter says:

    There is all ready so much evedince as to how good this is for us all Not just chronical ill people There has been so much resarch done. Why has the US got a patent on it as a medical product Come on people wake up

  24. Guy van Hazel says:

    ” we must build an evidence base for medicinal cannabis without destroying the hope of those patients desperate or its promised relief”

    What exactly does that mean?  If we have a proper controlled trial one of the obvious outcomes is that mediicinal cannabis does not work better than placebo or  in fact is inferior to placebo.  Are we saying that we will not allow an outcome like this because it might destroy hope? This is ridiculous. We have to maintain an open mind on the matter until we have the results.  And if the outcome is negative so be it.

    As far as the 77% who say we  have enough evidence I would venture to say you have never looked at the evidence. There is precious little evidence that would satisfy the TGA or PBS. The only reason there is this push for faster approval is  that lilly livered politicians have succumbed to  the lure of popularity.

  25. Philip Cook says:

    Where’s the Poll answer “No, the overwhelming scientific evidence from Israel, the US and many other contries is good enough”?

  26. Claudia Reynolds says:

    There is plenty of positive evidence that it is safe & natural – a lot safer & less toxic than drugs – people need it now!

  27. Andreea Kindryd says:

    For the past 5 years I have had experience with medical marijuana at my doctors suggestion while I am resident in california 3 months each year.  when I come back to australia I become a criminal if I choose not to use the oxy contin, both slow release and more immediate.  I have boxes of panadine forte if I like but I prefer to have a cannabis cookie and minimal prescription pain meds.  Even when I was in hospital for knee replacement and on heavy doses of Oxy I would whenever possible get a cookie so I could decline the oxy.  I know it works for my bi polar as well as my pain.  at 77 I have to become a criminal to get my needs met.  I grow all kind of herbs and some fruits in my garden why the hell not a little marijuana plant?  Doctors including my son in law need to open their minds, the UIC symposium was an excellent opportunity to actually learn something.  stop letting the pharaceutical and alcohol interest control your actions.  We the people know why you are holding this up.

  28. Murray Afredson says:

    By and large the medical profession has been dragging its heels for so many years on this.  The plant and its medicinal substances have been around for milennia.  It is certainly an almighty rush to the clinics.  Some people do gain relief and other benefits.  It is high time the medical research community pulled the finger out and investigated the one hundred and one questions about safety, dosage, etc.  they now suggest need to be asked.  Begin with Medline searches to see what is already known,  Possibly the research called for has already been done..

  29. John Gerofi says:

    A medilne search will reveal several studies that show highly suggestive evidence indicating that THC and CBD slow or even stop the growth of gliomas.   Their effect appears to enhance the effect of both chemotherapy and radiotherapy.  There is similar (but less) evidence for breast cancer.

    Parents with children who had frequent severe epileptic fits testify to the benefit of cannabis use.

    Beneficial effects are reported by people with chronic severe pain.

    In the case of the gliomas, especially glioblastomas, the conventional medical treatment leads rapidly to death.  While we are waiting for the additional research that will confirm or disprove the  benefits of CBD and THC for people with these conditions, what right does the State, or the medical profession, have to deny suuferers the opportunity to try this relatively safe substance?.   If they can’t try it themselves, you can be sure that they will be dead before the trials are funded, approved, done and analysed, and before the drugs become commercially available.  Would the outcome be worse if they tried the non psychotropic CBD??

  30. Peter Mounsey says:

    Who is speaking in this article – medical researchers or mouth pieces for drug manufacturers? 

    It seems to me that here is a drug derived from a plant, a not uncommon event, that has enough evidence through research and culture that a person above the age of 25 years and not suffering from certain mental health issues, can be used with as much safety and a probably a lot more safety than drugs that have had all the research and trials done and declared fit for medical use and it turns out to be the opposite result. For instance, Thalidomide.

    It is time to allow the use of Tetrahydrocannabinol or the plant itself, cannabis sativa for the relief of not just terminally ill or where no other form of medication is available; but for people who have a lifelong condition that sees them taking a cocktail of drugs for pain relief, which could possibly be controlled by cannabis. How safe is a cocktail of drugs with side effects to one drug where any side effect can be traced to a single drug and appropriate action enacted.

  31. Martin Male says:

    When I was studying @ uni , the effects of Marijuana I was appalled at the bias in research. Until recently JAMA , the Journal Of the American Medical Association, would not publish articles other than those that were unfavourable to marijuana. I still see evidence of this in current discussions. Very few organisations have funding to do accurate research or have been willing to do so. As a practitioner I see no rational reason for the almost hysterical fear that some have towards this medicine. As has been stated here, there are know pharmaceutical products that have severe adverse effects.There are many examples of these products killing people, there are no deaths that I have heard of that are attributable to Marijuana. 

    There seems to be a lot of confusion about the two types of marijuana. Medicinal marijuana is completely different to the product that is illegal and often smoked. It seems that the most beneficial way to ensure consistent dosages is to have it in a form for digestion , the adverse effects of smoking as evident. The bottom line is that we are looking at making this available primarily for people with terminal illnesses, or who have no other options. Serioulsy lets get moving and conduct the research on willing subjects. 

  32. John Whiteoak says:

    The profession has been far too slack and reactionary regarding this substance while people whose lives are hell could be immediately and greatly improved.    Get off your high horses and accept the already proven value of MM and if negative implications for certain situations come to light somewhere down the track add conditions to its use.  

    Have a heart or lose public respect..

     

  33. Tony Roberts says:

    I voted “no, the anecdotal evidence is enough”

    I certainly agree to the “no” part. I stongly disagree with whoever formulated the poll by just giving that as the only “no” option as I believe the anecdotal evidence is overwhelmingly strong and there is enough world wide research to justify moving forwards more quickly.

    WHY were we ONLY given a no option that was linked to supporting anecdotal evidence only????

     

  34. Katie Burke says:

    A flawed poll.  Why is the only option for “yes” aligned with anecdotal evidence?  There is more than anecdotal evidence for cautious use of this drug, however as is so often the case, unless big Pharma can patent and make big bucks from the research, it is discredited.

  35. Andrew Potts says:

    Anecdotal evidence? Israel has 30,000 patients accessing medical cannabis through its public health care system. Why are we waiting to replicate research that has already been completed overseas when people need this life saving medicine?

  36. Steve Hall says:

    All drugs have side effects.

    Aspirin causes stomach bleeding. It’s a good pain reliever and anti inflammatory and would be more widely used if it wan’t dirt cheap. That’s why it was demonised in the USA in the 70s by the makers of paracetemol.

    Paracetemol is a moderate analgaesic and less harsh on the stomach which is why it has great acceptance for decades. It is extremely toxic on the liver and an overdose is fatal (by destroying the liver) – much more so that other drugs.

    Ibuprofen is a supposedly less harsh anti-inflammatory but it is bad on the stomach & has other side effects. It’s only moderate for pain relief. The same applies to most anti-infalmmatroies. Cortisone in particluar is terrible for long term use. The makers of neurofen just got pinged for lying about its “targeted” properties.

    The opoids are better pain relievers but are a) potentially  addictive and b) cause chronic constipation and other nasty side effects. They are curently being demonised due to people’s “addction to prescription drugs”. The proposed solution is to make it harder for people in  pain to access them. No-one is saying what their alternative is, other than suicide or grin and bear it.

    I’m sure medical marijuana has side effects. I’m also reasonably sure it has benefits. However it’s the only pain relieveing drug that can get you imprisoned fpor trying to relieve your pain or help your loved ones.

    There is no excuse for denying people in pain and their loved ones access to compounbds that can help them, as long as there are safeguards. Throwing them into jail for seeking relief is not exactly a safeguard. It’s the patient’s pain and it should be their decision.

  37. Mark Eckermann says:

    Medicinal cannabis should be available to more people than just the terminally ill. It can provide relief for a number of ailments, and is effective for more than palliative care.
    In November last year (2015) I attended a Marijuana Management Symposium in Denver Colorado. It drew together police, civil authorities and the medical profession.
    In Denver cannabis is available to people over the age of 21. Before that legalisation was passed cannabis was available on doctor’s prescription. There are two sets of legalsation now and that has led to some confusion. The cannabis sold for personal consumtion is taxed whereas medical cannabis is untaxed and sold from separate outlets.
    The sooner cannabis is available to more than the terminally ill the better.
    Denver is applying the taxes collected from cannabis to alleviate the situation of the homeless in the city, a win win win situation. Those wbo wish to use cannabis can do soegally, pressure has been taken off tbe justice system and the taxes raised are being applied to help the poor.

  38. Samantha Burton says:

    Illness and pain does not wait for ‘evidence bases’ to be built. If medicinal cannabis is providing relief for the chronically and terminally ill then it should be immediately available. There’s plenty of time to build these bases without depriving those in need whilst it happens. 

  39. Didi Bower says:

    I am always interested that 99% of the time its always “experts” or non-users of MM that get all high and mighty about it, as if they have more knowledge of how it helps people.  Sure there will be some people that have adverse  reactions but thats the same for any medications on the market, prescribed or not.  Listen to the people who actually use MM, stop this persistant need to research everything to death, we’ll never have all the answers to everything and let people make their own decision about how they cope with these awful diseases or symptoms.  Until you’ve walked in their shoes you really don’t have a clue.

  40. paleo martin says:

    At least Australia is discussing the marijuana question, whereas here in New Zealand it is seen as too hot to handle,and has been pushed to one side with those on the point of death having to seek the approval of a minister not noted for speed of action.

    Good luck with your efforts!

    Paleo

  41. PL says:

    It appears there is vested interest in not fully supporting the call to legalize medical cannabis.

    Consult with researchers and scientists who have published widely and are knowledgeable in the use of medical cannbis.

    For people suffering from terrible pain which can not be relieved by drugs, medical cannabis is to be used as a last resort, and should be made available as soon as possible.

     

     

  42. Brett bradbury says:

    An inexpensive drug with so many positives that should not be ignored.

  43. Hans Paas says:

    There is no time for delay. People suffering conditions that have the potential to be relieved or improved through medicinal cannabis must have legal access to this substance. I encourage the medical profession to do all the research it wants to do but legalise and provide medical cannabis now! The balance between it doing harm and doing good is heavily on the side of good so for the sake of all those suffering at present, get out of the way and get with the program. Any further obstruction will put the medical profession on the wrong side of history.

  44. John Madden says:

    All this concern regarding the ” anecdotal benefits ” can be circumvented by simply legalising it.

    Our society is loosely based on the free market economy. Cannabis is currently available in several US state and has been available for decades throught the coffee shop culture in Amsterdam.  This is probably the model to go with, as it encourages small business, provides high quality cannabis products at a modest cost and can easily be integrated with existing police services.

    By ” medicalising ” cannabis, we will see an abundance of somatised presentations , diversion , and further costs on the PBS, for a product that is essentially a herbal extract, cannot be patented and is easily grown.

    Let the individual decide 

  45. mathew thomas says:

    Technically we don’t need a law to allow us to consume cannabis!
    Medication is a lawful right! And all usage of cannabis is medicinal (without an illness is preventative medicine)
    The real problem is the pharmaceutical industry and the government wants to be able to capitalise on its legalisation!
    I’d much rather grow my own! That way I know what went into growing it! What strain it is, what fertilisers if any was used, completely organic)
    How would we know if the cannabis was chemically sprayed and what chemicals were used if we allow pharmaceutical companies to grow cannabis

    The medical profession need an Unbiased education on cannabis from application to basic level on how to dose (joke: what do you call a cannabis overdose? A good night’s sleep)
    Classes on how to a) grow, b) make oil and butter c) cooking d) vaporise
    Taught by experienced users
    When it comes to health and education money should be outlawed

  46. Rob Daminato says:

    seriously people. The people who want more testing have no idea about the regulatory process and red tape that never needs to be forced on many drugs. After being in the Medical industry since 1982 I have a fair idea on why I want to see faster movement! The people who need it most need it now not in another 5-10 years. Enough is enough, the results are in the Doctors want it so legislate it. There is enough evidence to show that no side effects will affect the type of patients that require this medication.

    Gor Gods sake …….. Give them some peace and respite.

  47. Phillip Smith says:

    When I was a kid growing up in Victoria, my mother always had “Oil of Cannabis” in a bottle in the medicine cupboard. I think there might have been a couple of other medicines that also contained cannabis as an ingredient, but the “Oil of Cannabis” with its white and maroon label sticks in my minds eye the most clearly.  I think I can remember the label bore the words “Since 1889”.

    The couple of bottles Mum had, looked very old and she had to be sparing in its use, because our door-to-door visiting seller of medicines could not sell it any more.

    It is therefore obvious that cannabis was in regular use here in Australia until for some reason it was banned.

    I therefore think that further years of scientifically testing it before allowing its use are totally unnecessary.

  48. John Blayden says:

    If it helps those that are seriously ill and with no real chance of a full recovery, what harm is there?

    If the patients have essentialy a death sentence anyway and receive some relief and confort from this drug as has been shown, then it should be allowed for use immediately to let them have some dignity.

    There are so many pharmaceutical drugs on the market which I believe have much worse side effects than cannabis.

    I was once prescribed a prescription drug which would have caused liver failure for a condition which I now control with fish oil.

    So what harm can medical cannabis cause to people who have no real life expectancy, cronic suffering and no dignity left in their lives?

     

  49. Charles Lowe says:

    I speak as a qualified philosopher.

    The medical profession needs to confess primarily that it is one of many societal components.

    So Professor Martin’s judgement becomes irrelevant and unreal. And David Penningtons’ real, pragmatic and ethical.

    The profession needs to explain to the public why it appears to hold too defensively to the proposition “Do no harm” in relation to medicinal use of marijuana given that its use has never demonstrated harm (with the possible exception of accellerating a propensity to schitzophrenia in mid-to-late adolescents).

    This is a matter best addressed within legal philosophy. To be credible, a spokeperson must display philosophic proficiency 

    Enough proficiency to accept that the frst question is one of onus.

    Let me say it clearly.

    Marijuana is trusted, sufficiently societally and hence politically, to effect remarkable curative powers.

    So those who would argue against its immediate employment must demonstrate, efficaceously, effectively and immediately that its administration would likely cause harm.

    Yes, the  need to “do no harm” invites a conservative approach.

    That approach dissolves when the surrounding culture says “We trust it. Show us why and where we should not.” 

    Over to you.

  50. Nick Gayton says:

    This whole argument is completely idiotic. Are we supposed “play it safe” and work with in the medical system that has such a great track record with harm reduction in regards to medication? Just look at the medical system’s management of pharmaceuticals and it speaks for itself. Pharmaceutical drugs kill more people than all illicit drugs combined. Even over the counter medications like paracetemol have annual deaths and just about every medication designed to be taken long term causes liver, kidney or brain damage. I’m not just talking about those whoopsies like Thalidomide but drugs still being pushed by GPs everday. The process to get a drug to the market has been proven to fail on many occasions through fraudulent research or omissions of negative aspects of studies. Cannabis has never been attributed to an overdose death and long term effects pale incomparison to those of any pharmaceutical. Long term heavy use does not increase risk of lung cancer despite the smoke containing twice the amount of the same carcinogens as toacco smoke (perhaps something to do with the capacity for cannabinoids such as THC to bind to receptor sites of mutated cells and induce cell death). In fact Dr Donald Tashkin’s study, that was actually funded by NIDA, showed long time heavy cannabis only smokers had less risk of getting head neck & lung cancer, also COPD, than someone who smokes nothing at all. The only respiratory issues noted were a persistent cough, wheeze and some excess phlegm. 

  51. Nick Gayton says:

    There are some studies that infer that leng term heavy users show changes in their brains but there is no idication that these changes are negative. But it is clear that cannabis use does not cause brain damage in fact cannabinoids are one of the only known substances that can promote the growth of new brains cells and they also have neuroprotective qualities (as patendend by the US Federal Gaovernment who still schedule cannabis as having no know medical value, go figure). How about addiction you say. The percentage of cannabis smokers that become psychologically dependent, there is no physical addiction to cannabis, is the same as the percentage of the population prone to addiction in general. So if your prone to addiction and you use cannabis regularly you’ll probably become dependent on it but if you’re part of the other 90% of the population the addictive potential of cannabis is extremely low when compared to tobacco, alcohol or even worse, sugar. Many pharmaceuticals would be at the top of the list for addictive potential. With cannabis the “gateway theory” is reall quite laughable when looked at logically. But in regards to pharmaceuticals it’s more than plausible. Pain pills…. the gateway to herion. This is a common occurrance. Okay how about mental illness. There is not one credible study that shows cannabis can cause schizophrenia. Over the past decades we’ve seen cannabis use skyrocket and yet the incidence rate of schizophrenia has not increased what so ever. The most plausible studies show cannabis use in those predisposed to schizophrenia, and going to suffer from it anyway, may play a part in prompting the onset of symptoms but even then no more than alcohol use, a death in the family or many confounding factors

  52. Danielle Vosk says:

    Seriously, there is real evidence out there. Particularly in Israel there have been many successful trials that have been sought out by Australian journalists yet somehow news of these successful trials doesn’t make media. There is more than enough evidence already out there. Besides I have no doubt it is safer than alcohol yet alcohol is the legal drug. 

  53. loren paul wiener (tech-news.tv) says:

    Currently in all the recent Australian Cannabis Law Reform Bills in 2015 and already in 2016, the specfic wording and change in definition of the word “Cannabis” now means “Medicinal Cannabis” is not the same as “Cannabis for Medicinal Use” Where Medicinal Cannabis Products are now, anything from GMO, special manufactuered strains of Cannabis, and even synthetic Cannabis Type products that do not even come from a plant. These changes are purposeful and ones the public should be allowed to know about as the bills all passed recently nationally. This is the only reason trials are needed not for those natural products like Full Spectrum Cannabis but for the dangerous synthetics and new medicnes that do need testing. With the new laws recently introduced increasing penalties against Cannabis patients, and caregivers alike, all that is happening now is new criminials are being created by the recently new harsher laws. and the public are not even being made aware. Folks often, forget the laws are written so that Cannabias is viewed as dangerous because it is illegal, it is not illegal because it is idangerous. – 

  54. Annette Griffiths says:

    “In the US, the medicinal marijuana legislation was through a citizen-initiated referendum. It was not based on any scientific or medical evidence at all, and the medical profession has not been involved in the dispensing and supervision of medicinal cannabis in the US,” Professor Copeland told MJA InSight. Cripes! There was no scientific or medical evidence used to bring about prohibition in the first place!! And of course there is a plethora of anecdotal evidence – millions of people worldwide know the efficacy and safety of the herb – so it’s obvious that anecdotal evidence will be in abundance. But that doesn’t negate the good, detailed research coming out of the US, Israel and other countries. The truth is – there is no good reason for cannabis to be considered an illegal or controlled substance. It is a beneficial herb. Used raw, it has no psychoactive affect, but still delivers health promoting benefits to the body. And it is certainly less harmful than other “approved” drugs. We are moving too slowly on this one. 

  55. Laurie McAnulty says:

    It would seem there IS hard evidence that the use of MC works for at least some patients but that is being ignored. This has become a political and religious football and gone into the “don’t tackle difficult issues, don’t rock the boat” basket unfortunately.

    How about some consideration for the very ill patient who feels conventional medicene has failed to alleviate their condition? Personally the argument, if proferred, that it is just a placebo effect misses the point…the patient is feeling better with their lot, surely when all is said and done that is a positive outcome for the very ill.

  56. Carol Brand says:

    Please explain to me why medicinal cannabis is moving too fast? It has been used for medicinal purposes for aeons, therapists know how to administer it.  

    When you consider the awful drugs that have been permited by the TGA, or FDA administered by the medical professionals, to then  see people die, or made even sicker by these drugs, or peoples lives put at risk because of side effects.Then to find out that the was not as rigorously tested as we are led to believe.  Who has suffered from medicinal cannabis or died???  

     

     

  57. kay says:

    i think it ironic the stigma placed on cannibus use for medical purposes.  People need to be allowed to come forward and document there use of cannibis to assist with medical conditions without fear of being charged.  A privacy disclosure aggreement needs to be maintained so there are no repercussions for the user.  this is the only way to satisfy hierichy and get the study information effficiently.  While I believe there are some people that should never take cannibis due to the effects on them, there are some that it is there only chance of relief.  From what I can gather the side effects of its use in some conditions have a lot less long term effects and damage than many other drugs people are forced to use for relief or control of symtons.  egs. depression and pain control.

  58. Michael Lambert says:

    Cannabis has been used for Epilepsy for over 3800 years according to Chinese records. It ws used by the father of british neurology (Gower) and by American Drs in the 1850’s. Cannabis is epilepsy medicine. We’ve seen the results for ourselves. My 4 year old daughter has been taking cananbis happily for 1.5 years. If you are facing sudden death and severe brain damage from Catastrophic Epilepsy you have to weigh the “risk” of doing nothing compared to the risks of the legal and illegal drugs you are taking everyday.        

  59. Lyndal Breen says:

    Certainly get all the research happening but you will never know enough to answer every possible question that might arise about individuals and their pain, and their individual reaction to medicinal cannabis (or any other drug). No doubt more research will show up some extra unusual side effects. I’m thinking that many medicos must not be reading the lists of reactions / side effects that come with any prescription drug.

    Unlike many of our modern drugs, cannabis has been around for hundreds of years. It would have to be one of the best understood drugs out there. Contrast with the new information on morphine recently published in many places, which indicates that pain can be made worse by taking it.  http://www.sciencemag.org/news/2016/05/why-taking-morphine-oxycodone-can

  60. Thomas Greenaway says:

    It is pleasing to know that our clinicians, scientists, and researchers, many of whom attended the recent Medical Cannabis Symposium in Sydney, have such confidence that they can cast aside the many studies and clinical trials conducted internationally along with the wealth of evidence they have gathered, and get to the truth of the matter themselves.  Indeed, what would their American, British, Israeli, and Spanish counterparts know anyway?

  61. Mick Langford says:

    Professor Martin says that people calling for immediate prescribing of cannabis don’t understand the process of drug development.  While this is true in regards to man made “atificial” drugs, many of which are deadly if used incorrectly, it’s arrant nonsense in regard to cannabis.  Cannabis has been safely and widely used for millenia, and if it hadn’t been demonised by the Americans in the early 20th Century as something akin to heroin or cocaine, it would no doubt be a recognised and accepted safe alternative to opioids and opiates today.

    I agree that it will take time for the pharmacutical industry to develop a pill or some other delivery system to allow people to avoid the obvious problems associated with smoking cannabis to deliver the cannabinoids, but there are thousands of people suffering needlessly RIGHT NOW.

    I have had chronic discogenic pain with neuropathy for 20yrs from thoracic and cervical spinal injuries. The constant pain and nausea from migraines had me in bed for 11-12hrs per day and in a recliner for most of the rest, all while on the maximum dose Tramadol and the maximum dose panadiene extra.  We have tried a panoply of pharmacuticals over the years with little success, until I made a change in my treatment regime.

    I have been able to halve my opioids, stop using opiates altogether for breakthrough pain, now that I don’t hurt as much I can be more active and have lost 20kg, I no longer need to knock myself out with alcohol to be able to sleep more than 10 min at a time, I no longer spend part of every day vomiting from migraine activity, I no longer suffer chronic constipation from the opiates.  In short I have regained a semblance of a real life again.

    Guess why.

  62. David says:

    Prohibition is dead. The obfuscation by the government, medical profession and police is nothing more than the noxious gases of a rotten corpse. Because of a little fad called “the internet”, we are reaching a critical mass of ordinary people who can see through the lies and are revolted by “the culpability, stupidity and venality of the Establishments’ role” in “an ethical disaster comparable to the eighteenth-century rebirth of the slave trade” (T. McKenna)

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