MPs head back to Parliament this week, with the Government’s medicinal cannabis bill high on the agenda, and another medicinal cannabis bill from the National opposition simmering in the pot. So what is the path forward, and how can New Zealand get the world’s best medicinal cannabis law?
Back in January of this year, National MPs block voted against the Green Party bill that would have legalised medicinal cannabis and let patients grow their own or obtain it from pharmacies. They told Parliament they would instead work with Labour to make their bill better, and both Jacinda Ardern and Health Minister David Clark gave clear signals to parliament that amendments would be welcome. In defending the relative conservatism of their bill, Labour pointed the finger at New Zealand First, claiming it was all they could get agreement on.
The intent of the bill was widely supported, but it was criticised for providing immediate relief only for terminal patients, and for not protecting their family or caregivers. Cannabis is already used medicinally by one in twenty New Zealanders, and aware making it legal was supported by 89 per cent of respondents in a recent poll by the New Zealand Drug Foundation.
Labour and National each have four MPs on the health select committee. They heard testimony from hundreds of patients and dozens of experts. Although the committee was unable to reach consensus, the bill will proceed with some important changes:
- All non-psychoactive cannabinoids will be de-scheduled, potentially broadening the variety of products that can be more easily obtained by patients;
- Limited communications will be allowed with health practitioners about non-consented medicinal cannabis products;
- Crucially, the bill will now change the licencing provisions to allow commercial production, although it also now bizarrely prohibits non-commercial production of medicinal cannabis;
The committee’s report confirms regulations will allow non-pharmaceutical product standards, with an exemption from expensive multi-year clinical trials to prove efficacy for this traditional herb. This puts us on a par with the rest of the world and will greatly reduce costs and the time to get products to market.
While these changes are welcome – and the Government has the numbers to pass them – they don’t go far enough. It remains unclear what local production of medicinal cannabis products will look like, because the bill leaves that up to regulations that are yet to be developed.
National want more detail in the bill, but instead of working with Labour, National has crafted its own. The 33-page bill from Shane Reti, Whangarei MP and deputy of the health committee, would create a different scheme. ID Cards would be issued by doctors for patients to obtain medicinal cannabis products from pharmacies.
It’s close to what they do in Europe and North America. It also represents a sea change moment. National has never – ever – promoted any form of cannabis law reform other than ratcheting up prohibition.
National and Shane Reti should be commended for developing their model in such detail – although they have rightly been criticised for not working to make the Government bill better during the committee process.
In contrast to the Government bill, National’s bill won’t allow what they call “loose leaf” cannabis, and they Just Say No to a temporary compassionate exemption for the terminally ill.
In addition, while Reti’s bill would streamline the dispensing process, their ‘pharma-lite’ approach would not change the availability of products that can be prescribed. Clearly this has not worked out: there are very few products available and they are prohibitively expensive.
We need different rules, so medicinal cannabis products are more accessible and affordable. That’s what the Government is trying to do, but whatever the merits of their approach the Government has been left looking slow and unimaginative. David Clark has been criticised for being led by officials and not putting the work in. There has been little stakeholder engagement so far. And they’ve opened room for National to seize the advantage.
With Parliament due to vote on the Government bill in September, MPs now have an opportunity to regain the initiative and the confidence of patients. Some are working out what to do now – and appear open to suggestions.
There are good parts to both bills – and they’re not incompatible.
Here’s how MPs could take the best of both bills and make a medicinal cannabis scheme that puts patients before politics – in ten steps.
- Get on with it. Pass reforms with a sense of urgency. This is, literally, a matter of life and death.
- Show compassion. Provide an exemption for “severe and debilitating” conditions, consistent with existing non-pharma prescribing. Let patients who qualify provide for themselves or obtain it from licenced producers (as in Canada).
- Streamline the front end. Use National’s Patient ID Card approach to simplify the dispensing process. It will reduce prescriber reluctance while still retaining patient oversight through the pharmacy system.
- Regulate the back end. Get cheaper products quickly to market with Labour’s regulation-based approach for product standards. These should include whole plant extracts and be available in a range of dosages and delivery methods including pharmaceuticals and herbal remedies.
- Keep it green. Production should be sustainable and include those previously disadvantaged by previous policies. Investigate ways to avoid animal testing.
- Make it affordable. Recognising many patients are financially challenged, investigate ways to make access more affordable, including subsidies through Pharmac.
- A level playing field. Kiwi producers should be able to incorporate local genetics (including from hemp), just like they did in Europe, Israel, Canada and US states.
- Promote jobs and regional growth opportunities. Encourage exports to allow local producers to reach the scale needed to lower costs for patients.
- Learn as we go. Support ways to increase knowledge of medicinal cannabis, cannabinoids, the ECS, and available cannabis products, including unconsented products. Form a standing committee of patients, prescribers, producers and officials to promote regular updates to regulations, and review the entire scheme in 5 years.
- Do it right. Properly resource the Ministry of Health to enable these reforms and empower them to work to targets based on patient need. Bring in international expertise and properly engage with stakeholders throughout this process.
This isn’t rocket science, and we don’t need to reinvent the wheel. To get a good medicinal cannabis law, we just need to focus on patients.
Chris Fowlie is the CEO of PharmaCann New Zealand, a medicinal cannabis producer, and president of the National Organisation for the Reform of Marijuana Laws NZ Inc, co-founder of The Hempstore Aotearoa, co-host of Marijuana Media on 95bFM, and court-recognised expert witness for cannabis.