Australian Medical Association (AMA) President Dr Michael Gannon has criticised Tuesday’s senate vote, which makes it easier for terminally ill patients to buy unregistered medicinal cannabis from overseas, saying he fears the drug could end up in the wrong hands but cannabis experts have called his reaction unfounded.
The vote was led by Greens leader Richard Di Natale after he lost the same vote in May, but this time it won the support of Labor, One Nation and various crossbenchers after a procedural loophole allowed a re-vote.
Medicinal cannabis will now be classed as a category A drug on the Therapeutic Goods Administration (TGA) list, making it easier for doctors to prescribe the medication to terminally ill people and drastically reducing the time it takes for patients to get hold of it.
The senate vote also means terminally ill people can legally import the drug more easily from regulated overseas markets, provided they have a prescription. The first medicinal cannabis imports came into Australia in May from Canadian company CanniMed.
The Australian medicinal cannabis market is currently in its infancy after it became legal to cultivate, produce and manufacture medicinal cannabis products on October 30 2016. Good domestic product is probably 12 to 24 months away so securing an overseas supply is a necessary option for sick Australians.
Supply is not the only problem, draconian rules around prescription are too.
When the federal government legislated to make medicinal cannabis legal for some terminally ill patients last year, it also tightened up the conditions that had to be met before it could be prescribed.
The drug was previously classified as a category B drug under the special access scheme, which meant doctors had to get prior approval from the TGA, their state or territory health department and their hospital ethics committee or relevant association, before treating terminally ill patients, rather than just informing the TGA they intended to prescribe it.
It has obviously had an impact. Fairfax reported this week that only 133 people have been able to access medicinal cannabis since new laws came in.
But some doctors aren’t in favour of relaxing the rules.
Dr Gannon told Sky News he was ‘disappointed’ with the senate’s decision and said that giving patients access to unregistered medicinal cannabis products from overseas would knock doctors’ confidence in prescribing it.
“You’ve already got a situation where doctors are querying exactly how effective medicinal cannabis is. If you in any way put any doubt in their minds about the safety, you’re simply not going to see it prescribed by many doctors,” Dr Gannon said.
But he admitted the risks to patients were minimal.
“Certainly, in the palliative care setting, we’re not worried about addiction and, to be honest, we’re not too worried about major potential side effects. But we remain concerned about potential diversion into the general community.”
Dr Gannon said cannabis was still a major source of mental illness in the wider community and it was ‘absolutely essential’ any imports were safe.
“If cannabis was the panacea that the people who seem desperate to import it – if it really was that good, then it would be in liberal use across the entire medical system,” he said.
“We’re excited about its potential in palliative care, we’re excited about its potential when it comes to juvenile epilepsy, and forms of spasticity, but let’s look for the evidence.”
His views echo those of federal Health Minister Greg Hunt, who called the senate’s decision ‘reckless and irresponsible’ and argued that cannabis could end up in the pockets of criminals and out on the streets.
AMA’s fears unfounded, says expert
But medicinal cannabis expert Rhys Cohen, who works for the Australian subsidiary of Israeli medicinal cannabis company Cann10, called Dr Gannon’s statements contradictory and ‘completely unfounded’.
He said medicinal cannabis was unlikely to be diverted illegally, partly because it was already ‘incredibly cheap and incredibly accessible’ in Australia and medicinal cannabis was considerably more expensive.
He said only a few countries, including Israel, Canada and the Netherlands, legally exported cannabis and they all tightly controlled their product.
Companies needed export licenses and permits and Australian companies needed import licenses and permits. Prescriptions could still come only from specialist medical practitioners.
“The changes allow people who are very soon going to die to access it faster than previously,” Mr Cohen said. “We’re not talking about Joe Bloggs with a bad leg here but people on their death beds dying of cancer wanting to get relief from pain.
“The idea that there’s a chance they will sell it on the street is just ridiculous.”
While Dr Gannon has argued that cannabis should be treated the same as every other drug, operation or therapy Mr Cohen said it had always been treated very differently from other drugs.
“Any unregistered drug in the medicine world was accessible through special access A, except cannabis,” he said.
Mr Cohen said he thought the AMA’s misgivings were that doctors would be put under more pressure to prescribe medicinal cannabis, especially given pent up demand.
However, while he agreed these concerns were legitimate he said doctors were responsible for educating themselves about medicinal cannabis, especially when it had been proven to work so well for chronic pain, epilepsy and multiple sclerosis.
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