DOPE TEST - HOW POLITICS AND PREJUDICE ARE BLOCKING MEDICAL MARIJUANA

Patients Swear By It, Doctors And Experts Support It, But Medicinal
Marijuana Is Still Held Up In A Maze Of Politics, Prejudice And Paranoia.
Will New Zealand Politicians Have The Courage To Follow Overseas Examples
And Legalise It?

Before Bas got busted he had been using morphine. He was living like a
zombie, people would come up and talk to him and he wouldn't know what they
were saying. He would fall asleep in the middle of a conversation and wake
up five minutes later, unaware he'd been out. But when the cops came around
they weren't interested in all that. All they wanted was the marijuana
plants. The morphine was perfectly ok. The difference was that a doctor
prescribed the morphine. The marijuana had been prescribed too, in a way,
but the law doesn't recognise that kind of advice.

Ten years before Bas wouldn't have had much time for the stuff, he liked a
bevy, he could drink and stay up all night, the weed just put him to sleep.
But one day after work in late 1993 a car turned in front of his motorbike.
He went in through the passenger window and out again through the back
window. He woke up two weeks later. The nerves in his spine had been ripped
out; his left leg, left arm and penis were badly affected. He made several
more visits to hospital and in early 1995 they took his arm off. His wife
left him.

The legal drugs weren't doing much for him, they tried Codeine, Kapanol,
Tramadol, Methadone and Severadol, he had stomach cramps, an eruption of
pus out of his face and body and he was sick all the time. He could not go
to the loo when he wanted to. Very quietly a doctor suggested he try
marijuana, he did and he found that it made his life easier and helped him
relax. He still got the pain, but it didn't seem as bad, it certainly took
the edge off. When they came and took the marijuana away things got worse
for a while. He was in a lot of pain without it. He told the court what had
happened, even got a pain specialist to come in and give evidence for him.
In the end he got ten months, with an 18-month suspension. These days he
buys from his friends, its expensive and he has trouble affording it. He's
on ACC now, he used to be a butcher but it is hard to break up the meat
with one arm. He tries not to smoke it but the pain will get too bad. So he
smokes until he feels better. So far the cops haven't been back.

Bas is not alone with his problem. Several people with serious illnesses or
injuries claim marijuana uniquely helps them deal with pain and side
effects of other medication. Some have been jailed for growing their own
remedy, others are waiting for the knock on the door that will mean prison
or a police record and a return of the pain and nausea that they say
marijuana alleviates. Others pay black market prices from their sickness
benefits for the only thing they say makes them feel well.

One day soon things may change. Health select committee head Labour's
Stephanie (Steve) Chadwick has said publicly that medicinal cannabis can be
effective in relieving chronic pain in some situations. And would be
registered as a medicine. She also said she was confident the rest of the
health select committee supported her. The official select committee's
report is rumored to be due out within a month. Chadwick has not been able
to answer questions put by the Listener over a three-week period, despite
repeated emails and phone calls and promises. The reason remains unclear.

One person who will comment is Dr Lynda Scott, National Party spokesperson
on health, and a member of Chadwick's select committee. She says marijuana
does have some active medicinal properties, but whether those medicinal
properties are better than anything else on the market already has not been
proven. If they are she doesn't see too many problems releasing marijuana
as a drug for sick people. "When you look at opium and morphine for
instance, it is not legal to smoke opium but it is legal to control pain
with morphine in medicinal use. It is highly regulated but can be used by
the medical profession to relieve pain. But with medicinal use (of
cannabis) you have to make sure there aren't negative side effects that
outweigh the benefits."

In fact there exists already the possibility for medical use under the law.
Health Minister Annette King can personally authorise the use of cannabis
on an individual basis if she sees fit. She has received applications but
has never given her permission. King, Scott and everyone else involved in
the debate are waiting for the results of field trials by an obscure
British firm called GW Pharmaceuticals before they make up their minds.

GW is a 32 million pound company run by a very serious looking bunch of men
in expensive European suits. They grow thousands of marijuana plants in a
secret British location, and give it to volunteers suffering from a variety
of ailments. Reputable scientists measure the effects and the collected
results are checked by the British government.

Most people involved in the marijuana debate in New Zealand seem unaware
how far these trials have progressed. In fact GW will have their first
product, an under tongue marijuana spray to alleviate the symptoms of
Multiple Sclerosis, legally on sale in Europe before the end of this year.
It will probably be the first of many.

On May 22 they announced a partnership with pharmaceutical giant Bayer AG
to market the product throughout Europe and the world. Another marijuana
product aimed at alleviating cancer pain will be on the way shortly. Their
share price is rocketing, rising 50 percent since the beginning of March.
An ex-pat New Zealander, Dr. David Hadorn is a consultant to the company.

He is a kiwi by choice. After working for twelve years as a doctor in ER
rooms around California he spent time at the Rand institute working in
research design, health economics and statistical analysis. In New Zealand
he became the manager of special projects for the National Health
Committee, spearheading an initiative to change the way elective surgical
services were managed. He became a New Zealand citizen, and is currently
back practicing in California. He was GW's medical director for North
America but stepped down when he felt too confined in what he could say and
do in terms of marijuana generally. He says that using marijuana to treat
MS was really just going after the low-lying fruit.

"It has been known for years that cannabis has unique and remarkable powers
in that particular setting. It is not even approached by other agents. That
was one that was good to start with, because you knew it was going to work
and be dramatic and also because there is a whole population out there
suffering for want of this medication. Pain, spasticity, bladder spasms,
sleep, all are much improved in statistically significant ways based on
randomised, double blind, placebo controlled studies."

The GW spray will be a 'whole cannabis product' not an isolated part of the
drug. And yes, it will be possible to get high using it. "THC is the
psychoactive agent and it is present because it has therapeutic value,"
says Hadorn. "It is considered to be the active ingredient in cannabis when
it comes to pain, nausea, promoting appetite and anti-spasticity. But what
has been shown in the trials with in large part with middle aged or older
women - the typical MS sufferers - who have never really smoked and
wouldn't smoke, that they need such a small amount to relieve their
symptoms that they don't need to continue on taking more. So what GW are
saying, is that for most people it is not necessary to get high."

Hadorn is definitely an enthusiast for the drug. But others are not too
fond. The principal opponent of marijuana, medical or any other kind, is
usually identified as Peter Dunne, leader of the United Future party.
Dunne's family oriented party support the Labour minority government, one
price of which has been the firm promise from the Labour junta that
marijuana will not be legalised.

After Chadwick's comments Dunne was reputed to say that medical marijuana
was the 'thin end of the wedge' towards legalisation. It was taken slightly
out of context, he says. At the time GW had not reported back their
findings. "It was more in the area of the jury still being out on that
particular issue, rather than the context of it being the first step
towards legalisation."

Dunne wants to see the GW results too and is not prepared to comment before
then. "I would make this observation though, a variety of drugs are
considered illegal in common usage that are used in highly controlled
medical situations. The tests we would look at are whether you could
develop similar highly controlled situations (for medicinal cannabis), and
that is something I think we don't have an answer for at this stage."

Dunne says many of the people who are advocating for the medicinal use of
cannabis are long-time campaigners for its legal recreational use. "So that
obviously heightens our anxiety. We didn't want to see the sort of argument
that says 'lets move on the medical use and then having proved that there
is no problem with that we can move to open up its availability in a more
widespread way.'"

In fact, this is exactly what is happening in California. In November 1996,
(with the financial support of well-known legalisation advocate Peter
Lewis) the state passed proposition 215, making marijuana cigarettes legal
for medical users. Seven other states and Canada have similar laws on their
books. On recommendation from a doctor, a patient can grow marijuana or
designate others to do so for them. A huge cottage industry has grown up
which resembles Dutch 'coffee' houses; specials of the day are offered on
blackboards and different varieties of cakes and cookies and spreads are
available. A knock-off of GW's spray is already being touted around the traps.

This has opened a deep division between states and the federal authorities,
which do not recognise anyone's right to grow marijuana anywhere in the
USA. The Drug Enforcement Administration (DEA - a federal agency) has
launched raids on people commissioned by Californian authorities to grow
marijuana. California's counties have reacted with fury and lawsuits, in
one case deputising the growers. Even the blueblood New York Times took
time out to eviscerate the feds in an editorial. Hadorn says central
government has backed off for now in the face of the negative publicity. He
personally has little hesitation in writing marijuana recommendations for
the vast majority of his patients who report relief with cannabis.

"The people who I am seeing in my practice are the exact same patient
population I would see in the emergency room. They have chronic pain and
when I saw them in the ER it was because they had an exacerbation of that.
In the emergency room there was absolutely no hesitation in writing them a
prescription for narcotic containing pain medication or potent
anti-depressants where these were clinically indicated. I think a good case
could be made that if a doctor could write a narcotic or potent
psychopharmatropic drug prescription, then that is a serious enough
condition that it would be also appropriate to recommend cannabis for
appropriate patients. You are not going to hurt anyone with it just because
it is so non-toxic. You are not going to blow anyone's kidneys or liver out."

Who won't he give it to? "People who have had a bad reaction with cannabis
in the past, and schizophrenia is a big question mark." Hadorn recommends
edible forms and the use of vapourisers, which remove much of the harmful
byproducts of smoke. He started prescribing it in October, taking three
months out to be in New Zealand over the summer. He has turned down one out
of about 150 applicants (who are pre-screened by his practice nurse). Other
doctors have seen thousands of patients.

"All of my patients have already been using cannabis and wanted to get
higher quality or different preparations and also protection under the law.
Chronic pain is the number one complaint then there is a whole slew of
anxiety, depressive, anorexic, phobic type of disorders. Which you would
typically see them prescribed SSRI's (Selective Seretonin Re-uptake
Inhibitors) or other types of strong psychoactives for. There is a
smattering of AIDs patients and cancer patients and MS patients. A fair
amount of headache patients."

Californian law does imply that patients must be seriously ill. But there
is no guide as to what that constitutes exactly. The Californian medical
board has launched investigations against at least nine doctors who have
recommended cannabis, most at the instigation of police denied arrests. The
board is also trying to work out guidelines as to what is a serious
illness. This happens to be one of Hadorn's specialties, and he says with
all its physical and emotional components there will probably be no strict
definition possible as the subject is just too hard to pin down. It will
ultimately remain largely at the discretion of the individual doctor and
patient.

If it is approved here, New Zealand doctors will have the option of
recommending GW's spray for anything they see fit. It is called off-label
prescribing. Drug companies that make the drug cannot market or promote it
for any use other than what it is officially approved for. But doctors,
with great care, can use it for whatever they want. And once it is on the
market, it may find all kinds of applications, particularly for chronic
pain. Though state drug subsidiser Pharmac will probably limit their
subsidys to include only the manufacturers recommended use, making it more
expensive for any other users.

In 2002 The US General Accounting Office - an unusually reliable source on
what is happening in US, from the effectiveness of Gulf Way weapons to the
quality of school food - examined medical marijuana use in Oregon, Hawaii
and Alaska, states allowing medical use and requiring user registration.
The GAO found 2,450 people using marijuana on recommendation from a doctor.
More than seventy percent of users were over 40 and more than seventy-five
percent had come to the prescribing doctors with severe pain and conditions
associated with muscle spasms. Less than one percent of Hawaiian doctors
had recommended marijuana, about three percent of doctors in Oregon had
done the same. In Oregon, the only state that tracks such figures, 62
percent of the doctors recommending marijuana had done so just once, though
one Oregonian physician had his licence temporarily suspended after he
approved it for 823 patients.

More than half of the law enforcement bodies interviewed said medical
marijuana laws had no effect on their duties, while more than a third said
they did.

The efficacy or dangers of marijuana was outside the GAO's brief. Hadorn,
naturally, says it is safe as houses. So there is no reliable peer-reviewed
scientific research showing cannabis can be harmful? "I hate to be so
blanket about it", says Hadorn, "but, when used as directed, no."

Dunne's party has no single internal document that proves marijuana is
dangerous in the wider sense. "We have drawn on a lot of material, some
promotional material that groups have produced, some anecdotal experiences
they have reported and also a lot of the professional data that is floating
around," says Dunne. These sources include Trevor Grice, Pauline Gardiner
and the Institute for Environmental Science and Research (ESR).

With Tom Scott, Grice is co-author of an anti-marijuana book The Great
Brain Robbery. He lectures at police college on the effects of drugs and
alcohol on the brain and works with Child Youth and Family and police youth
aid. Gardiner is executive officer of Weltrust - a secondary school alcohol
and drug support service.

Although no fans of marijuana, Grice and Gardiner are surprisingly open
minded about its use generally and as a medicine. Both claim to have been
mislabeled in the media as promoting abstinence and zero tolerance. Grice
says he actually couldn't care less whether fully-informed adults use
cannabis or not. Gardiner doesn't care about the seventy percent of users
for whom it is a harmless recreational drug. Both say (as does almost
everyone on all sides of the cannabis debate) that it is very dangerous for
children and the pubescent. Gardiner and Grice maintain it also has a
devastating effect on a significant minority of people who will become
abusers or dependent.

Grice wants to see neuroscientists on the select committee rather than
"ex-teachers and social scientists". He thinks hard science should be the
sole basis for a decision on the use of medical marijuana and that it
should then be given a clinical trial. He says that the California
situation is indeed the "thin end of the wedge" and doubts that it could
even be controlled in a more restricted setting. "Medical marijuana could
be a good thing if we can control it. But we can't even control (legally
sold methamphetamine ingredient) ephedrine."

Gardiner is against the California-Canada grow-your-own model. "You don't
ram a bloody great Foxglove plant down someone who needs digitalis
(Foxglove is the source of heart drug digitalis), and people aren't out the
back door growing a great paddock of deadly nightshade for atropine or
poppies for morphine. We give them a pill. I think we should be relatively
consistent on this if we are appreciating its value as a medicine. Let's
make it a medicine and separate the issue about any kind of relaxation of
laws. Medical and legalisation arguments should remain absolutely separate.
They should be in no way related. But the medical use of cannabis has
actually become a flag-bearer for that debate. And it shouldn't be, because
cannabis could possibly have tremendous benefits for people."

For its part, the ESR has been drawn reluctantly into the cannabis debate
by the direct invitation of the Health Select Committee. But it had
insufficient information to make a judgment on its role in road deaths or
youth suicide. And, it finds, although a future increase in the potency of
marijuana from skillfully grown hydroponic crops was not ruled out, in the
period of study from 1976 to 1996 the potency of cannabis, (including the
limited amount of supposedly very high grade "skunk weed" tested) did not
generally increase. Overall, the ESR's findings are inconclusive as far as
the medicinal-use debate is concerned.

Greg Soar heard Peter Dunne's 'thin end of the wedge' comment. "I felt like
mailing him a bag of my bloody vomit," he says. "I take 28 HIV pills a day
and 28 anti-emetic pills a day. And I get sick every single day unless I
have some cannabis."

Soar and fellow sufferer Steve are members of Green Cross, a support group
for medicinal users of cannabis.

Soar is on a benefit now, but he says that he was a social user with a
responsible job driving trains before he was diagnosed HIV positive, and in
no way a pro-legalisation campaigner. Nowadays he is constantly pushing
pro-legalisation outfits like NORML to be more involved in the medical
debate. "No sick people, no genuinely sick people want some easy ride on
cannabis, they want a better life for God's sake."

Steve is in the same boat, HIV positive, holding down a job, trying not to
be sick. "The first thing I was told when I was diagnosed was that a bit of
green therapy wouldn't go amiss." He lists the long paragraph of dire side
effects from his legal medication. "And now having to prove marijuana is
safe really gets my goat."

There is a tin of marijuana on the table and the air is ripe with its
smell. Obviously they have no trouble getting their drug of choice and to
date the police have left the high profile Soar alone. Why don't they just
keep quiet and take their medicine in peace? Aren't they just looking for
the taxpayer to pick up their tab? "It is a humane issue, not an economic
issue," says Soar. "I can go to the dairy and buy some tobacco, but I am
not allowed to buy the evil pot. Even when my doctor says so I am not
allowed to have the pot. It is a matter of being treated like a decent
human being by your government and your fellow country people."

This argument has softened at least one dyed-in-the-wool marijuana
opponent. On May 21 NSW Premier Bob Carr announced his state would commence
trials of cannabis for medicinal relief by the end of the year. He used the
examples of a 62-year-old bowel cancer sufferer and an 80-year-old prostate
cancer sufferer who were helped by marijuana. "No decent government can
stand by while fellow Australians suffer like that, while ordinary people
feel like criminals for simply medicating themselves," he told the state
house. Previously Carr's government had a zero-tolerance approach to the
drug and had been criticised for using sniffer dogs in streets and pubs.

Soar doesn't think that over prescribing of marijuana will be a problem.
"We are not going to have doctors who are highly qualified, generally
sensible people, starting to write out prescriptions willy-nilly for this,
that and everything else".

Green Cross has been in touch with United Future, but hasn't had what it
considers a satisfactory answer from the party as to why United won't
support it. Soar eventually met party members directly. He says they told
him there were other things that he could take for his nausea. But they
wouldn't tell him what they were. "I said you've got a moral obligation to
tell us immediately what that is, because we will take anything that will
ease our suffering. Anything. They have chosen not to respond to that at all".