The use of cannabis as a medical treatment should be decided between doctor and patient rather than the results of upcoming clinical trials in New South Wales, says the author of a perspective published in the Medical Journal of Australia.
Professor Emeritus David Penington — a medical researcher, an advocate to legalise cannabis and a Victorian of the Year — says the clinical trials have confused the debate about the medical use of cannabis in Australia.
In September, Premier Mike Baird announced NSW would hold clinical trials on the use of medical cannabis for children with epilepsy, chemotherapy patients and adults with terminal illness.
However, Professor Penington says the clinical trial presumes that cannabis would then be approved and regulated as a pharmaceutical substance.
“Cannabis can never be a pharmaceutical agent in the usual sense for medical prescription, as it contains a variety of components of variable potency and actions, depending on its origin, preparation and route of administration,” he says.
“Consequently, cannabis has variable effects in individuals. It will not be possible to determine universally safe dosage of cannabis for individuals based on a clinical trial.”
Professor Penington says the debate has been characterised by extreme views on both sides, both in conflict with existing evidence about cannabis’ harms and benefits.
Australia is behind the times, he says, because 23 states in the United States, Canada, Israel, Holland and the Czech Republic, all permit its use in medical situations.
“Eliminating prohibition is not a disaster if there are sensible processes to control drug-related harms,” he writes in the journal.
“There is no rational basis for the view that weakening prohibition to permit use for medical conditions would lead to a surge in general use.”
A recent US study found that the states with medical cannabis use over 10 years had a lower death rate from opioid overdose than those without.
Medical uses of cannabis include relief from pain in the last stages of cancer, muscle spasms in multiple sclerosis and nausea caused by chemotherapy and reducing seizures in rare conditions such as Dravet syndrome.
“If legislation permits sale to people suffering from a condition diagnosed by a doctor and scheduled in legislation, there should be no problem with provision of cannabis by this route without waiting for completion of a clinical trial,” Professor Penington says.
The stock market anticipates medical cannabis will become big business in Australia. The medical marijuana company Phytoech this month became the first medical-grade cannabis company to list on the ASX.