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Cannabis could cut opioid abuse off at the knees

Medicinal cannabis and its compounds show great potential to stem New Zealand’s opioid use in three important ways, writes Shane Te Pou 

Recently I have been travelling through the US and have had several alarming discussions with ordinary folks about the opioid epidemic shaking middle-class America into action. 

As our Government moves towards legislation that will make medical cannabis more widely accessible, these discussions have me thinking - What can New Zealand learn from America’s deadly opioid-based painkiller epidemic?

Described as the worst self-inflicted epidemic in America’s history, opioid overdoses claimed 63,600 lives in 2017. This horrible trend has even driven a decline in the country’s life expectancy, for the second year in a row.

Sadly, New Zealand has been slow to learn lessons from abroad. Fentanyl, morphine, codeine. You’ve heard the names. These are opioid-based pain medications, often prescribed here. Strong opioid use remains on the increase across our country, while opioid-related deaths continue to rise, up 33 percent between 2001 to 2012.

Actually opioid-related are underreported as there is currently no central agency that definitively captures this information .

Fortunately, we have an opportunity to reduce the harm of these painkillers in New Zealand.

As consumer attitudes are increasingly moving towards natural therapeutics, medicinal cannabis has emerged at the forefront of change. The evidence has become clear that cannabis will have an important role to play in reducing our reliance on traditional prescription painkillers.

The most common reason that people seek out medicinal cannabis is for chronic pain. That’s because cannabis is extremely good at treating it. According to a US report by the National Academies of Sciences, Engineering, and Medicine (NASEM), there is now conclusive or substantial evidence (enough to make a firm conclusion) that cannabis can be an effective treatment for chronic pain.

Further research supported by the National Institute of Drug Abuse, conducted "the most detailed examination of medical cannabis and opioid deaths to date" and found something few initially expected; an approximately 20 percent decline in opioid overdose deaths between 1999 and 2010 in states with legalised medicinal cannabis.

As sure as day follows night an increase in opioid-related deaths will have disproportional impact on Māori and Pacific people. 

Medicinal cannabis and its compounds show great potential to stem New Zealand’s opioid use in three important ways. Cannabis can help treat pain, reducing the need for opioid painkillers from the outset. Cannabis is also effective at easing opioid withdrawal symptoms, much like it does for cancer patients suffering the side effects of chemotherapy. Finally, and perhaps most importantly, the compounds found in cannabis can heal the diseased addict's brain, helping them break the cycle of addiction.

There is no other known substance that can accomplish all this. If we had to start from scratch and design a medicine to help lead us out of the opioid epidemic, it would likely look very much like cannabis. This is important for New Zealand because it has implications for how we treat pain and how we assess the enormous value of having locally-produced, affordable medicinal cannabis.

Fortunately, New Zealand already has two companies gearing up to cultivate and produce medicinal cannabis products. One is Hikurangi Hemp, a small group in Ruatoria with an industrial hemp farm business, and the other is high-tech start-up, Helius Therapeutics.

Helius is a particularly exciting company that may just hold the key to affordable, high quality medical-grade cannabis in New Zealand.

The Hon. Dr David Clark has said the intent of the Misuse of Drugs (Medicial Cannabis) Amendment Bill is to “give more people the choice to access medicinal cannabis should they wish to”.

However, for these products to be accessible, it will be essential that government does not legislate who can and cannot benefit from cannabis-based products. Health practitioners are indeed best placed to decide whether a person would benefit from medicinal cannabis, so there should be no government-level restriction based on specific qualifying ailments. With cannabis now legalised in many developed countries, the industry is moving at pace. Like the wider nutraceuticals sector, new products and strains are continually being developed for an array of ailments. Someone living with HIV, osteoporosis, muscular dystrophy or chronic pain deserves the same right to access medicinal cannabis as someone suffering from cancer.

It is my hope that Pacific and Māori MPs can cast aside their traditionally conservative stance on such issues and vote to support this Bill. As sure as day follows night an increase in opioid-related deaths will have disproportional impact on Māori and Pacific people. Also my relations who have been participating in the green economy for decades now may be able to put their experience to use legitimately. 

Making medicinal cannabis available should come with certain obligations and mandates, like with any other medicine. It should be well-regulated to ensure it’s safe, consistent, effective and free of contamination. So let’s put patients before politics. Let’s stem the use of dangerous opioids. And let’s ensure medicinal cannabis is accessible through doctors, to every person it can benefit.

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