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Legislative Council - Fifty-First Parliament, Third Session (51-3)
2008-11-26 Daily Xml
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CONTROLLED SUBSTANCES (PALLIATIVE USE OF CANNABIS) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 13 November 2008. Page 763.)

The Hon. B.V. FINNIGAN (00:56): I am aware that there are historical uses of cannabis for medical purposes and claims that cannabis is effective for the alleviation of a wide range of medical conditions.

Members interjecting:

The Hon. B.V. FINNIGAN: In response to the interjections opposite, I am quite happy to say that I have never partaken of the substance at all. It is one thing that I cannot be accused of.

In fact, the range of medical conditions for which cannabis is claimed to be effective is so wide that requests to allow therapeutic use frequently look like requests for legalisation. What is needed is a clear separation of therapeutic and social use. While the bill put forward by the Hon. Ms Kanck goes some way towards addressing this, it does not go far enough in applying the standards that are required for the licensing of any therapeutic product. Those standards include examining the research evidence of therapeutic effectiveness and determining whether there are medical conditions where the therapeutic benefits of cannabis outweigh the risks of cannabis use.

Several reviews of medicinal use of cannabis have been undertaken over the last 10 years; however, to date, this research has only determined that there is sufficient evidence of potential therapeutic benefit to justify further research being undertaken. The research evidence for therapeutic efficacy of cannabis remains limited, and claims of efficacy are often based on opinion and anecdote not controlled studies. There has also been very little research which has compared cannabis or cannabis products with the current best conventional medical therapies for particular conditions.

If the government was to support any arrangement to allow cannabis to be used for therapeutic purposes, there would need to be solid research evidence and medical opinion that shows cannabis is the most effective treatment for a particular condition and all other conventional therapies were considered unsatisfactory.

SA Health has advised that there are some conditions where it is thought cannabis may be an effective treatment, such as neurological and movement disorders, nausea associated with chemotherapy in cancer patients, and neuropathic pain. However, I again stress that there is no medical evidence to support any claims that this treatment is more effective than all other conventional therapies. The government would require advice and support from medical bodies such as the Australian Medical Association, the Royal Australasian College of Physicians and the Royal Australian College of General Practitioners before it could consider palliative use of cannabis.

The bill before us also proposes to exempt individuals holding a valid certificate from fines relating to personal use of cannabis. However, there would still be significant issues relating to obtaining supplies of cannabis that have not been addressed. The bill proposes that cultivation of cannabis for personal use and the sale of equipment for cultivation of cannabis would be exempt from fines under the certificate arrangements.

In South Australia, any cultivation or purchase of cannabis is illegal, and this bill does not seek to change this. This means that any possession of cannabis for therapeutic use could not be separated from illicit markets, which would create significant confusion over the legalities of the use and supply. Those patients charged with possession could present their case in court, but there is no defined criteria for courts to decide these cases.

I am aware that there are some therapeutic cannabis products available overseas, such as Sativex, which is an extract of cannabis that is administered as an oral spray and absorbed in the mouth. Sativex is approved in Canada and is being investigated in Europe, the United States and New Zealand for symptomatic relief of neuropathic pain in multiple sclerosis and for adjunct pain relief in patients with advanced cancer who experience moderate to severe pain. However, these products can be registered for medical use in Australia only if a pharmaceutical company applies for registration in this country. My understanding is that, so far, no company has applied.

The government is not prepared to support this bill. There is no clear definition of what medical conditions would be eligible for therapeutic use of cannabis, and there is no definitive medical research to support the use of cannabis as being more effective than other available treatments.

The Hon. J.M.A. LENSINK (01:00): This bill, which was introduced by my colleague the Hon. Sandra Kanck, proposes that fines be waived for the personal cultivation and use of marijuana for people suffering designated medical conditions on the proviso that a medical practitioner has signed a palliative cannabis certificate to indicate that that person is suffering from a specified illness or disease.

I note that the use of cannabis for medical or any other purpose is currently prohibited in all Australian states and territories. There are a number of harmful effects of cannabis use, which are becoming much better understood as the research record continues, and these include effects on memory, learning and cognitive processes, short-term cardiovascular effects, long-term risks of bronchial disease and cancers, links to psychotic conditions in vulnerable individuals, drug dependency and impacts on the immune and reproductive systems.

There have been a number of reports released on the topic of palliative cannabis use in recent years and, of the two most cited in the literature, one was produced by the US Institute of Medicine, (IOM), and another by the House of Lords Select Committee on Science and Technology (SCOST). Both of these reports found that cannabinoids, which are the reactive chemicals in cannabis, have potential for use with certain medical conditions and that there is a need for further research on the clinical uses of crude cannabis plant products and cannabinoid compounds.

One of the reports, at least, also recommended that, while the results of research are awaited, cannabis should be made available on compassionate grounds to patients with a limited range of life-threatening and chronic health conditions such as HIV-related wasting, nausea caused by chemotherapy, neurological conditions and pain which is unrelieved by conventional analgesics. There has also been a report convened by the New South Wales government in 2001 which was largely in agreement with the other research projects to which I have referred.

The most serious problems associated with the palliative use of cannabis are caused by smoking, although the impacts of smoking occur on a medium to long-term basis so that if somebody has a terminal illness, that is probably not their chief concern. Locally, at least, a report was prepared by Drug and Alcohol Services (DASSA) in 1998 which concluded that the greatest potential for medical use of cannabis is as an appetite stimulant, in management of neuropathic pain and for quick relief of nausea associated with some cancer chemotherapy treatments.

I have received correspondence from various individuals on this issue urging us to support their use of cannabis as the only means by which their symptoms can be relieved. However, I think that we do need to be led by the evidence and there clearly is not enough evidence at this stage that would ensure that the negative impacts of cannabis are not promulgated on the rest of our community, because there are very serious impacts indeed.

I am sure that I will get a reaction from the honourable mover of this bill when I state that when things are legal it sends a very clear message to the community as to its use. I would just like to back this up with an example in relation to alcohol consumption. I think young people understand very clearly that, because it is illegal to drink-drive—apart from the odd offender, who is very much in the minority—they just do not do that these days, whereas clearly a number of them drink to excess and get into other sorts of problems because there is no prevention of drinking to excess most of the time, unless it is on licensed premises where responsible alcohol service can monitor their behaviour.

We do need to be led by the medical fraternity on these issues, and the AMA in particular supports further research. However, I think that as a parliament we are unable to move on this issue until the research community has got some firmer evidence. On that basis, the Liberal Party will not be supporting this bill.

The Hon. D.G.E. HOOD (01:05): I rise briefly given the hour to indicate that Family First will not support this bill, and I am sure that comes as no surprise to members. This bill—

The Hon. J.M.A. Lensink interjecting:

The Hon. D.G.E. HOOD: Yes, absolute shock. This bill seeks to legalise the use and cultivation of cannabis if a doctor so approves. I am certainly sympathetic to people dealing with long-term chronic pain. In fact, some members might know that I live with chronic back pain and, at times, it is very debilitating. It is something I have lived with virtually my whole life—certainly my whole adult life. It would therefore be unfair to say that I am unsympathetic to people suffering significant chronic pain. However, in the same breath I will not let my suffering be used for the legalisation of dangerous illicit drugs. In my own case I use prescribed drugs each day. I take a substantial dose these days but, by and large, they are able to treat the problem adequately, and one soldiers on.

Some terrific new drugs can be used in the place of cannabis for a number of conditions, particularly in the area of antiemetics. Some very impressive new drugs have been launched, particularly one called ondansatron, which members may have heard of and which has been a real breakthrough in the field of intractable vomiting and the like. The medical profession seems to find a way to use prescription drugs that, in many cases, are adequate—in some cases they are barely adequate but in many cases they are more than adequate.

We used to call cannabis a so-called 'party drug' or 'recreational drug'. In the 1980s South Australian cannabis legislation was relaxed on the assumption that marijuana was mostly harmless, or so many people thought; and, to some extent, other states followed our legislation. In fact, we decriminalised the cultivation of up to 10 cannabis plants for personal use—10 plants, Mr President. Now we are facing up to the consequences of that lax approach with a mental health epidemic and, indeed, in other areas.

Cannabis is not a harmless party drug; we know that now. The assumption was wrong, and it is now having a dangerous impact on our community. I wonder what sort of warning labels would be proposed should this bill pass. One warning label might be 'Use may shrink the brain'; another might be 'Product may cause serious mental health issues'; and perhaps another warning label could be 'Use may trigger psychotic episodes'. All these hypothetical warning labels are headlines that respected medical journals have actually used with respect to cannabis use. They have also been quoted in the lay press. In fact, the Daily Mail stated:

Even a small amount of cannabis triggers psychotic episodes, warns doctors.

The Advertiser had the headline 'Dope risk to mental health', and a specific quote from the Channel 9 News is that 'heavy marijuana use shrinks brain parts'. Many experts are now convinced that cannabis causes not only psychotic illnesses, such as schizophrenia, but also depression and anxiety disorders, particularly when smoked by young people. A recent five-year review of the histories of mentally-ill patients in New South Wales found that four out of five had smoked marijuana regularly in adolescence. Dr Andrew Campbell of the New South Wales Mental Health Review Tribunal is on the record as saying 'the psych wards are full of these people'. Of course, he was referring to people who used cannabis when they were young.

The bill allows that, if people want to smoke cannabis, they can go to the doctor to get a 'palliative cannabis certificate', which would say that you were suffering from some condition which could be treated by smoking cannabis. If you are carrying one of these certificates, then you cannot be fined for cultivating or using the drug. Family First objects to this. A government that is serious about the health of its citizens should not be giving tacit approval to the use of a dangerous drug posing serious physical and mental health problems potentially—and cannabis fits squarely in that category.

When legislators overseas have allowed medicinal use of marijuana, the results have been less than optimal, and that is the saying the least. Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon and Washington in the US are all prime examples. In those states, cannabis addicts constantly abuse the medical use loophole. Apparently, people without genuine medical problems find it easy to get prescriptions for cannabis nonetheless, and there are doctors who are more than willing to issue these consent forms inappropriately.

Medical use provisions provide a foothold for an easy and plentiful cannabis supply to the community. Indeed, in California, drug dealers operated with impunity, opening up so-called 'legitimate' cannabis dispensaries in family neighbourhoods. The news reports talk about 'multiplying problems and thefts, landlord complaints, distribution to minors and non-patients and the public odour of marijuana', but, despite this, the authorities were not able to do anything.

I refer to a court case in the US, Gonzales v Raich. When it was handed down, this US Supreme Court decision authorised the federal government to launch a crackdown and, out of necessity, the drug enforcement agency started shutting down the cannabis suppliers. There we have a situation where in the US they have gone down that path and then retreated at a rapid rate. From the San Francisco Chronicle:

Luke Scarmazzo and Richard Montes were convicted by a federal jury in Fresno on Thursday. Federal officials say that the case sends a message to marijuana growers and dealers who believe they are shielded from prosecution under the California law legalising medical marijuana use. Scarmazzo and Montes made millions by exploiting and hiding behind California's medical marijuana law.

If we pass this law, then we run exactly that same risk. It is a disaster in California and we do not need to recreate the US nightmare here. Having said that, if the Therapeutic Goods Administration suggested that there may be some value in these sorts of therapies, then, in that case, Family First would have a somewhat more open mind to these sorts of measures. At the moment, of course, they do not. For that reason, Family First will not support this bill. It poses many more risks than benefits, and for that reason we will not support the bill.

The Hon. M. PARNELL (1:13): I do not intend to speak for long as I think I am the last speaker for tonight. The Greens will be supporting this bill as it is a part of our policy platform. Our platform states that we will work towards the introduction of 'the regulated use of cannabis for specified medical purposes such as intractable pain'. Tonight I do not intend to prosecute the detailed case for this measure. I think that the Hon. Sandra Kanck has done a good job outlining the reasons why this measure is justified. There is a significant body of credible scientific evidence and strong support from organisations such as the Cancer Council of New South Wales in favour of such a compassionate response.

However, I do want to respond briefly to the comments that were made by the Hon. Ann Bressington in her second reading contribution to this bill. In her contribution she made a number of assertions that misrepresent what the Greens stand for. Only this afternoon, the Hon. Ann Bressington made a plea for mutual respect for differing points of view in the drug debate, and she reassured us that her contributions to this debate were based on sound evidence.

I certainly hope that her call for mutual respect is indeed genuine, because part of that respect is not to misrepresent those who hold different views. It was a shame that the sound evidence on which the Hon. Ann Bressington prides herself did not extend to researching the Greens' policy on drugs, because if she did, she would have discovered the following first four principles of the Greens' drugs policy, which is headed 'Drugs, substance abuse and addiction'. The No. 1 principle of the Greens' policy is: the Australian Greens do not support the legalisation of currently illegal drugs. It might be inconvenient for members who like to attack the Greens on what they think its policies are, but I cannot state it any clearer than that.

The Hon. R.I. Lucas interjecting:

The Hon. M. PARNELL: The honourable member asks: how long? I do not know the exact date, but it is at least the past couple of years. Principle No. 2: the Australian Greens believe that a harm minimisation approach is the best way to reduce the negative effects of drug use and drug rehabilitation. Principle No. 3: the Australian Greens believe that harm minimisation policies and programs are those directed towards reducing the adverse health, social and economic consequences of drug use to the individual user and the community. Principle No. 4: the Australian Greens believe that the use of illegal and legal drugs, including alcohol and tobacco, and some regulatory approaches, can have a wide range of adverse health, social and economic effects.

I put that on the record because it is inconvenient for some members who like to have a view about what they think others stand for but, if we are going to have a sensible debate on issues such as drugs, my call is for all members to actually be honest in their approach and to look at the policies and positions of parties and not to misrepresent them. What I have just outlined is the Greens' policy, it is what we believe and I do not think that it could be stated any more clearly. We do not, as the Hon. Ann Bressington falsely asserted in her second reading contribution, believe in the decriminalisation of methamphetamines and cocaine. That is not our policy.

Debate adjourned on motion of Hon. J. Gazzola.

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