Earlier this week I announced that applications to prescribe non pharmaceutical grade cannabis based medicinal products would no longer require my approval as Associate Minister of Health. I further announced that I would be advising medical authorities of a list of known such products that were of a sufficiently reputable manufacturing standard to be available for prescription for New Zealand patients.
Those two announcements have been generally welcomed as a step forward. Indeed, they build on a progressive series of steps I have taken to facilitate access to these products since the issue first came onto the public agenda a couple of years. First, was the development of a specific set of clinically informed guidelines for the prescribing of such products; then there was the decision last December that Sativex (the only pharmaceutical grade cannabis medicine available in New Zealand) could now be prescribed for multiple sclerosis patients by specialists without reference to the Ministry of Health; and now, this week’s announcements. I have made it clear that throughout I have been following a deliberate, evidence based process, drawing on emerging international best practice, and that further evolutions are inevitable.
What has become clear, however, in even the reporting of this week’s developments is that some considerable misconceptions still remain. While most people now seem to understand that what we are talking are medical products based around extracts from the cannabis plant, rather than the raw leaf itself (for which there is absolutely no political appetite across parties for change), there is still confusion about how such products ought to be treated.
Presently, medical products that are not registered in New Zealand as pharmaceuticals are effectively unregulated – which is why there is the provision in the Medicines Act for them to be approved on a case by case basis by the Minister (which has been the case up until my decision this week for cannabis based medicines – so the call by some editorial writers to just treat cannabis based medicines the same way as other pharmaceuticals is misplaced. That cannot happen until and unless such products are registered as pharmaceuticals, something that the composition of most of them makes very unlikely. At the same time, it would be grossly irresponsible to allow such products to be prescribed on a totally unregulated basis, and I can only begin to imagine what the public outcry would be were that to happen and things go wrong. The ill-founded hysteria that accompanied the attempts to create a regulated market for synthetic cannabis products a few years ago is a classic reminder in that regard.
Another issue that is often raised is that of protection of people with terminal conditions who chose to use some form of cannabis to ease their suffering. The New South Wales regime where terminal patients can go a register which means they will not be harassed by the Police over their cannabis use is cited as an example of what we should be doing here. In New Zealand, both the Police and the Government have made it clear over a long period of time that we have no interest in pursuing people using cannabis in such circumstances, so the practical difference between the New South Wales and New Zealand situations is essentially cosmetic. However, it may be worth further consideration, if it is seen as giving vulnerable, suffering people a little more assurance at a very stressful time of their lives.
Overall, my intention all along has been to establish an environment within which cannabis based medical products can be prescribed for patients with conditions where it has been shown that there would be benefit from having access to such products. That requires an open and pragmatic response from medical practitioners, and I am very keen to ensure that doctors are fully aware of the options and willing to discuss these with patients. For patients, my advice is equally clear: if a patient feels they might benefit from a cannabis based medicine they should talk to their doctors in the first instance.
As I have said many times, this is an evolving area internationally. There are potential benefits for certain categories of patients. We need to be open to facilitating these possibilities, with falling prey to the emotionalism, misinformation and self-interest of those with a wider pro-cannabis agenda.