Hard News by Russell Brown

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Genter's Bill: Starting at last on medical cannabis

Julie Anne Genter's private members bill on medical cannabis emerged from the ballot this morning – and it raises some interesting questions.

The first thing you need to know is that there is no chance of Genter's bill (or David Seymour's voluntary euthanasia bill) even getting a first reading before this year's general election.

You'll recall me posting to the effect that the scheduled rewrite of the Misuse of Drugs Act – a process I've been told could begin as soon as November – makes drug policy an election issue. Even though it will presumably be subject to a conscience vote, Genter's bill being drawn makes it even more so.

But it's complicated, Genter's bill is written as an amendment to the Misuse of Drugs Act. It's entirely likely that the MoDA reboot and voting on the bill will aiming to amend it will overlap, and that the two could be in select committee at the same time. Genter's bill – if it passes its first reading –  would go to the Health select committee. These things are political decisions, but consideration of new Misuse of Drugs Act might also go to Health. It will need to be managed.

It seems possible subsequent readings of the bill could be deferred until there's a new MoDA to amend – which could be years. I guess it's also possible the bill could give impetus to the rewrite process, or be used to expedite the relevant parts of the new MoDA. Again, all that will be political.

Anyway, the policy statement on the bill is as follows:

The medical use of cannabis should be legal, accessible and affordable.

The purpose of this Bill is to make it legal for New Zealanders who are suffering from terminal illness or any debilitating condition to use cannabis or cannabis products with the support of a registered medical practitioner.

The Bill amends the Misuse of Drugs Act to make a specific exemption for any person with a qualifying medical condition to cultivate, possess or use the cannabis plant and/or cannabis products for therapeutic purposes, provided they have the support of a registered medical practitioner. The exemption for cultivation and possession would also apply to an immediate relative or any other person nominated by the person with such a diagnosis, for the sole purpose of administering or supplying cannabis or its related products to the person.

The Bill also ensures that non-psychoactive cannabis plants and products are not con- trolled substances under the Misuse of Drugs Act. It clarifies that a non-psychoactive compound, Cannabidiol (CBD), is excluded from the definition of cannabis, and therefore exempt. 

At first blush the "interpretations" section of the bill is the most crucial and the most likely to be subject to challenge. The definition of "medicinal cannabis", for example, is much broader than anything in current regulations. It's any weed for what ails you, basically: 

medicinal cannabis means any form of cannabis referred to in this Act, including (without limitation) any cannabis plant, preparation, or derivative, that is cultivated, supplied, or possessed (as the case may be) solely in order that it may be used by a person with a qualifying health condition for therapeutic purposes

"Nominated support person" in the bill is anyone nominated by the prospective patient to "cultivate, administer, supply, or possess medicinal cannabis" on the patient's behalf. Only a medical practitioner will need to be told that person's name.

You'll need two things to qualify to use, cultivate or be supplied with medical cannabis. The first is a "qualifying health condition" and the bill's definition of that is notably broad – 4. (d) makes it broader even that California regulations (you can read a US state-by-state rundown of qualifying conditions here):

  1. (a)  any terminal illness: and

  2. (b)  any severe chronic disorder of the immune or nervous system: and

  3. (c)  chronic back or other pain: and

  4. (d)  any other medical condition that a medical practitioner certifies may benefit from supplementary plant cannabinoids 

The second thing you'll need is a "supportive medical report":

supportive medical report means a report from a medical practitioner, containing all the prescribed information (if any), supporting a person with a qualifying health condition to use medicinal cannabis for therapeutic purposes

This not a prescription – more like a note from your doctor. Some (maybe many) doctors would doubtless be happy to fulfill this role. But I also strongly suspect you will see submissions against the bill from doctors' groups, whose members may feel that it is de facto prescribing and they want no part of prescribing drugs whose contents they cannot know.

The bill as it stands does not seem to preclude a nominated support person supplying for financial gain – and I actually don't think it should either. But if we're going to open dispensaries, we're going to need some proper guarantees of product composition, cannabinoid ratios, etc. It's going to have to be regulated, which will make the bill more complicated. 

I think you'd also need to look at ways of avoiding, say, the loophole in Oregon's medical cannabis law, which requires a doctor only to confirm the applicant has a qualifying condition, but leaves the rest to a "primary carer" with no qualifications. The situation depicted in the Weediquette 'Stoned Kids' episode, with parents free to give their cancer-stricken children massive daily doses of cannabis oil in the tenuous belief if will be a cure, isn't something we should aspire to.

In political terms, there will be some support in the National caucus for the bill to proceed to select committee, but possibly not a lot. If Labour and Māori Party MPs can't bring themselves to do that, they should pack up and go home. Dunne will vote for it at first reading but seek some changes (he's all good with the Greens now, anyway). New Zealand First, with an eye on the senior cannabis lobby, will be more supportive than some people expect. Seymour will support it, as will The Opportunities Party, in the unlikely event it is represented in the next Parliament.

Nothing ever happens soon enough in drug law reform – marijuana is alawys mañana – and for the reasons I've outlined above, this bill will take some time to bear fruit, assuming it does. But, coming on top of the mandated rewrite of the whole drugs law, it pushes our politicians even harder to actually talk about something they've mostly been trying to avoid talking for years.

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