A PRESCRIPTION FOR CANNABIS (WITHOUT CHANGING THE LAW)

Here is a plan, writes WAYNE HALL, that would spare AIDS and cancer patients
pain without them having to resort to the black market.

The Working Party on the Medical Uses of Cannabis was asked to advise the
Premier on the possible medical uses of cannabis and cannabinoid drugs. At
the Premier's request, we examined ways in which cannabis or cannabinoids
could be legally used for medical purposes without decriminalising
recreational cannabis use.

We reviewed the scientific evidence on the safety and efficacy of the
medical uses of the crude cannabis plant (which is usually smoked) and of
cannabinoid drugs. These are pharmaceutically pure forms of substances that
are found in the cannabis plant, such as tetrahydrocannabinol (THC), the
active ingredient of cannabis, or they are drugs that act on the same sites
in the brain as THC.

We agreed with the British House of Lords and the United States Institute of
Medicine that THC is useful in treating AIDS- and cancer-related wasting and
the nausea caused by cancer chemotherapy. We noted the suggestive evidence
that THC may be useful in treating muscle spasm in some neurological
disorders and in relieving pain that has not responded to conventional
treatment. We recommended further research on the therapeutic use of
cannabis and cannabinoid drugs in managing these conditions.

Our conclusion was that smoked cannabis is unlikely ever to be prescribed in
Australia because a smoked plant product will not satisfy the requirements
for registration as a "therapeutic good". Registration is required if
cannabis is to be medically prescribed. This means that any prescribed
cannabis derivatives will need to be natural or synthetic drugs derived from
THC or other cannabinoids.

No cannabinoid drugs are registered in Australia. THC (marketed as Marinol)
is registered in the US and a synthetic drug, naboline, is registered in
Britain. Both are taken orally but because they are not well absorbed they
are not widely used for medical purposes in Britain or the US. These drugs
could be registered for medical use in Australia but only if a
pharmaceutical company applies to have them registered. None has so far
applied.

In the longer term, the best prospect for medical use of cannabis lies in
the development and registration of new synthetic drugs or better ways of
administering THC that do not involve smoking a crude plant product. In the
meantime, there are patients with AIDS and cancer who are smoking cannabis
for medical purposes. Under existing law, these patients risk criminal
prosecution if they are detected by the police.

The working party's view was that the Government should not compound the
predicament of these seriously ill patients by prosecuting them for using
cannabis. It accordingly recommended that these patients be given a limited
exemption from criminal prosecution for using cannabis. The exemption would
be restricted to people who suffered from a specified set of medical
conditions which evidence suggests may benefit from the use of THC. It would
be an interim measure until pharmaceutical cannabinoids become available and
its effects would be evaluated after a two-year trial.

The exemption would be restricted to patients who had been certified by a
medical practitioner to be suffering from one of a list of medical
conditions. These would be: AIDS- and cancer-related wasting, nausea for
cancer chemotherapy, muscle spasm in neurological disorders and pain
unrelieved by conventional treatments. Certification would have to be
obtained from an approved medical practitioner before medical use. The
practitioner would counsel the patient about the risks of smoking cannabis
and review their health regularly. The patient would have to renew the
certificate after six months.

To avoid these patients having to get their cannabis from the black market,
we recommended that they be allowed to grow a small number of cannabis
plants for their own use. In the case of seriously ill and debilitated
patients, a carer would be allowed to grow the same small amount of cannabis
on behalf of the certified patient.

The working party's report aims to balance the needs of these patients with
community concern about recreational cannabis use by young people. In the
long run, these patients should be able to use pharmaceutical drugs derived
from cannabis, thereby obviating the need to smoke a crude plant product. In
the interim, we believe these recommendations provide the best way to allow
patients to use cannabis for medical reasons without changing the existing
legal prohibition.