THE STASH THAT HEALS

A Select Committee Will Investigate Marijuana Decriminalisation, But The
Herb's Therapeutic Potential Isn't On The Agenda

Life comes in pills. Greg Soar swallows 98 each week, a powdery,
foul-tasting cocktail that represents his best hope of slowing the virus
that is replicating inside him and staving off the onset of full-blown
Aids, perhaps for several more years. Unfortunately for Soar, the pills
produce extremely unpleasant side-effects. Worse still, the one substance
that offers some relief - easily administered, effective relief - could put
him behind bars.

Those pills. "They make me sick with severe nausea; I can't sleep, I get
uptight, anxious; I can't eat and so I get diarrhoea from taking the pills
on an empty stomach." He was offered heavy tranquilisers - more pills - he
was given anti-nausea medication. Been there, got addicted. Not so with
cannabis. "Two puffs on a joint or a couple of tokes on a vapouriser and
it's instant nausea relief. It's gone."

Soar's GP is happy to oversee his use of the herb. "We've nothing better to
offer him," concedes Dr Arvind Ranvhhod. "It's a shame that Greg has to
break the law to help himself and it's a shame that he has to pay an
artificially inflated price for it. Because of his limited means he's not
guaranteed a regular supply of the medication."

Soar's friends help out; he buys as often as he can afford to. If worse
comes to worse, he could always risk prosecution and grow his own. But
there is a better option. Under the Misuse of Drugs Act, Soar can apply to
the Minister of Health, Annette King, for an exemption. Twice he has
written, backed up by a second GP and a specialist in infectious diseases,
asking the government to supply him with what he considers to his "best
medicine", or failing that for permission to grow six female marijuana
plants, or at least for the threat of arrest and imprisonment to be lifted.
Two replies from King, same response: in the absence of clinical evidence
that cannabis is safe and effective, she will not be granting any dispensation.

King says she has received four applications to use marijuana
therapeutically, all declined. One of those is from tetraplegic Danuiel
Clark, jailed for 21 days in 1999 for cannabis cultivation, and this month
facing a charge of possession for personal use. Soar, who is likely to
protest with a group of supporters at Clark's trial, asks the obvious:
what's the point of a power to exempt if it's never exercised? "The fact
that we're not allowed to use cannabis when everyone is using it for social
reasons is completely obscene to me. Prohibition is causing more harms than
people realise."

An empty gesture? King defines her powers narrowly: she is able to approve
a doctor to prescribe a drug from the category to which cannabis belongs.
She argues that none of the applications she has received, including
Soar's, has met the necessary "clinical criteria" - although she is unable
to define those particular hurdles. Her strongest objection is apparently
reserved for the likely form of delivery. "People have asked me to [let
them] smoke cannabis. One of the problems with smoking is that you don't
know what your dosage is. It's also bad for your health."

The line leaves NORML's Chris Fowlie aghast. "For someone to say we can't
have a medicine that involves smoking, and that that outweighs your quality
of life is pretty narrow-minded." Fowlie argues that in the absence of a
non-smoking device that would deliver cannabinoids to the lungs - far more
efficient at metabolising THC than the stomach - smoking is actually the
best way of regulating a dose, better, for example, than Marinol, a pill
form of THC available overseas.

King's attention is on the bigger policy picture, and particularly a couple
of overseas clinical trials into the possible therapeutic uses of cannabis
derivatives - "that's of more interest to me than some exemptions."
Possible scenarios? "If you're talking about marijuana being used for
medicinal purposes, then you're talking about it being put in the same
regime as morphine, or whatever: registered, prescribed and managed by
people trained in these matters. It would be done in the same way that we'd
register any medicine in New Zealand."

In other words, we're talking tinctures, capsules, pills - the
pharmaceutical route. In essence, then, Soar and others are left waiting on
those overseas clinical trials and on a kindling of interest among drug
companies, traditionally wary of cannabis's illegal status and the fact
that the raw product itself can't be patented. Most likely, they are
waiting on researchers to find a means to separate the buzz from the source
of the therapeutic effect - to remove the stoner's high from the argument.

Green Party MP Nandor Tanczos believes King is "hiding behind" the
wait-and-see argument. "We don't need to synthesise a pill and buy it off
some pharmaceutical company for millions of dollars and then have a doctor
prescribe it. We just really need some recognition that these people
shouldn't be arrested for growing their own medicine and using it."

King seems unlikely to allow a doctor to prescribe cannabis unless as part
of a "properly conducted" trial. Okay, says Ranvhhod: "Greg would be more
than happy to be a guinea pig if that's what they need!" But joking aside,
his own expert opinion should be all the "clinical evidence" required. Of
course, his patient is aware of the potential risks of smoking. "But he's
looking at the quality of his life now, not some long-term future. It
really shouldn't be such a hurdle if we think that it's his best treatment."

NORML would go a step further. "Self-medication has to be an interim step,"
says Fowlie. "Not everyone can grow their own, and those who do are at risk
of being robbed for their medicine." The future of medicinal marijuana
isn't in extraction or synthesis, but growing specific strains of the raw
plant for specific ailments, he believes. "What we'd be after would be a
proper supply of cannabis in the prescription system."

The mystery of physics: Ranvhhod hasn't a clue why cannabis seems to be the
best answer to Soar's symptoms. "Greg and I are interested in the effect,
rather than how or why it works," he says. But medical science is learning
more about the therapeutic potential of THC and the various other
cannabinoids (there are more than 60) found in the plant. Both the US
National Institute of Health and the British Medical Association have
reported that cannabinoids may be useful as analgesics, anti-emetics,
anti-spasmodics and appetite stimulants.

Even deeper in the heart of the Establishment, a select committee of the
House of Lords has itemised the conditions for which marijuana may hold
therapeutic potential, namely: HIV-related and cancer-related wasting; pain
unrelieved by conventional treatments; symptoms of neurological disorders
such as MS; nausea and vomiting in cancer patients undergoing chemo. Of
interest to Soar, a University of California study has found that patients
on HIV medication who smoke cannabis do not have their immune systems
suppressed and experience significant gains in calorie intake and weight.

There is some political movement, too. In the US, several states have
allowed the medicinal use of marijuana (butting heads with federal
authorities; at press-time the Supreme Court was to rule on the conflict).
The Spanish Catalan parliament is to consider it; and in Canada, where the
prosecution of medicinal users threatens to invalidate federal drugs laws,
the Minister of Health has authorised a number of applicants to use the plant.

The Australian example is arguably most relevant. New South Wales
authorities are considering how to implement a recommendation from the
National Drug and Alcohol Research Centre (NDARC) that seriously ill
patients be given exemption to smoke. NDARC's report recognises that the
development of synthetic cannabinoids or approved alternative methods of
delivery is at best several years away. In the meantime, it proposes,
anyone who can provide medical certification that they suffer from certain
conditions (those same illnesses recognised by the House of Lords
committee) should be allowed to grow as many as five small plants.

"Cannabis is not a first line treatment," says Professor Wayne Hall,
executive director of NDARC. "For most of these conditions there are other
forms of treatment that are likely to be much more effective. But for some
individuals who don't respond to conventional treatment it could be life
saving."

He cites chemo patients whose side-effects can get so bad that they quit
their treatment regimes. As things stand, many of these patients will be in
their 60s and 70s and unable or unwilling to access cannabis through the
black market. "I don't think any sensible, humanitarian-minded person would
want to prevent people with those conditions having access to it."

Participants in the scheme will be monitored at six monthly intervals. The
downsides? The potential harms of smoking is the only major one that he can
see. "People talk about diversion, but that's not something that one would
take seriously given how readily available the drug is now. I also think
it's pretty unlikely that it'll do much to affect attitudes towards the
recreational use of cannabis - it needn't if the government is very clear
and explains what it is doing." "And", he adds, "given that people are
likely to be doing it anyway, isn't it better that they should be doing
this under medical supervision with the opportunity to pick up on any
adverse effects?"

Yet, this side of the ditch, the Ministry continues to say no. Is this
about sending a message? Not at all, answers King. A Health select
committee is to report later this year on decriminalisation, but the herb's
therapeutic potential will not be on the agenda. "Personally, I don't want
to see it mixed up in that wider debate about marijuana. I would have
thought people who seriously consider it a good medicine wouldn't want it
mixed up in there, either."

Fowlie doesn't see how the two can be divorced. "Admitting that cannabis
has therapeutic effects [undermines] the whole justification for
prohibition. They believe it will open the door and that's a valid fear,
because it will. This is a prime example of prohibition causing a huge
amount of unnecessary harm."

NORML is spoiling for a fight. To date, courts in New Zealand haven't
accepted the defence of possession for medicinal purposes. But British
juries have acquitted, and Canadian courts have ruled that prohibition,
overly broad in its application, goes against the individual's right to the
best possible medicine. Fowlie, who argues that New Zealand drugs law was
only ever aimed at stamping out recreational abuse not medicinal use,
believes that such a legal attack might be mounted here. "Human rights
legislation guarantees access to the best possible treatment," he says.

Alternatively, the next time Soar is knocked back, someone with a flush
wallet might want to fund a writ for judicial review. The next visiting
cannabis-friendly billionaire, perhaps?