May 21, 2019 Stone the crows

The Northland Age - - Opinion - By Peter Jack­son

AHori­zon Re­search sur­vey of 1156 New Zealan­ders, com­mis­sioned by li­censed medic­i­nal cannabis com­pany Helius Ther­a­peu­tics, has re­port­edly found that 14 per cent of us will def­i­nitely try to ac­cess medic­i­nal cannabis prod­ucts when they be­come more widely and legally avail­able, with an­other 10 per cent most likely, or some­what likely, to go look­ing for them.

Twenty-three per cent said they were most un­likely to use them, 22 per cent def­i­nitely won’t, and 12 per cent weren’t sure.

One would hope that those fig­ures would give pause to the politi­cians who are de­sign­ing the reg­u­la­tions, li­cens­ing rules and qual­ity stan­dards around medic­i­nal cannabis, which will then be­come part of the Mis­use of Drugs Act, but they prob­a­bly won’t.

Apart from sug­gest­ing that the canny in­vestor might look at buy­ing shares in the com­pa­nies that will man­u­fac­ture and mar­ket these drugs, the sur­vey re­sults could be read in sev­eral ways. Per­haps we are in poorer health than most of us imag­ined, given that so many of us are hang­ing out for prod­ucts that are not yet avail­able as a more ef­fec­tive sub­sti­tute for the drugs we are cur­rently be­ing treated with.

Per­haps 24 per cent of us are liv­ing with a ter­mi­nal con­di­tion and are await­ing the op­por­tu­nity to use medic­i­nal cannabis prod­ucts to ease our pass­ing from this life to the next. Or per­haps some of the 24 per cent er­ro­neously see the in­tro­duc­tion of medic­i­nal cannabis as the next best thing to le­gal­i­sa­tion of the drug in its more fa­mil­iar form.

Helius Ther­a­peu­tics’ ex­ec­u­tive direc­tor, Paul Man­ning, was quoted last week as say­ing that the 14 per cent who would def­i­nitely try to ac­cess medic­i­nal cannabis prod­ucts rep­re­sented “phe­nom­e­nal” de­mand, a “groundswel­l” of de­mand, and a timely re­minder that New Zealan­ders were in­creas­ingly see­ing cannabis as a main­stream health

prod­uct.

Per­haps. More likely it dis­plays a fun­da­men­tal mis­un­der­stand­ing of the po­ten­tial ben­e­fits of medic­i­nal cannabis. Surely there can­not be that many of us who be­lieve we need it to treat the nar­row band of ail­ments that it can sup­pos­edly ame­lio­rate, or who are dy­ing and can find no other drug that will con­trol our pain.

The Royal New Zealand Col­lege of Gen­eral Prac­ti­tion­ers’ med­i­cal direc­tor, Dr Richard Medli­cott, said he wasn’t sur­prised by the sur­vey re­sult, although the point of amend­ing the Mis­use of Drugs Act was to make medic­i­nal cannabis more avail­able to those suf­fer­ing a ter­mi­nal ill­ness or chronic pain. The bill had had quite a high pro­file, he said, as had plans for a ref­er­en­dum on “wider cannabis is­sues” (per­sonal use), so a lot of peo­ple had be­ing think­ing about these is­sues.

An ear­lier Helius-com­mis­sioned sur­vey of al­most 1100 med­i­cal pro­fes­sion­als re­vealed that around twothirds of GPs and three-quar­ters of head phar­ma­cists had been asked for medic­i­nal cannabis prod­ucts over the past year.

Eighty-nine per cent of med­i­cal pro­fes­sion­als said they would pre­scribe the prod­ucts for one or more of 20 med­i­cal con­di­tions, if they had enough in­for­ma­tion, but only 6 per cent re­garded them­selves as very well in­formed about the prod­ucts.

Per­haps cannabis has more wide­spread medic­i­nal ben­e­fits than those with­out ex­per­tise in the field, the writer in­cluded, had imag­ined, and it may be no bad thing if ex­tracts of the plant were to su­per­sede some of the ‘main­stream’ drugs we cur­rently use. It is cer­tainly dif­fi­cult to mount a com­pelling ar­gu­ment against its use by those who gen­uinely need it to ease their pain or symp­toms.

Many drugs are de­rived from plants, and there is no rea­son to re­ject this one purely be­cause, used in an­other form, it can be hugely dam­ag­ing. The big­ger is­sue is the im­pact of le­gal­is­ing cannabis for ‘recre­ational’ use — recre­ational in this con­text mean­ing oc­ca­sional use for en­joy­ment. The be­nign picture that paints is surely mis­lead­ing.

As we brace our­selves for next year’s ref­er­en­dum on le­gal­is­ing the use of cannabis, we can only hope that those who plan to vote are also con­sid­er­ing the col­lat­eral is­sues, such as the role cannabis use plays in the road toll.

Ac­cord­ing to Op­po­si­tion leader Si­mon Bridges, in 2017 il­licit drugs played a role in 79 deaths on New Zealand roads, com­pared with al­co­hol’s con­tri­bu­tion to 70 deaths. Some go fur­ther, say­ing Min­istry of Trans­port data showed drugs were “the rea­son” for 21 per cent of fa­tal crashes in 2017, 3 per cent more than al­co­hol. Whether drug use ac­tu­ally caused those fa­tal­i­ties might be a moot point, but the UK, Canada and Aus­tralia are all tak­ing it se­ri­ously enough to have in­tro­duced road­side drug-driving tests.

As­so­ciate Trans­port Min­is­ter Julie Anne Gen­ter is on the record as say­ing those tests are too in­tru­sive for her lik­ing. Some would con­sider dy­ing as a re­sult of en­coun­ter­ing a driver un­der the in­flu­ence of drugs is also on a lit­tle on the in­tru­sive side.

Ms Gen­ter has also of­fered the view that, “un­like al­co­hol breath tests”, drug tests can only de­tect the pres­ence of drugs or med­i­ca­tion. They can­not test if a driver is im­paired.

Say again? An al­co­hol test sim­ply es­tab­lishes the pres­ence of al­co­hol in the driver’s breath or blood. It does not de­ter­mine any de­gree of im­pair­ment. There will be many, many drivers who have been fined for driving with more than 250 mi­cro­grams of al­co­hol per litre of breath who were not in the least im­paired.

The fact seems to be that those whose abil­ity to drive safely is re­duced by the con­sump­tion of il­licit drugs, cannabis in­cluded, are on our roads in sig­nif­i­cant num­bers. Greater num­bers, per­haps, than those who are im­paired by al­co­hol. Yet ac­cord­ing to Si­mon Bridges, only 200 peo­ple were pros­e­cuted for drug driving in this coun­try in 2017, com­pared with 16,000 drink driving pros­e­cu­tions.

A lot more work needs to be done be­fore we get close to vot­ing on the le­gal­i­sa­tion of cannabis. At the very least we must have an ac­cu­rate, af­ford­able means of de­tect­ing those who drive un­der the in­flu­ence of drugs other than al­co­hol.

We must get be­yond the fix­a­tion with drink driving (which, ac­cord­ing to the Min­istry of Trans­port was not in­volved in 82 per cent of fa­tal crashes in 2017). Al­co­hol ac­tu­ally seems to be a rel­a­tively mi­nor player in death on our roads.

If those who frame next year’s ref­er­en­dum wish to con­sider the wider ram­i­fi­ca­tions of le­gal­i­sa­tion, as they surely will, they might look to Colorado, re­search there show­ing that while le­gal­i­sa­tion of cannabis led to a de­cline in hos­pi­tal­i­sa­tions for chronic pain, there was a 10 per cent in­crease in road ac­ci­dents and a 5 per cent in­crease in al­co­hol abuse and over­doses that re­sulted in in­jury or death. There was a 2 per cent in­crease in over­all hospi­tal ad­mis­sions.

Ms Gen­ter, in par­tic­u­lar, needs to con­sider that, along with her stated aim of re­duc­ing the road toll to zero. A 10 per cent in­crease in road crashes here would in­evitably in­crease the road toll, and no level of en­force­ment will change that.

The im­me­di­ate pri­or­ity though is to en­sure that the is­sues of medic­i­nal cannabis and recre­ational use of cannabis do not be­come con­fused, be­fore any­one goes any­where near a polling booth.

"A lot more work needs to be done be­fore we get close to vot­ing on the le­gal­i­sa­tion of cannabis. "

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