Two paths to cannabis reform

The nation's politicians are about to debate two different types of cannabis reform. Thomas Coughlan explains where they both sit on the reform spectrum and details their pros and cons.

After 10 years of waiting, politicians wanting cannabis reform suddenly have two options in front of them in one week.

The Government’s bill, introduced by Health Minister David Clark, would amend the Misuse of Drugs Act to allow the use of cannabis-based products and provide a defence for terminally ill patients charged with using them. It was introduced last year and debated for the first time on Tuesday.

An alternative bill, introduced last year by the Greens’ Julie Anne Genter and picked up by Chloe Swarbrick after the election would also seek to amend the Misuse of Drugs Act. It would allow anyone with a prescription from a doctor to use cannabinoids, including those they grow themselves — a detail that has caused controversy from the bill’s detractors. It is set to be debated on Wednesday.

While the Government’s bill, with the support of all three governing parties and National, is expected to go to select committee, the fate of Swarbrick’s bill is less certain. The Green party will support the bill and Labour and New Zealand First have signalled they will allow MPs a conscience vote. Key figures in the Government, including Prime Minister Jacinda Ardern, have indicated they would support it, at least to committee stage. However, Swarbrick will have to rely on some National votes for the bill to pass its first reading.

Opposition Leader Bill English said the National Party would oppose the bill in general, but a “small number” of MPs would, unusually, be allowed to vote for it at the first reading.

Swarbrick is keen to play up the differences between the two bills.

“What the government's bill does is sets up a defence for those with a terminal illness. That means those people would still have to get an illicit supply," she said.

Currently only 70 people have been able to get approval to use medicinal cannabis under the current structures, she said.

'Eventually they'll morph together'

The Government’s bill will also mandate a review to take place in two years after the law commences to test its effectiveness and recommend further changes. That could mean the cannabis regime in put in place by the Government ends up being similar to what Swarbrick proposes within a few years.

Her bill will not restrict the use of medical cannabis to the terminally ill, paving the way for those suffering from Multiple Sclerosis and other chronic illnesses to treat themselves with medical cannabis.

Another distinction is that Swarbrick’s bill will allow patients (or an immediate relative or person nominated by the patient), with a doctor’s permission, to grow cannabis to treat themselves. This has lead the bill to be derided by detractors like Family First as a “grow-your-own-dope bill”.

Swarbrick insists that this is an essential provision. The cost of currently available products like Sativex is around $1,200 a month for a prescription, patients growing their own would be far cheaper.

Some within the medical field have cast doubt on the usefulness and safety of medical cannabis, particularly the concern that legalisation for medicinal purposes could lead to specious claims by patients keen to use cannabis for recreational purposes, leading to legalisation in all but name. This has has happened in some US states like California, where medicinal cannabis has been legal in some form since 1996.

Dr Giles Newton-Howes, a senior lecturer of the University of Otago, said the possibility of a medicinal cannabis regime abetting widespread recreational use was a “significant problem” and questions the suitability of current cannabis products as medicine.

Cannabis plants possess “a massive variety of psychoactive substances," many of which are not suitable as medication. As a plant, with different strains grown in different conditions, it is unlike other medications.

'Would you grow your own aspirin?'

Indeed, cannabis contains over 400 distinct compounds, including 100 different phyto-cannabinoid compounds.

“We need to be sure what they’re getting. I cannot see how you would grow your own for a medicine," he said.

“If I prescribe aspirin, I know what I’m prescribing." By allowing people to grow their own cannabis, doctors would effectively be telling patients to “go out, find some willow bark and make [their] own aspirin."

That said, there is the prospect of new strains of medical-grade cannabis becoming available in the future.

"It is highly likely a whole dried cannabis plant will reach a sufficient level of consistency to gain Medsafe approval," Dr Newton-Howes said.

“If I prescribe aspirin, I know what I’m prescribing." By allowing people to grow their own cannabis, doctors would effectively be telling patients to “go out, find some willow bark and make [their] own aspirin."

Both of these bills apply to current strains of cannabis, which would continue to be illegal for recreational use.

All of this makes it very difficult to distinguish debate and legislation for medicinal cannabis, from the wider debate on decriminalising the drug completely. Indeed, medicinal cannabis users themselves conflate the medication with recreation. A US study in 2016 showed that 86% of those reporting medicinal use also use cannabis recreationally.

Swarbrick thinks it is possible to partition the debate between medical and recreational cannabis, though the Green party supports both.

“It is really crucial that we don’t conflate the issues of recreational and medicinal use,” she said.

“California is used as an example of where not to go”, she says, “We should be looking more towards the model of Canada”. She said that she will be waiting until the bill’s select committee to come back with recommendations with how to ensure New Zealand’s regime preserves the distinction between medication and recreation.

“It is really crucial that we don’t conflate the issues of recreational and medicinal use,” she said.

A slippery slope to widespread abuse?

Ross Bell, the executive director of the New Zealand Drug Foundation said that his organisation had lobbied for both bills to proceed to select committee, though he preferred Swarbrick’s.

He disputed the idea that the bills would lead to a “slippery slope” and widespread abuse.

“The Government bill is similar to regimes in Canada and the Netherlands that have set up bodies within health ministries to oversee the regulation of cannabis prescription and growing."

Cannabis reform has long been Green policy and an early victory, even in the form of a non-Governmental member’s bill, would be a political victory for the party early into its first ever term in government.

“Last time a bill like this was before Parliament was in 2009 in the name of Metiria Turei, and we can’t wait another ten years."

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