The Guardian • Issue #2012


Calls for drug policy reform increase nation-wide

Part 1

Photo: Marco Verch – (CC BY 2.0)

Calls for drug policy reforms are sweeping the country after the Legalise Cannabis Australia party received 2-6 per cent of the Senate vote in each state, making it the fifth or sixth most popular party in each state and territory except for the ACT where recreational cannabis use has already been decriminalised since 2020.

Despite medicinal cannabis being legalised in 2016, only 2000 prescriptions were issued in 2018 when cannabis products were first made available. Since 2018, prescriptions have rapidly grown as access has become easier. Therapeutic Goods Administration (TGA) data shows more than 122,000 prescriptions were issued in 2021 alone, more than doubling the 2020 figure. FreshLeaf Analytics’ H2 2021 report forecast 90,000 active patients by the end of 2021.

Medicinal cannabis is a rapidly growing global industry predicted to be worth $80 billion in 2024 by the Australian Medicinal Cannabis Industry Report. FreshLeaf Analytics forecasts Australian medicinal cannabis sales of $423 million in 2022, with more than 224 medicinal cannabis products on the market and more than 430 authorised prescribers.

Medicinal cannabis is most commonly prescribed for chronic pain, followed by anxiety, cancer pain and symptom management, insomnia, neuropathic pain, PTSD, depression, autism spectrum disorder, and epilepsy. Oil and flower products are the most popular products, together accounting for over eighty per cent of available products, followed by capsules, wafers, and sprays.

There is a growing body of research demonstrating that medicinal cannabis is a safe and effective medical treatment. Importantly, legalisation allows users to find appropriate doses to suit their needs and provides access to reliable, safe, and regulated products without the threat of criminal conviction.

However, despite legalisation, there remain numerous barriers facing people in need of treatment.

A 2020 study from the Lambert Initiative for Cannabinoid Therapeutics found that ninety-seven per cent of Australians using cannabis for medicinal purposes were purchasing it illegally due to a lack of awareness of its legality, limited access to medical practitioners willing to prescribe it, and the high price of legal medicinal cannabis.

Patients unable to find a GP willing to prescribe medicinal cannabis are forced to pay from $300 to $500 for an initial appointment at a private cannabis clinic, with further costs for follow up appointments for subsequent prescriptions. In addition, FreshLeaf Analytics reports an average patient spend of $278 per month for medicinal cannabis products. As price is determined by the strength of active ingredients, those requiring stronger doses are forced to pay even more.

Medicinal cannabis is a research-backed and popular health product taken by tens of thousands of Australians every day for numerous health conditions. Medicinal cannabis products must be added to the PBS to make them more affordable and accessible for those who need them.

Medicinal cannabis users also face discriminatory road rules. Tasmania is the only state or territory to provide a legal exemption to drug driving laws for patients legally prescribed medicinal cannabis.

This means that in the majority of Australia, legal medicinal cannabis patients are de-facto barred from ever legally driving. This is due to roadside drug test kits detecting for traces of THC in saliva, rather than impairment. THC generally stays in saliva for at least twenty-four hours, well after consuming or experiencing impairment from taking medicinal cannabis.

Patients taking medicinal cannabis daily may always test positive for THC. Yet, there is no test for actual impairment used in Australia, nor a defence for medicinal use.

The UK, New Zealand, Norway, Germany, Ireland, several US states, and Tasmania all have a medical defence for drug driving charges. Legislation to provide a medical defence to drug driving laws is currently before the NSW, Victorian, and South Australian parliaments. However, the NSW Liberal Party has already come out against the reform.

Such bills would bring medicinal cannabis in line with other impairing prescription drugs, making it legal to have traces in your system so long as you are not driving under the influence and have a prescription.

There are also increasing calls to legalise the medicinal use of MDMA (ecstasy) and psilocybin (“magic mushrooms”) for therapy to address the mental health pandemic. This comes after a number of large overseas studies tested the products alongside psychotherapy, while the Australian government’s Medical Research Future Fund in 2022 committed $15 million for trials.

MDMA has been trialled for treating PTSD, while psilocybin has been used to treat a variety of mental health disorders including depression.

Despite an independent expert panel telling the TGA of the emerging evidence of therapeutic value and recognising that psychedelic drugs could be used to treat mental illnesses in supervised clinical settings, the TGA recently denied a request from psychedelic advocacy group Mind Medicine Australia (MMA) to drop MDMA and Psilocybin to Schedule 8 to provide better access for mental health treatment.

The TGA cited concerns over misuse by patients or diversion of medicinal products onto the illicit recreational market as reasons for rejecting the request.

MMA co-founder and Chair, Peter Hunt, rejected these claims, arguing that there are a whole range of medicines already in use that are far more dangerous if abused, and that doctors or pharmacists are unlikely to risk losing their licence to divert medical grade drugs onto the recreational market where they would be far more expensive than current options.

The continued insistence on rejecting demonstrated medicinal use-cases to prevent recreational use shows the failure of the “tough on crime” war on drugs policies. The new Labor government needs to listen to the advice of health experts and legislate medicinal drug use when recommended.

Medicinal cannabis should be more readily available from GPs, subsidised by the PBS, with users exempt from drug-driving charges when not genuinely driving under the influence. MDMA and psilocybin should be available for the supervised treatment of mental illnesses.

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