Medicinal Marijuana - Australian Government Moves Ahead of Medical Debate

By Mal Fletcher 
Posted 27 July, 2015

‘The best advice I ever got,’ wrote David Bailey, ‘was that knowledge is power and to keep reading.’

The Australian government might be well advised, in deciding its next steps with medical marijuana, to move forward slowly and to keep reading.

A cross-party alliance of Australian senators is recommending that the nation’s Parliament endorse a bill legalising medical marijuana.

Led by the leader of the Greens party, Richard Di Natale, the proposed Regulator of Medicinal Cannabis Bill would make the federal government responsible for overseeing the manufacture, distribution and medical use of the drug.

Notwithstanding claims about the drug’s potential medical benefits – which are still hotly debated – there are several central issues which do not seem to have been adequately addressed.

In an increasingly hyper-connected global political scene, this potential precedent would have an impact on governments in other nations, who are under pressure to find quick answers to difficult social and ethical questions.

First, if this bill is passed, it will represent a situation in which the Australian federal government has moved ahead of the medical community in deciding the efficacy of a particular treatment.

The Australian medical community is divided over the efficacy of marijuana as a medical treatment. This is largely because no clinical tests have been conducted over a reasonable period of time.

There is, as supporters of the new law suggest, anecdotal evidence that the drug helps some people deal with chronic pain – of the type associated with some cancers, for example.

Yet without clinical testing there is no way of knowing what dosages of marijuana have been used in each cited case, or the exact makeup of the drug as it was applied. The substance may vary from batch to batch.

There is also no way of deciphering how the drug was administered and therefore which is the best method for its application.

There are, then, few verifiable facts upon which regulatory decisions can be based.

As a result, some leading medicos have called for legally approved, randomised testing to begin under clinical conditions over a reasonable period of time.

This is a fair proposition, one which was only recently taken up by several state governments. It will eventually lead to a more reasoned regulatory debate, which takes into account the longer-term medical, social and ethical implications of marijuana use.

Campaigners for an immediate introduction of medical marijuana point out that proper clinical tests might take several years to complete. During that time, they say, people will continue to suffer chronic pain unnecessarily.

Yet this longer-term aspect is surely the crux of the matter. Arguably, the rapid growth of new pharmaceutical technologies represents a real challenge to society’s capacity to evaluate and regulate for their long-term effects.

Many ethicists are already concerned about the so-called Law of Unintended Consequences. The pace of development and regulatory acceptance of new drugs – or old drugs with new uses – is overshadowing the debate about their future implications.

This is partly driven by the enormous financial gains to be made in producing effective treatments. In the case of marijuana, some estimates put a value on Australia’s potential medical marijuana market of approximately $AUD1 billion per year.

Already, the growing American industry is expected to be worth $US14 billion per annum by 2020. The global medical marijuana industry might be worth as much as $US500 billion at that time.

When big money is involved, political decisions are all too often skewed away from ethics in favour of raw economics.

The new law raises another troubling possibility. By moving ‘ahead’ of medical consensus, it may indirectly place the direction of drugs policy, above all, at the whim of public opinion.

Politicos – even the most conscientious among them – are susceptible to pressure from opinion polls. They are impact by emotive public demonstrations and the 24/7 campaigning which sometimes disguises itself as media reportage.

Much is said about the wisdom of crowds in the age of social networking, but the wisdom of crowds is not always so wise.

In some otherwise respectable political circles, at different points in history, both eugenics and thalidomide were thought to be appropriate responses to specific problems.

(In the case of eugenics, I’m not referring to Nazi Germany. The basic principles of this pseudo-science were accepted by more than a few prominent thinkers within British society, for example, at the end of the first world war.)

Hindsight is always easier to achieve than foresight, but there can be no excuse for rushing potentially game-changing decisions simply because they have political support at the time.

The possibility that the Australian government might fail to properly await a consensus within the medical community, also raises another important question.

Will it also eventually, for political reasons, move independently of medical advice when it comes to legalising marijuana for recreational use?

Or worse, will public service agencies take it upon themselves to move ‘ahead’ of governments, by de-stigmatising and therefore effectively approving personal marijuana use?

This may seem far-fetched, but it happened last week within an English police force. The Durham police service, in England’s north, announced a decision not to take future action against most private growers and users of cannabis.

Most personal use of cannabis, classified in the UK as a Class B drug, will remain technically illegal. Yet these police personnel will not employ their resources to prevent small amounts from being grown or used privately.

This, they say, will free up time and money for the pursuit of those pushing harder drugs.

This ignores the fact that international studies over many years have indicated that marijuana use often leads to experimentation with harder, Class A drugs. In some users, dependence breeds more dependence; the addiction to a chemical high leads to a desire, and then a life-altering craving, for more.

It also overlooks the fact that what might be ‘saved’ within law-enforcement will likely be lost within the already embattled national health services. They might struggle to keep up with treatment of more serious drug problems, which can’t necessarily be undertaken by third sector groups.

Moreover, who makes laws in the first place: is it the police service, or the Houses of Parliament? If a private citizen were to ignore a law, would that individual be allowed to walk away, after arguing that he or she was simply trying to pre-empt a change to the law?

In behaving as it is, the Durham police service – the only one in Britain to take this stance, so far – is arguably subverting the role of government and therefore challenging the democratic principle.

If in time an Australian government or its agencies were to allow – or turn a blind eye to - recreational marijuana use, this would represent a real health threat to many Australians, especially the young.

Potential dangers associated with recreational marijuana use have long been acknowledged within the medical community. In a number of studies, the drug has been linked to the development of psychosis.

This effect is exacerbated by stronger variations on the theme such as skunk. According to Cannabis Skunk Sense (CanSS), a UK charity, this is the variety of cannabis that is smoked by 80 to 90 percent of cannabis users in Britain.

It contains on average, they say, a 16.2 percent content of tetrahydrocannabinol (THC), the chemical which acts on the brain and emotions. Apparently, the Dutch government, famously liberal for its drug policies, considers any cannabis with a THC content of over 15 percent to be a Class A drug.

A few years ago, a British mother by the name of Julie Myerson published a book in which she shared the pain her family endured as they tried to help her teenage son overcome a life-controlling addiction to skunk.

Her story of ‘tough love’, retold in the nation’s press and media, was both harrowing and inspiring. Ms Myerson ‘outed’ her son as a drug user in her controversial book The Lost Child, which was nominated for the distinguished Man Booker Prize.

In it, she described how her son Jake stole from the family and fought with them when they tried to banish them from the family home in order to protect younger siblings.

At the time, Jake described his mother as the ‘worst mother in Britain’, only to publicly recant and thank her for the tough love approach five years later.

We can only wonder at the fate of those children and young adults who, unlike Jake Myerson, don’t have parents who are equipped or willing to take such a resolute and painful stance.

Drug-related charities would find any loosening of marijuana-for-recreation laws disheartening.

It is so often they, not government services, that provide effective rehabilitation programmes and ongoing personal support for recovering addicts.

In England, where cannabis is not legally recognised as having any therapeutic value,  a 2015 poll by the Centre for Social Justice think tank found that 69 percent of 100 charities surveyed would be concerned if the Government decriminalised cannabis. Seventy-three percent were concerned about the effects cannabis had on their clients and families.

Charities need to know that law-makers and law-enforcers are on the same page when it comes to reducing drug usage.

The key here, of course, is not simply tightening criminal codes. Prison sentences are not necessarily the best way to treat the drug problem – especially as it relates to first-time users, or those whose use is restricted to drugs considered to be less harmful than opiates.

A debate about the penalties applied for recreational marijuana use would be welcome. As would be a series of clinical tests on the medical effectiveness of marijuana.

Governments are responsible for devising, producing and maintaining regulatory policies. They should not, however, supplant the role of the medical profession and its ethicists, when it comes to deciding on the efficacy of drugs.

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