Angel or demon? The medical cannabis question

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.[113] Preliminary studies have also shown potential over psychiatric conditions such as anxiety, depression, and psychosis.[114] Because cannabidiol relieves the aforementioned symptoms, cannabis strains with a high amount of CBD may benefit people with multiple sclerosis or frequent anxiety attacks.[30][113]

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).

  1. severe or life-threatening condition (tick)
  2. 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).
  3. 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!)
  4. patient hospitalised when treatment is initiated (wtf!)
  5. patient or guardian has provided informed consent
  6. 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!)
  7. applicant or specialist prescriber has sought adequate peer review eg, Hospital Ethics Committee approval, Drug or Therapeutics Committee review(impossible and slow!)
  8. 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.

 

Sources

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.

2 Replies to “Angel or demon? The medical cannabis question”

  1. Shiva

    Angel or demon? Dichotymizing is not valid argument.

    Firstly, the English word for this plant is in fact ’hemp’(cognate with the German ’Hanf’) and is from the Proto-Germanic ’*xanipis’ (asterisk means reconstructed) which is cognate with the Greek ’κάνναβις’, first used by Linnaeus in 1753 (i understand) as the botanical name for the genus as (in italics) ’Cannabis’.

    Thus, it has been used a long time, and the earliest records being from China are of medicinal use; and it was used medicinally mainstream even up into the 1930s when most medicines prescribed by physicians were still natural substances, and the word ’drug’ meant ’a natural substance, whether from animate or inanimate source, that has medicinal properties’; therefore, alcohol under this meaning is not a drug, but a toxin, and strictly speaking pharmaceuticals are not drugs either. I see nothing good about ingesting alcohol, and don‘t use it per se myself, although it has its uses as a preservative in coughmixture for example. To compare hemp with pharmaceuticals is false, pharmaceuticals being manufactured in factories from artificial chemicals, and even opiate is subject to artificial chemical manipulation such as in codeine (not everyone can synthesize codeine).

    There are, for example, some who are allergic to hemp, and perhaps nothing in excess is good for one: it is a matter of context. The phrase ’knowing all of the possible side-effects’ is another way to prevent its use, to forstall the beneficial, endless analysis—no-one is to blame for anything here, it is not a pharmaceutical, only pharmaceuticals have ’side-effects’ in this sense.

    The use of the term ’cannabis’ as common usage is an attempt by prohibitionists to make it seem exotic, and most have fallen into their trap; in the US the word ’marijuana’ was used by Anslinger (who had alcohol interests) and Hearst (who had forestry interests) in the 1930s to also make it seem exotic, Mexicans being seen as decadent subhumans (and look up the contemporary public media about the ”dreaded marijuana” and the racism here); the initial anti-hemp was really to protect forestry corporations where wood-cellulose was being made into plastics, and much less efficiently and with much more pollution than if made from hemp-cellulose. The most famous 1930s fallaciousness about hemp is the absurd ‹Reefer Madness› movie where the ingesters by smoking it become a maniacal axe murderer and a jumper out of a window, bad sets and bad acting as well; this later being used as the source for claiming that LSD25 caused users to jump out of a window also.

    I refuse to be treated as an childish imbecile by the psychopathic élite who are protecting their and others‘ profits by banning hemp and persecuting the innocent for using it, or by profiting from the innocent by having complete control over its growing and distribution—for under such one would still be persecuted for growing one’s own herb: this is corruption and vanguardism. The reason for the false propaganda about hemp is that the privileged stand to lose from its free use: it has multiple uses including medicine, food, paper, plantplastics, hempcrete, being too many to list—truly a wonderplant.

    Hemp is a natural herb —cannabinoids are natural in humans and much of life, and cannabinoids are an active part of mother’s milk— and no-one has the natural right (not to be confused with ’privilege’) to stop anyone growing it for their own use, anymore than growing any other herb such as chamomile or feverfew, both of which have medicinal properties. Being also very unwell, in pain, and with multiple inflammatory conditions the use of hemp whether raw, juiced, or vaped (as in aromatherapy) would be very beneficial to me, and i object to others telling me that i have to beg a medical doctor for, and to pay a corporate to use, a natural herb that has been used medicinally for millenia.

    Hemp just wants to be free…

    Reply
  2. Scum

    I just really want to undercut that patronising and condescending reply by pointing out that hemp and marijuana are actually different plants. They are cousins. Hemp is the one with industrial and medical uses based on its high levels of cannabidiol whereas marijuana is high in THC which just gets you fucked up.Relief without intense side effects are what most chronically ill people want.Its jackasses like that being preachy and co-opting the ill and POC’s struggles in trying to get marijuana legalised for their own personal use that give me a bad impression of marijuana users.

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.