I’ve been doing a lot of thinking about my prognosis lately. Like most disabilities and illnesses, how things progress is individual and uncertain. But if it all goes downhill, I want to know I have options.
I used to be vehemently against any use of marijuana, recreational or medicinal, and I can’t say I’ve completely reformed. Every (unbiased) source I have read reinforces the lack of research into the 500 compounds contained in the cannabis plant. Up to 80 of these are classed as ‘cannibinoids’ and are unique to marijuana. That makes me concerned about the longterm health impacts of habitual use.
But, like my recent post about assisted dying, I’ve been looking at the issue more closely since it became something that could have a big impact for me. And yes, I’m aware of how selfish that is. Sue me.
Cannabis is the third most widely used drug in New Zealand, behind alcohol and tobacco. According to Norml, ‘Official statistics from Auckland University’s Alcohol and Public Health Research Unit show half of New Zealanders aged 15-65 have tried cannabis, and one-in-six define themselves as regular users. That’s about 1.5 million ordinary Kiwis who have ignored the law and tried cannabis, and around 400,000 who continue to use it.’
Given this figure, the idea that legalization, or decriminalization, would lead to more widespread use seems flakey. It appears that anyone who wants to do it already is, illegal or not.
In fact, people who are concerned about drug safety should find solace in the idea that a decriminalized industry is a regulated one. If cannabis were legally available, it’d be easier to use trustworthy products.
I often hear people comparing cannabis use favourably to alcohol use, and I tend to agree with that observation. Alcohol is the world’s most socially acceptable drug (except maybe coffee), and it can be damaging beyond repair. Even at a use that’s considered far below substance abuse, it impacts physical and mental wellbeing – and seriously alters the user’s behaviour. I’ve never felt afraid for my body or my life around a stoned person. But I won’t go into the city on a Saturday night because of drunk people.
I also agree with the reasoning that a lot of resource is spent chasing and convicting cannabis users, that could be better allocated elsewhere. I don’t know what reasons those 4000,000 users having for smoking, and it’s none of my business. But I find it heartbreaking that anyone who is self medicating this way would be criminalised for it.
I don’t agree with Norml’s position that people who need it for medical reasons should be allowed to grow it themselves. One of the strongest arguments for decrminalization, for me, is that the product can be properly researched and regulated. Strains would be separated and developed, so that prescriptions can be measured and targeted towards certain conditions. It would be possible to take oil or a pill that only provided medicinal support, and didn’t get you high. At the moment, even basic pharmaceutical opiates can’t do that.
A 2007 review said cannabidiol had shown potential to relieve convulsion, inflammation, cough, congestion and nausea, and to inhibit cancer cell growth. Preliminary studies have also shown potential over psychiatric conditions such as anxiety, depression, and psychosis. Because cannabidiol relieves the aforementioned symptoms, cannabis strains with a high amount of CBD may benefit people with multiple sclerosis or frequent anxiety attacks.
Former Council of Trade Unions President Helen Kelly, who has terminal cancer, is responsible for making me really consider my position. As I said, I’ve reflexively been against legalization for a long time. One of the reasons for this is an historic association with a user, whose behaviour I blamed solely on cannabis use. That may have been narrow-minded and short-sighted. Then again, it may not. I still have very real concerns about the impact of marijuana on young people’s brains, about it’s reputation for destroying motivation, and about its under-researched implications for mental health.
However, it’s impossible not to feel swayed by Kelly’s position, outlined in this post by her. She is calling for a referendum on the issue to be part of the upcoming election.
Associate Health Minister Peter Dunne has previously said the Government will not be swayed by “emotional nonsense” colouring calls for wider access to medicinal cannabis.
I’m not sure that feeling heartbroken for a dying woman who just wants some relief is “nonsense.”
Until I read the above piece, I wasn’t aware of the hoops a candidate for medicinal marijuana, and their doctors, are required to jump through. The conditions for application are: (with Kelly’s notes in bold).
- severe or life-threatening condition (tick)
- evidence that all reasonably applicable conventional treatments have been trialled and the symptoms are still poorly controlled (so not that cannabis controls them better – but that nothing else works – well you could zonk me up on morphine and make me a zombie – its still not as good however especially for the old bones).
- evidence that the risk/ benefit of the product has been adequately considered by qualified clinical specialists – that is, the risk of treatment with an unproven product is less than the risk of non-treatment and account has been taken of any evidence of potential benefit and weighed against known adverse effects (so the Doctors have to attest to this without knowledge or training based on my research!)
- patient hospitalised when treatment is initiated (wtf!)
- patient or guardian has provided informed consent
- application from a specialist appropriate to the medical condition being treated or the Chief Medical Officer of a District Health Board (but this is not full proof – and what a burden!)
- applicant or specialist prescriber has sought adequate peer review eg, Hospital Ethics Committee approval, Drug or Therapeutics Committee review(impossible and slow!)
- provision of a Certificate of Analysis, preferably from an accredited laboratory, so that the concentration of the active ingredient(s) is known (this is proving hard to get)
There is evidence that cannabis oil helps in pain management for many conditions – including inflammatory arthritis. But there’s no way someone like me would meet the above criteria.
I mentioned earlier that my prognosis is an uncertain one. I have a friend with Ankylosing Spondylitis who is about to be in a wheelchair, and one who goes running nearly every day. I’m selfish. I want to know that as many options as possible are going to be available to me.
On the other hand – I have been taking Kytruda (the drug all the publicity is about – a break though for melanoma and has had some success with lung cancer but not with me). I have paid for is (this is what Kiwisaver will be for in the future – to subsidise our underfunded health system). It is completely experimental and the Doctors admit it – they don’t know who it works with, why, exactly how or really even how to administer it the most efficiently – but oh fill me up with it – exactly because I have nothing to lose. I have also had whole brain radiation – massively dangerous – huge side effects possible – I have been lucky – but I can’t take cannabis?
I really identify with Kelly’s frustration here. The drug I take, Humira, is also dangerous. So are opiates. So is long-term use of paracetamol and ibuprofen and pretty much anything else that might help my pain.
And no, we don’t necessarily know all the possible side effects of cannabis, and I’m certainly not saying it is unilaterally worse than or better than other drugs. I don’t want to demonise or glorify.
All I want to do is point out that, for many of us in pain situations, relief is very difficult to obtain. And it would be reassuring to know that there’s going to be more choices.
Life, death, and medical cannabis – Helen Kelly
Medicinal cannabis – New Zealand Drug Foundation
Medical cannabis – Wikipedia
Norml – The National Organisation for the Reform of Marijuana Laws.