“This is an historic day for Australia and the many advocates who have fought long and hard to challenge the stigma around medicinal cannabis products so genuine patients are no longer treated as criminals”

– Health Minister, Sussan Ley

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The Australian federal government yesterday passed a Bill making marijuana legal for medical purposes.

The Amendment to the 1967 Narcotic Drugs Act will allow cannabis to be grown in Australia for ‘medical and scientific purposes’. This cannabis will then be used to provide sufferers of certain medical conditions – including childhood epilepsy, chronic debilitating pain and chemotherapy-induced nausea & vomiting – access to the previously banned substance.

Previous fears about the substance’s legalisation have centred around the potential for an increase in recreational use, thus creating the need for tight government regulation. Exactly what this regulation will look like is as yet unclear, however Ms Ley has ensured the government is working towards a practical and effective solution.

The government, she says, will be able to ‘closely track the development of cannabis products for medicinal use from cultivation to supply, and curtail any attempts by criminals to get involved.’ Indeed, at this stage growing the plant will only be allowed under a national licensing scheme, and a national body will be created to issue licences and to regulate local crops.

While the Health Minister says this piece of legislation is the ‘missing piece’ in the treatment puzzle for many Australians, Greens leader Richard Di Natale, long a supporter of medical marijuana’s legalisation, remains somewhat sceptical. Continuing Ley’s puzzle analogy, he said yesterday that ‘it is one piece of the puzzle but there’s a lot more that needs to be done’, citing the lack of information on how the drug will be distributed, supplied and prescribed.

Part of Mr Di Natale’s hesitancy to welcome the move completely relates to how much reach (or potentially lack thereof) the amendment will have. He views it as a step in the right direction, yes, but a step which he thinks should be the first of many.

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Somewhat counter-intuitively, medical marijuana is still classed as a ‘prohibited substance’ under the poisons schedule, something that remains the case despite yesterday’s decision. The federal government remains in discussion on this point with the Therapeutic Goods Administration (TGA) with the aim of rescheduling it to the ‘controlled substances’ list, which would place it alongside morphine and other drugs of dependence. An interim decision is expected in March.

A broader debate

This issue is not new. The use of cannabis products to alleviate pain and suffering has been around since as far back as 2737BC in ancient China (interestingly used back then in the form of a tea), and has continued to be used throughout the ages to the current day.

Until this week its use in Australia remained illegal in all circumstances, though that didn’t stop many people around the country. One of these people, Dan Haslam, made news by going public with his use of medicinal cannabis to alleviate the extreme pain and nausea of terminal bowel cancer and its treatment. He died a year ago today at the age of 25, but his legacy lives on.

His vocal fight rejuvenated debate on the issue. What he did was illegal, though few who know his story would criticise him for it.

Prioritising health

For Dan, the benefit was clear: after trying the drug for the first time as a treatment option ‘the difference in how I felt was amazing; it can’t be understated’. But his case is not just an isolated success story.

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Though research on cannabis’ medical use is difficult to conduct and consequently still somewhat lacking, modest benefits that outweigh harm in certain cases are apparent. A systematic review published last year in the Journal of the American Medical Association found a moderate benefit for a variety of conditions, including chronic pain and side effects of chemotherapy. This conclusion by no means recommends medical cannabis as a first-line treatment, but where other options have been exhausted it can be invaluable.

Similarly, a study published last year in the Medical Journal of Australia concluded that ‘medicinal cannabis is acceptably effective and safe, and probably also cost-effective’, bolstering its case for use in patients who have failed to improve in response to other therapies.

What the decision to legalise medical cannabis will realistically mean for Australia remains to be seen, but if well executed it will at the very least enable a more open discussion to be had. If we can get past just seeing marijuana as a recreational drug that does more harm than good and instead look at it as a rational treatment option to alleviate suffering, then maybe we are indeed moving towards finishing Ms Ley’s treatment ‘puzzle’.