Let The People Grow (They Do Anyway)

Part Two in a series of opinion pieces by Shane Le Brun, Coordinator, Medical Cannabis Awareness New Zealand (MCANZ)

There is strong public support for significant reform of Medical Cannabis (MC) regulation. The system currently in place, which focuses wholly on pharmaceutically trialed cannabis-based medicines, removes patient and prescriber choice, and costs are prohibitive. New Zealand may have the highest priced MC in the western world – a side-effect of our remote location and small market.

MCANZ has avoided the issue of ‘grow your own’ cannabis partly to avoid the stereotypes around the more strident and vocal supporters of MedCan, partly to be seen as the sensible voice on the issue. As a charity it is essential that we have repeat business with medical specialists in order to enable us to best advocate on behalf of patients. For this reason we often find ourselves biting our tongues and generally try not to do anything that would be perceived as too negative or critical of the medical profession. Another part of our advocacy with doctors is our decision to take a stance that is completely against the smoking of cannabis for medicinal purposes. Smoking cannabis doesn’t fit with the Ministry of Health targets for smoke-free New Zealand by 2025, and when there are alternative options such as vaporising or edible products, there is no longer any reason for patients to smoke cannabis.

Some western countries have recognised the ability to grow one’s own medicine as a basic human right. Canada in particular went down this path. The Canadian Supreme Court overruled Parliament, to rule in favour of patients rights in this regard. Essentially, patients took the Canadian government to court and won. For this reason the initial Canadian cannabis regime was set up in 2001. Other western countries have followed suit. Some states of Germany are more pragmatic, by allowing patients to grow their own cannabis if they exhaust all routes for accessing funding for the expensive pharmaceutical options available. (In a New Zealand context that would mean, if Pharmac does not subsidise the product then you would have the right to grow.) In South Africa, most recently the entire cannabis law was erased legalizing both medical and recreational use. Again in this case this was recognised as a human rights issue.

Unfortunately New Zealanders’ human rights don’t appear to count for much to the current government as displayed by Paula Bennett’s faux pas several weeks ago on the issue of the rights of gang members. There appears to be no accessible mechanism by which to challenge the goverment on the cannabis issue on human rights grounds. For this reason alone, MCANZ has completely detached itself from the debate around making cannabis a human rights issue under the current government.

Instead, we have focused on Canada with success in getting reasonably priced Canadian products to our shores and into patients’ hands. From this experience, I would point out that with a good domestic industry, the demand to grow our own would be greatly reduced. In Canada, over 200,000 patients are registered for access, yet less than six and a half thousand have permits to grow. This lack of desire to grow cannabis compared to that existing in New Zealand is directly linked to the ease of access. If licensed cannabis in NZ was stronger AND cheaper than illicit cannabis and already processed into edible forms, then the demand equation would shift quite rapidly and people wouldn’t bother with the extra effort required.

The single greatest benefit of ‘grow your own’ to patients is cost. Even with a “near pharmaceutical” regime the cost can still be several hundred dollars a month. If there is no political will to fund even those low costs (Compared to the thousands to tens of thousands of dollars pharmaceutical options cost) then for beneficiaries and ACC claimants the only realistic option is to grow their own. Thousands of patients are already doing this, so this rather controversial law change would merely be decriminalising what is already happening.

The most important thing is making patients safe from police interference, as the police treat cultivating a class C drug as a heinous crime meaning charges are immediately laid on arrest. Triple amputees and people who have been battling leukemia for several years have been prosecuted for cultivating. It is the view of MCANZ that this is not in the public interest, and at the very least a legal defence of ‘medical necessity’ needs to be put on the books to ensure police leave patients well enough alone.

The main concern raised around a ‘grow your own’ policy appears to be around medical cannabis leaking onto the black market. This is, if anything, a minor harm - more people will be able to access cannabis without dealing with organised crime such as tinny houses et cetera. A sickness beneficiary or an ACC claimant making a little extra cash from surplus cannabis is certainly at the lower end of social harms, however a robust system would have measures in place to prevent such offending by controlling plant quantities. This would not be a free-for-all and there would be penalties for abuse of the system as there are now.

The other concern is about control in a clinical setting. Doctors will have to rely on the patients declaring how much they consume if they seek to keep tabs on use. This hasn’t been an issue in Canada where doctors don’t directly prescribe particular cannabis products but effectively grant the patient access with an upper limit on how much they can consume. The patients then order products that meet the requirements of this prescribed amount as they see fit.

One of the risks of a ‘grow your own’ system that is not widely known is the risk to property from people growing indoors. We don’t have a major issue with this in New Zealand, however in California there are multiple house fires each week in some regions from indoor grow-ops catching fire. This can be due to a multitude of reasons but primarily people get greedy and install more and larger lights than tents were designed to house (lights can be up to 1000 Watts). All it takes is a single cooling fan to fail while the person is at work and they return to a burnt down house.

A simple solution to the safety issue is to have a licensing scheme with annual inspections. If recreational cannabis is to remain illegal then people’s medical grows will be highly desirable and patients will revert to growing indoors for greater security from theft. Safety inspections on an annual basis could keep tabs on how big peoples grows are getting and also mitigate the fire risk by ensuring there are smoke alarms and other safety equipment and perhaps ensuring that there are not too many heat sources such as lights in a small area.

In other countries there are also limits that are placed on the size of a grow patients. Many of these limits aren’t terribly effective, for example in Colorado there is a ninety-nine plant limit. Initial thoughts would be that this is an absurd limit, but it was set with compassionate suppliers in mind. However with the ability to grow massive outdoor plants, these plants limits take on less meaning. A better solution is to institute an area limit, of a certain area per patient (for example 4m2 in flower at any one time).

Cannabis in Oregon, making a mockery of plant limits such as those proposed by The Opportunities Party

Another issue that must be addressed is product quality for the safety of the patients. In the underground world of “Green Fairies” or compassionate suppliers in New Zealand, the long-term growers, on the whole make very high-quality products. However, there is a new wave of enthusiasts and get rich quick types, some of which are preying on patients by making products that are substandard. There are accusations of people lacing their topicals with DMSO, a potentially dangerous ingredient. In other cases there have been people making butane extracts and not purging or evaporating the butane, leaving dangerous residue in the products for the patients to consume. I have personally met someone who qualifies for the Darwin awards, for cooking Butane Hash Oil in a caravan unventilated. He is permanently disfigured from the resultant explosion.

Such risks can be countered with education, some of which is already happening illicitly as cooperatives are beginning to be set up. Generally the illicit market is improving and self-professionalising, lately there has been dramatic improvement in labelling and specification of roughly what ratio of THC/CBD is in the products. As the availability of specially bred medical strains with known cannabinoid ratio’s increases in New Zealand, this standard will no-doubt continue to improve.

Despite these negatives, many countries and states of the USA have implemented successful home grow regimes that greatly enhance patient access and reduce the final cost to the patient of medical cannabis. The main issues are around safety of the grow itself and the safety of the finalised products should the patient wish to make concentrates. All of these issues can be mitigated quite substantially through a mix of education and regulation. There is a perk to being late to legalising medical cannabis, we can see what has worked and what hasn’t worked overseas and plan for the unintended consequences that may emerge after law reform.

The patients already grow, no amount of cracking down will change that. In the interests of recognising cannabis as a health issue, which even the current government has accepted, the best thing to do would be to design a regime that focuses on nullifying the negative effects encountered overseas, and providing the right knowledge and tools to patients and compassionate suppliers to ensure the products are as clean and safe as can be reasonably expected in a domestic environment. Prohibition has been futile, as is continuing it. So long as the only options on the table legally cost thousands per month for small doses, thousands of patients will opt out of the legal supply chain and grow/make their own cannabis medical products.

Editor’s Note:

To have your say on Medical Cannabis go to the Scoop's HiveMind page and vote on various statements on the issue or submit your own views.

Click here to go to the HiveMind.

Part 1 of this series of opinion pieces covered whether New Zealand really needs ‘Pharmaceutical Grade Cannabis.’ It is available to read here:

http://www.scoop.co.nz/stories/HL1709/S00020/do-we-really-need-pharma-grade-medical-cannabis.htm

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