Hard News by Russell Brown

0

Testing the fairies

A new paper by ESR scientists, published in the Australian Journal of Chemistry, has confirmed what close observers of the local cannabis community already knew, or at least suspected: the cannabinoid contents of local "green fairy" products vary widely, ratios in many products are not as claimed – and most products claiming to be high in CBD are not.

But, short of real regulation, a solution is in the wings – via the drug-checking law currently making its way through Parliament.

In 2019, the ESR scientists collected and tested a hundred green fairy products, most of them passed on via the Auckland patient advocate Pearl Schomburg. They included cannabis flower, FECO (fully extracted cannabis oil), carrier oil preparations, balms, tinctures and even vape liquids.

The results in this subsequent paper, Medicinal Cannabis – The Green Fairy Phenomenon, are not entirely news: ESR Forensic toxicology and pharmaceuticals manager Mary Jane McCarthy, who led the project, warned in February 2019 about a "product administered to an epileptic child, which "should have been high CBD and low THC – in fact it was the opposite. I would be very worried about a child taking a product like that." She presented the testing results last November at the inaugural MedCan Summit in Auckland – and said that the testing ended because its funding ran out.

I noted at the time that there was "a compelling harm reduction rationale for continuing to test these products and sharing the results." It now seems likely that will happen, via the Drug and Substance Checking Legislation Bill (No 2), which replaces the temporary legislation introduced to allow drug-checking at events last summer and is now at select committee. Like the temporary version, the bill aims to "try to minimise drug and substance harm by allowing drug and substance checking services to operate legally in New Zealand."

I have spoken to the Auckland businessman who has spent $50,000 on cannabis analysis equipment to do just that in the cannabis market. It would be fair to describe him as mild-mannered. He prefers to be known simply as "Tester Guy" (we'll call hm TG) until he secures a licence under the new law (currently, the only organisation licensed to carry out testing is Know Your Stuff) but he has already had discussions with Ministry of Health officials.

"We've been working with them so they know what the processes are to check a product," says TG. "They're writing the legislation, so they need to see what the processes are. But they did say, if you are currently testing illegal flower, stop instantly. That was detailed to me quite abruptly."

It's very likely that ministry officials won't be taking any new licence applications until the permanent law is enacted and accompanying regulations are written, but you can expect to see applications to test for safety outside the purview of Know Your Stuff, including for meth, opioids and potentially synthetic cannabinoid products, where dosage is literally a matter of life or death. Peer relationships are crucial to this form of harm reduction, so it makes sense for testing to be done within the respective user communities.

For TG, this new project is a matter of reaching out to help the community that helped a family member.

"My wife's mother has terrible migraine headaches. She's been on mainstream medicines for a long long time, with awful side-effects – and then taking another pill to offset the side-effects from the first one. It wasn't doing her any good at all.  She's been to every possible facility in the greater Auckland area to try and sort the migraines out, for years. Then she happened across cannabinoids and started to try some of the different [green fairy] products. She's off all mainstream medicines now, completely."

Talking to members of the cannabis community he discovered there was a problem with simply knowing what was in each batch. Patient advocates have been asking for safe access to product testing for at least five years, but for so long as the products have been illegal, that has not been possible.

"I thought, hey, what can we work out? What's in these amazing medicines and flowers? That led me to spend six months investigating the instruments worldwide. I put together a 50-page report on the different instruments available and narrowed it down to the one I purchased."

The equipment, from a North American company, can already provide detailed assays of cannabinoid contents, but TG plans to expand that capability.

"One of the major decision factors with the instrument I've brought in is that it's future-proof. We're working on methods and standards for detecting toxins, including the main pesticides. We're working on 11 terpenes at the moment. You need a gas chromatography instrument for the terpenes, while the best way of testing for cannabinoids is an HPLC instrument, which I have."

One area where TG's service could help curb a real health risk is in plant growth regulators, or PGRs. These are prohibited for use in food crops, but are readily available in grow shops, as "bud hardeners" and the like. They make plants appear more productive, but often at the expense of cannabinoid levels – and they're associated with organ damage and elevated cancer risk in humans.

"That's coming," says TG. "PGRs are so cheap and they're heavily promoted. Buy the 10 different bottles for $400 and that's all you need. All the amateur growers think it's brilliant."

These are all things organisations like ESR could do, but don't have the workflow for. The same is doubly true for Know Your Stuff, which has been turning away people who want to check plant matter almost since it began testing. TG sees his plans as complementary to what Know Your Stuff does.

"I want to help out the green fairies, so they're sure about what they're administering, and the growers to know what they're actually growing before they put it into their tinctures and oils. We want to go right back to the coalface of growing."

The government is unlikely to stand in the way. Health minister Andrew Little, who has been under fire for perceived inaction on medicinal cannabis, told the recent Parliamentary drug symposium that harm reduction via drug-checking would not be limited to festivals, but should be available through the community.

This kind of community testing falls short of the GMP standard decreed under our embattled medicinal cannabis scheme – which is so high that no New Zealand company has yet been able to get a product past the ministry's "minimum quality standard" and only four products, all from the Canadian company Tilray, have passed. But the gulf between no testing at all for quality and contents and our high official bar is very, very wide. There are perhaps 3000-4000 New Zealand patents being prescribed cannabis products (although many of them will be receiving CBD products allowed under the current transitional regime but not meeting the minimum quality standard). The number using illicit cannabis therapeutically is likely 10 or 15 times greater.

The ESR paper acknowledges "frustration at the restrictions to access prescribed cannabinoids in New Zealand" as a key reason for the growth of "a black market of home-made cannabis-based products for medicinal use", but it also seems that public attitudes towards these products have changed in the past couple of years and they are being used in some cases by people who would not have countenanced cannabis previously.

It also notes that product consistency is easier to achieve through a conventional pharmacological process of isolating individual cannabinoids, typically THC and CBD, than in whole-plant extracts, but that this may mean "the loss of potential benefits of the many other cannabinoids and terpenes in the cannabis plant (the entourage effect)."

There's also the simple fact that the transition from a high-THC recreational market established over decades to one where different attributes are sought from cannabis just isn't easy. It can be challenging to grow for CBD levels, let alone for potentially useful minor cannabinoids, especially when the growers are flying blind and can't test what they produce. This doesn't necessarily mean the products are inactive (although a small number seemed to be), but it makes consistent dosing difficult for people who need it.

The paper makes the point that even where CBD was present in the green fairy products, it was often at a level less than that thought to be a therapeutically useful dose (which is typically greater than that for THC). Reliably high levels of CBD are still largely the preserve of imported products, whether they meet the minimum quality standard or not.

It's also worth observing that nearly all the samples which closely matched their claimed contents came from one producer: the Northland green fairy Gandalf. Global investors are already sniffing around New Zealand genetics and our medicinal cannabis law allows New Zealand companies to bring in  illegally-developed strains. This would seem to be an area to watch.

11

The Drugs Meetup

"We just kept saying yes," New Zealand Drug Foundation executive director Sarah Helm told me the evening before Through the Maze: On the road to health, where nearly 50 people and organisations were represented on the stage over two busy days.

In contrast to the foundation's last four-yearly symposium at Parliament, there was no carefully-staged policy bid and the pandemic meant that, apart from a couple of visitors from Australia, there were no marquee international speakers in the room. Instead, it was a chance for the diverse group of people who gathered to feel like a community and to reaffirm shared perspectives.

Health minister Andrew Little, the symposium's Parliamentary host, gave the opening speech. He began by addressing "the elephant in the room" – which, to his mind, was last year's referendum on a bill to legalise and regulate cannabis.

The referendum was mentioned several times during the symposium, but the minister's perception that it was somehow hanging over the event was really his alone. The sad truth is that if there was an elephant in the room, it was Andrew Little himself.

There was chatter that he might use the speech to make an announcement, or as a way to shift the policy stasis he himself had ordained. People talked earnestly about whether it would be more productive to protest, or to avoid backing him into a corner, given that he seemed to have responded so poorly to the recent open letter from multiple health and social service organisations calling for drug policy reform. There were few, if any, offstage conversations in which the Minister of Health was discussed as anything other than a problem.

In the end, there were no real announcements. It was a short speech (as someone observed to me, it felt like it suddenly ended two pages early) largely concerned with justifying the government's position. If you were to go looking for nuggets, then the affirmation that the government sees drug-checking as an everywhere-all-the-time service, and not just something that happens at summer music festivals, was one. That sounded like an acknowledgement that these services will need to be funded. It might have made it a little easier to think about a service to test green fairy products under the same law.

It's worth recalling that drug-checking was a reform that the Prime Minister effectively ordained over Little's head, after he'd declared there would be no reform for the foreseeable future about an hour after the referendum result. Nothing bad happened and there was no discernable ngeative impact on public opinion. Indeed, over a summer when eutylone flooded the market, it quite probably saved lives. The minister who declared there would be no reform ended up very happy to own this one.

Little also tossed in what might have been a revealing definition of cannabis decriminalisation – "self-use and some sharing" – before dismissing decriminalisation as an option, and there was some thought that he might have left scope for a broadening of the current palliative defence for the medical use of cannabis. The two Parliamentary journalists present checked with him afterwards: no, he hadn't.

You don't really get to present yourself as compassionate until you can logically explain why someone with a terminal condition who gains relief from cannabis is a patient, but someone with a debilitating chronic condition who finds similar relief is a criminal.

The minister said that "the medicinal cannabis regime is not yet operating as we expected" – he could hardly do otherwise – but gave an assurance there would be more products available later in the year. He may actually have strayed from his prepared text and said that manufacturers had told him so. But that is not really what local producers are telling the ministry.

Medical Cannabis Scheme a "Blazing wreck" read the headline of a release from the patient advocacy group MCANZ on the day following the minister's speech. Not a single new product has been made available under the new regime – and unless the ministry makes a third six-month extension to its transitional rules, which allow prescribers to import their own, the price of CBD products will go up, not down. Meanwhile – more in some districts than others – the police are raiding green fairies who the courts seem increasingly unhappy about punishing. It's a rolling mess.

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With the minister out of the way, the real symposium could begin. Several presentations stood out for me. Firstly, there were the addiction services practitioners – the humble, modestly-paid people who work at the frontline. They explained the way that there's a huge social dimension to helping people with methamphetamine problems get better: forging relationships, making connections.

Rachel Scaife of Odyssey and Lifewise talked about Haven, the drop-in support centre they opened during last year's Covid chaos, making a space for people with alcohol and other drug problems to feel safe and make a first step.

Odyssey's Andrew Munro emphasised that effective treatment for meth dependence needs to encompass families as well. The most destructive stigmatising, he said, can come from close family members. They need to become part of the process. Andrew Hopgood from the Porirua initiative New Zealand P-Pull explained why they don't make clients relinquish their gang membership: "that's their whanau".

Philippa Jones of NZ Needle Exchange revealed that her organisation has been doing work on where it would fit in to a true health-based approach to drugs: some of the services that work envisages, she observed, are simply not possible under current law – criminalisation is too much of a barrier. Even now, Needle Exchange doesn't know basic things about its client base – including how many Māori there are – because it would be imprudent to find out those things.

"Of course," she said, "if our clients weren't criminalised they might feel more confident about sharing that information."

In one way or another, each of these frontline workers made clear that criminalisation is the major barrier to wellbeing for their clients. This isn't really news – it was the clear conclusion of the 2018 Mental Health and Addictions Review – but hearing it directly from the people doing the work gave it an extra resonance.

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In a completely different vein, I found Professor Joe Boden's speech about the conceits of science compelling. Joe, the director of the Christchurch Health and Development Study, has his name on research that was brandished on both sides of the cannabis referendum debate last year. He was critical not only of its misuse by prohibitionists, but, remarkably, of some of the assumptions of the work itself.

Most notably, he revisited Tests of causal linkages between cannabis use and psychotic symptoms (Fergusson et al, 2005), which used data from the CHDS. It also used what now looks like a pretty bad tool for the job, or at least used it poorly.

The most commonly-endorsed items on the SCL-90 checklist used to assess potential psychological issues for the study were  "I sometimes have thoughts that other people do not share" and "never feeling close to another person". If these were removed, the association between regular cannabis use and psychosis disappeared. (It's worth noting that the study was actually criticised at the time for not stating which symptoms were most reported or whether the difference in average symptom level came from a few people having many symptoms or many people having a few symptoms.)

Joe also talked about "the nomothetic curtain": the difference between imvestigating "the thing" (in this case, drug use), which is nomothetic research, and idiographical study of the "unique and contingent aspects of individuals". A focus on nomothetic approaches, he observed "can obscure what's really happening".

He said that he last year led a trajectory analysis of the same CHDS data on cannabis use. That produced something that looked a lot more like individual human lives.

This was important, he explained, because too much research in this field assumes, through labels like "drug addict", a permanence of condition, and pays not enough attention to the dimensional aspect of any condition. That is, its severity.

"Remember there are people out there, and not just things," he concluded.

In sum, it was was an important affirmation that science is not values-free. Or to put it another way, when all you have (or allow yourself to to use) is a hammer, everything looks like a nail.

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Some of the ideas Joe shared were expressed more forcefully in a session on drug stigma.

Director of Māori Development at the Universty of Otago (and former Drug Foundation chair) Tuari Potiki talked about the institutional racism he experienced when he was younger ("the bias didn't seem unconscious at the time"). And how his youthful drug convictions counted for more than everything else he's done with his life when he was asked to address the UN General Assembly in New York. It took seven months to secure him a US visa and it was unclear until five weeks before the event that he'd be allowed in.

He was followed by Wendy Allison, the founder of KnowYourStuffNZ, who talked about the privilege that means her organisation gets reform allowing it to do its drug-checking work, while reform for users of other drugs – who are generally poor, non-white and more marginalised – goes missing.

Thus, we are not willing to be used by the government to show everyone how progressive they are. In fact I would suggest that tutuing about with the Misuse of Drugs Act in a way that makes privileged people safer while not helping anyone else, is not that progressive. We deserve better.

So what can we, as privileged people, do? 

One thing I’ve learned from the KnowYourStuff project is the power of ethical non-compliance, and that privileged nobodies can make things happen if they have the courage. We need to use that privilege get on with doing the things that help the people in our communities who need it, whether the government approves or not.

That’s what the needle exchange did in the 1980s, it’s what KnowYourStuffNZ has done, it’s what the Green Fairies are doing, and if you’re in a position of privilege, then it’s what you should do too. Because vulnerable people die while privileged people wait around for government approval.

That might come at a cost – she revealed that she tanked an interview for a white-collar job last year by refusing on principle to submit to a pointless pre-employment drug test – but those who can bear the cost, should. That might mean coming out as one of the one in eight New Zealanders who uses illcit drugs.

I’m aware that most people aren’t in a position to take that risk, but if you are – if exposing yourself to that stigma won’t ruin your life, I encourage you to do so, even if it's only to those close to you. Change their view, let them change someone else’s. 

It was, she said, "an understanding of the normality of drug use" that underpinned the effectiveness of KnowYourStuff’s practice, which had been praised earlier in the day by the minister himself.

In an environment without judgement, stigma can’t thrive - and in the absence of stigma we create space for real, honest conversations about drugs with our clients.

Without stigma, we'd be able to have real, honest conversations about drugs as a country. We’d be able to take a hard look at the actual drivers behind problematic drug use: Inequality. Disconnection. Trauma. We’d be able to talk about what actually works to reduce harm instead of always focusing on use (and by extension, users). And if we care about reducing harm, it’s our duty to make that happen.

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The Australian researcher Professor Nicole Lee drew a similar distinction between seeking to define success in the rate of use of any drug rather than the incidence of actual harm. She noted that meth use in Australia (they have much better data than us) has been trending down for a decade – at the same time as hospital admissions and other measures of harm are spiralling up. What, we have to ask, is drug policy for?

This is an understanding that has developed in, it needs to be acknowledged, New Zealand law enforcement. Detective Inspector Blair MacDonald, manager of the National Drug Intelligence Bureau, presented on the drug early warning service High Alert and working with "our good friends" KnowYourStuff and the Drug Foundation. It shouldn't escape us that this is a good and remarkable thing.

Perhaps invitably, he was asked whether asked whether legalising real MDMA would help quell the problem of dangerous and sometimes deadly cathinones being sold in its stead. His answer was diplomatic but clear in its way. There had been a shift in recent years, he said, in the police approach to drugs, focusing on preventing harm.

"We don't want to be the ambulance at the bottom of the cliff. That's about as much as I can say."

Noeleen Chaney of Northland DHB rattled through a lot of data on the Te Ara Oranga scheme in her region, under which police work with health providers to offer help to people with meth problems as an alternative to prosecuting them. Short version: it works. (The scheme was launched under the last National government, but I imagine would be derided as "soft on drugs" by the version of the party that festers in Opposition were it to be proposed today.)

I had an enjoyable chat with Tuari onstage at the end of the first day about the prehistory of the war on drugs as it related to New Zealand, based for my part on the history I wrote for the Drug Foundation magazine in 2014, which I think you would still find an interesting read.

Two notes from the introductory video from Johann Hari resonated: one is that our first drug law (the Opium Prevention Act 1901) was bound up in race. The other is that ever since then – through the International Opium Convention, the League of Nations, the United Nations Single Convention 1961 – we've basically been ordered around by more powerful nations. How much easier might medicinal cannabis have been if we hadn't bowed to UN instruction to stop our doctors prescribing tincture of cannabis in the late 1950s?

The story of UN pressure circles right back to America and its chief prohibitionist Harry Anslinger, who drove international policy in his country's name. We got the draconian Narcotics Act after police officer Bob Walton returned from being instructed by Anslinger's people in America and we've been trying to climb out of it ever since. Ironically, America might be climbing out faster than we are.

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There were some politicians in the room: Chloe, of course, and Australian Reason Party member Fiona Patten, who was a delight to meet and talk to. Labour MP Arena Williams stood out on the political panel as someone her party could and should encourage to pursue an interest in evidence-based drug policy.

But over two days of listening – and bearing in mind the mindless Parliamentary squabbles of recent weeks – I started to despair of politics and politicians. As Helen Clark pointed out, Norway's deeply considered move away from its prohibitionst past to decriminalisation is now at risk because there's an election this year and their Labour Party has decided to use that reform as a point of attack. There is no principle in that. Just politics.

I do understand, to an extent, our government's wariness around cannabis reform. Although the referendum result was very close, "Yes" didn't actually win in many electorates – and it fared badly in Labour's South Auckland heartland, where people might have been forgiven for not wanting cannabis retail on top of their problems with liquor retail.

But to declare, as Andrew Little did, that "even though the case for change is obvious", the government didn't get the "social licence" for any reform at all just defies reason. The last government was supposed to review the Misuse of Drugs Act 1975. Little himself promised to do so. The Law Commission called for a review a decade ago. How on earth does the referendum result preclude sending the damn law to a select committee to hear submissions?

There is a debate within Labour's caucus on this stalling of reform and an even stronger one amongst its party membership. Andrew Little simply does not seem to be the minister capable of steering a way through that debate – not least because he will also be stewarding a staggeringly large reform of the entire national health service. Please, just give the drug delegation to someone else.

• If the Salvation Army, the NZMA, the Mental Health Foundation, the Public Heath Association et al collectively ask you to remove the criminalisation from the use of cannabis, don't go off in a huff. Talk to them.

• Acknowledge that the current medicinal cannabis scheme has real problems. Accept that the public increasingly sees the therapetic use of cannabis in a different light to "recreational" use – there are 80 year-olds using cannabis balms – and respond to the real environment, not one that simply fits existing practice. Ask yourself: are these really the people we want to drag though court? If not, do something about it rather than relying on pissweak John Key rationalisations about police discretion. Police would welcome the guidance.

• Send the Misuse of of Drugs Act 1975 to a select committee for review. It's hard to imagine a move with less political cost attached than that.

In short, fear and stigma sometimes make good politics. They very rarely make good goverment.

NB: I was able to take a week to prepare for and attend the symposium, and to write this, because some of you contribute to that work via our PressPatron account. If you appreciated this post, feel free to click the Supporter bar beneath this post and chip in a little. Cheers, RB.

9

A picture of official callousness and detachment

Last night, the New Zealand Herald posted a story from its political reporter Derek Cheng which bundles together a number of current issues around medicinal cannabis. The most alarming is that of Katy Thomas and her epileptic son Eddy, which has recently been taken up by Green MP Chloe Swarbrick. Their story was first reported a couple of weeks ago by TVNZ.

Swarbrick – the only member who seems willing to be caught caring about this stuff – posted her letter to Health minister Andrew Little on Facebook on April 23. I've posted it in turn in the comments below, along with a reply from Andrew Little, the Minister of Health.

The gist is that CBD oil imported from and prescribed by their GP was intercepted at the border twice in a month – and as a result six year-old Eddy's nocturnal seizures are now poorly controlled. This is not only distressing, it's potentially deadly. Any one of those seizures could be fatal.

One oil was apparenty intercepted because of paperwork – the prescription wasn't attached on arrival. I was mystified as to exactly why the other, which was to be delivered to the GP, was confiscated and destroyed. Swarbrick's letter cites Section 2A(1)(b) of the Misuse of Drugs Act, which defines a CBD product. She doesn't actually say the medicines were intercepted because they contain more than 2% CBD, but the two journalists who have reported the story have taken that meaning. But anyway, it's not the case. That's not what the law says.

So they're wrong on a key detail, but not in a way that reflects an iota better on minister Little, the Ministry of Health or New Zealand Customs. What is happening here is an awful picture of official callousness and detachment.

Section 2A doesn't limit the quantity of CBD in a product to 2% (which would be pretty low). It says that "specified substances" – that is, any form (isomer, esther, etc) of THC –  can amount to no more than 2% of the quantity of CBD. The products that have been intercepted did not contain any form of THC. So what actually happened?

I've spoken to Katy and been able to determine that, to an extent.

Since at least 2018, Katy has been importing products from the British company CBD Brothers, a licensed producer of CBD products. Recently, via her prescribing GP, she has been bringing in two products, the Purple Plus Water Soluble and the Red Edition CBD Oil, a full-spectrum oil derived from cannabis indica plants.

According to the WHO, CBD enjoys more evidential backing as a treatment for childhood epilepsy than any other condition, and these ren't dodgy novelty products. Each one comes with a certificate of analysis of the batch from which it is bottled. What happened is not that Batch 68 of the Red Oil contained THC, but that its certificate showed it contained 0.136% CBN, which equated to 3% of the total CBD content. (Ironically, if the oil contained more CBD, there wouldn't have been a problem.)

But CBN, while a cannabinoid, is not THC. In the absence of THC, it is not intoxicating, still less in the trace amount at which it is present in the oil. It's not mentioned on the Ministry of Health page covering the definition of  a CBD product, although Katy told me it is cited on one page I've been unable to find. But, again, it is not THC.

So why single out CBN, when the certificate of analysis shows one or two other innocuous cannabinoids? I wonder if the officials are hanging on these lines in Section 2A specifying:

a substance that has a structure substantially similar to that of any substance described in subparagraphs (i) to (iv);

Where you may find CBN in the real world is in degraded or oxidated cannabis – it's what THC turns into in old weed. That is not the case for the oil in question – and again, it is not THC. If the Ministry of Health believes it is – and this is the ministry that spent years insisting against expert advice that CBD was really THC in drag – then that needs fixing in the regulations.

Little's reply to Swarbrick doesn't address any of this.  Instead, he directs Katy to the only two CBD products that have so far made it through New Zealand's strictest-in-the-world regulations for approved medicinal cannabis products, both from the Canadian company Tilray.

(Last September, the government quietly put a six-month extension on the transitional rules that allowed GPs to import unapproved CBD products in order to prescribe them. Then in March, it extended the transitional scheme for a further six months – because, still, no local producer has been able to meet them.)

Katy has already tried the Tilray products and they are not suitable for Eddy.

"Eddy's particular phenotype is nocturnal seizures, tonic-clonic," she told me. "They are the most difficult to treat. They are the most resistant to anti-epileptic drugs – and they're the most deadly. It also happens that indica CBD works better because it has more sedative properties. But also no one makes it, because it's really hard to harvest CBD from [cannabis] indica plants. There's not a huge concentration in them."

Most CBD oils, including those from hemp, are derived from cannabis sativa. This is why Katy and Eddy's GP have been importing the cannabis indica products from the UK.

"[The Tilray products] don't work for Eddy. Every time we've tried to use sativa strains or isolates, although it does control his seizures, it had adverse effects that almost make the seizures more preferable. They're stimulating – and where Eddy's seizures happen are at the transition between light and deep sleep. So if you give him a stimulant, it's very hard for him to get under and stay under.

"So he's kind popping in and out of those sleep thresholds. And we see more parasomnias – and those parasomnias, if we give him sativa CBD, present as self-harming and screaming fits. Because he has auras, he'll often try to physically run away from his seizures, which when you're quite heavily medicated at night with other things as well as the CBD, is not the time to be running through the hall."

"He just sustains more injuries and he's much harder to control. So those products that we have here are not a safe option for us. They're great for daytime epileptics, they have a place for so many conditions. But not for us unfortunately."

She laughed when I asked her whether anyone at the Ministry of Health had offered to help with what is obviously an extremely distressing situation. Incredibly, she is now facing what looks, at best, like bureaucratic carelessness from New Zealand Customs, in trying to get in a product that has not been deemed unacceptable under the cannabis regulations:

"I received an email to say that I needed to apply for a licence and get my client codes, because the value of the goods that I was bringing into the country were over $1000. Which is completely new to me, because I've been spending more than $1000 on this medicine for years now and I've never required a client code or whatever that process is.

"So I started that on the day that I was asked to. I sent off all my documentation including my ID, then I followed up a couple of days later to see where we were at and they said, oh, we still haven't received it. So I forwarded the same emails again. Over the weekend I got in contact with another customer service agent from UPS and she asked me to send the documentation over again. I spoke to another girl on Monday and she asked me to forward it again.

"Then I just rang Customs and said where are we with this application? Where is the medicine? When is it going to be delivered back to us? And they said, oh, you're going to have to send over the documentation again. So I sent it over again. And then I sad, when is this going to be processed? And they said, two to three business days ..."

This is a mother who is just trying to keep her son happy, healthy and alive.

Happily, CBD Brothers have been more caring and she's been able to talk to the senior analyst at the company, which will now produce an oil for Eddy that will be acceptable to New Zealand officials – either by reducing the quantity of CBN (which she's not keen on, given that CBN may have anticonvulsant properties) or adding more CBD isolate to change the ratios.

"But I guess the issue is that there's no continuity of care for Edward. Every time we make these changes, we don't know if it's going to work – we're just hoping. There's no guarantees and it's actually really dangerous to suddenly change his medicine the way we have been doing."

Eddy's condition is now such that he's been out of school for six weeks. And Katy was scathing about the response from Little to Swarbrick's letter advocating on her behalf.

"We've been told in no uncertain terms that he's not even going to look at it. His reply was so callous and dismissive. It showed a complete disconnect from our lived experience and Eddy's lived experience.

"He really seems to not care in the slightest. Just the fact that he won't even consider any of it. And the idea that we're going to have this thriving local industry that's going to be the panacea to all our problems in September is a joke. Because if it was going to happen in September, then it would've happened in March, or last year.

"And in the meantime, we've still got to get there. And unfortunately, Eddy doesn't meet the definition of palliative even though any single one of his seizures could kill him. So we're not exempt and we just kind of have to go without. There's no urgency. It's not like I'm buying fancy furniture from overseas, or that this is a business product. It's lifesaving medicine. The bureaucratic hurdles we have to jump through are just monstrous."

The ministry may be correct in saying it's just applying the government's rules – albeit according to its own questionable interpretation – but Andrew Little has nowhere to hide on this. This is exactly the kind of case where the minister should be taking an interest, asking questions and looking for a way to help a family that needs helping. He has powers to intervene that he seems simply uninterested in using.

Little seems to have simply disengaged from this and the other issues raised in Swarbrick's letter, such as the prospect of a green fairy amnesty or any widening of the palliative exemption. He needs to be moved on from this part of his portfolio, not only for the sake of Katy and her son, but quite probably for the credibility of New Zealand's medicinal cannabis regime.

"The thing that surprises most people is that they think the law was passed and our problem was solved," Katy said. "But it's gone from bad to worse. It was definitely not improved – it's gone backwards. I actually feel embarrassed for even campaigning for the law in the first place, because it does nothing for us and the patients that we know. It's just a useless piece of legislation."

1

The drumbeat for reform gets louder

It should have come as no surprise after the narrow referendum defeat last year of a bill to legalise and regulate cannabis that its loudest and best-funded opponents should have wandered off to find a new culture war. The people behind SAM-NZ, Family First and Say Nope to Dope have never really cared about drug policy, evidence or reducing harm to the vulnerable.

But one prominent "No" campaigner, the Salvation Army, issued a statement immediately after the result calling on the government to develop "legislation that provides comprehensive and well thought-through decriminalisation", which should include "the further removal of criminal sanctions for casual use of cannabis" and better funding for drug treatment.

There hasn't been a lot since then, but last week, Ian Hutson, director of the Social Policy and Parliamentary Unit of the Salvation Army, joined addiction medicine specialist Professor Doug Sellman, a declared "Yes" voter in the referendum, to write a column expressing "frustration" at political intransigence and urging Parliament to "immediately enact decriminalisation of cannabis for all users of cannabis".

Their call follows an open letter from the Public Health Association, the New Zealand Medical Association, the Mental Health Foundation and others to overhaul the Misuse of Drugs Act 1975 – which provoked a ridiculous response from Health minister Andrew Little.

There was a similar call from Dr Huhana Hickey, Professor Khylee Quince, Manu Caddie and Dr Mark Hotu, the guests on TVNZ's Marae yesterday, who agreed that reform of our creaking 46 year-old drug law was a matter of urgency. (Dr Hotu seems to have forgotten that he wrote a poorly-reasoned and factually wayward column opposing a "Yes" vote last year, but we'll let that pass.)

Manu expressed the view that further reform this Parliamentary term was not only urgent, but – the statements of Minister Little notwithstanding – likely this term. My understanding is also that Little's position does not necessarily reflect that of his colleagues in government. But I wonder if far too much of the energy required to get to that point will be expended on concocting a way for the minister to save face.

If there is a consensus around decriminalising cannabis, it would be fair to say that is less the case around what decriminalisation should mean.

The Salvation Army called for a removal of criminal penalties for "casual use" of cannabis, but it's unclear what that means. What is non-casual use? Does it include self-growing? The ability to possess a limited quantity without question? Social supply?

In his column with Professor Sellman, Ian Hutson seems to favour Portugal-style decriminalisation of all drugs. I would love for New Zealand to follow Portugal, Norway, Oregon and Australian Capital Territories in doing so, but I'm not sure the Portugese model, which was developed in response to a crisis in intravenous drug use, usefully addresses the reality of cannabis in New Zealand.

Portugese police are supposed to interact with someone using or possessing cannabis in the same way they do for heroin. But they actually don't, because it doesn't really make sense to do so. They're more likely to just ignore someone smoking a joint. So you've still got a law that relies for its viability on not being applied by police.

Professor Sellman writes that his preferred legalisation model would be an equivalent to Sweden's "SOE model" for alcohol, under which the supply of cannabis is a state monopoly. I, too, worry about Big Cannabis – and I thought that the Cannabis Legalisation and Control Bill included provisions around market size, marketing and licensing that could have set an example for the rest of the world. I'd have amended it further to Keep Cannabis Small. But I'm not sure a state monopoly is really a good answer for cannabis.

Why? You only had to be at J Day in Auckland on Saturday to see. There were more vendors this year, a dozen or more, offering a range of home-made cannabis products. There's already a community producing and distributing these products, in a way that doesn't really answer to traditional perceptions of the "drug trade", and it's not simply going to pack up because the state grants itself a monopoly on production or supply.

But it's actually worse than that under the current law. Take a moment to admire these cannabis-containing muffins:

These muffins – and the cooking oil, balms, tinctures and infused honey that were for sale on Saturday – are "cannabis preparations" under the Misuse of Drugs Act 1975. That means that while cannabis flower is a Class C drug, baking it in a muffin escalates it to to Class B – the same as morphine, amphetamine and GHB. If you hand the muffin you have baked to another person, the maximum penalty is 14 years imprisonment.

Of course, the law is not generally enforced that way, because that would be crazy and unjust. For similar reasons, police have taken the approach of regarding J Day events as a form of advocacy and steered clear of them. And, frankly, they have no other need to attend – Saturday in Albert Park was an extremely relaxed affair, thanks in part to the absence of alcohol.

But it's not possible to look at our 46 year-old drug law and honestly declare it's not in need of comprehensive reform. It's time for some moral courage.

---

Audioculture recently republished my epic two-part feature on touring Europe with The Chills in 1987. But the decision was made to leave out a couple of passages that ran in the mag originally but were deemed unsuitable for a website used in schools. Which is fine and prudent – but it did strike me that landing in this place where things were done differently had prompted me to write for the first time about the culture and economy of drugs. I was just very interested in how it worked:

It tickles something else to appreciate the way cannabis preparations from around the globe have found their way to the corner of the bar of a tiny cafe in Amsterdam. Café dealers will be able to offer a range including Mexican seedless, dry, dusty grass from Africa or Colombia, dark, spicy-smelling buds from Jamaica, hash from Afghanistan (purchased, they say, from rebel forces on the Pakistani border), Nepal, Turkey, Morocco ... and even locally-grown sinsemilla, the product of Californian consumer grass technique. The man will have a board listing his products and prices and possibly a folder, like a photo album, of sample bags. As befits its retail status, most quantities are worked round a 25 guilder (about NZD$25) standard price. At that price for two grams of Jamaican buds it’s not wondrously cheap, but this is retail. If it’s all too confusing you can buy a piece of “space cake” for five-seven guilders.

There are hundreds of cafés in Amsterdam but only dozens which encourage cannabis smoking. Of those which do, some are large, perhaps with two floors, some are small. Those aiming for young tourists have big video and sound systems, while others just hum with a quietly hip soundtrack and low conversation. The big ones serve alcohol, the small ones usually don’t. Some are part of a chain, like the Bulldog cafés, which even extend outside Amsterdam. The Bulldog tries to play both games with its Leidseplein branch which has two basement hash cafés and a big, bright, airy restaurant for tourists upstairs. Periodically, a straying group of English matrons will have to be quietly told by the barmaid that hash is being smoked down here and perhaps they’d be happier upstairs. They have to be careful. One such matron last year was served a piece of space cake, hallucinated, and demanded that the British Foreign Office declare war on Amsterdam.

I was also very interested to, for the first time, read High Times magazine, which was strictly prohibited in New Zealand:

Many bookshops carry English-language publications as well. Notable among them is the legendary drug culture magazine High Times. It’s an obscene publication in many countries – if the ever-lovin’ NZ customs found one in your suitcase they’d certainly take it off you and probably want to have a quick look up your bottom for good measure.

It’s pleasing to find out that High Times is an excellent magazine. It’s well-written, very well researched and the four-colour printing is spot-on, which it has to be to depict the subtle but important differences between one cluster of brown-green buds and another.

Inside each ish there’s Ask Ed, a comprehensive growers’ problem page (“The increasing pH is probably being caused by the gravel, which is probably limestone ...”); the Trans-High Market Quotations, a nationwide chart of current recreational drug prices compiled from readers’ figures; Activist News; a legal directory; a readers’ Top 40 of favourite things (usually topped by sex); and even a lung-watering centrefold.

Individual issues include features like a Ken Kesey interview and short story; an enthusiast’s (everybody connected with the mag seems to be an enthusiast) account of a gruelling trip up the Amazon to sample a little-known hallucinogen called Nu-Nu; good music features covering ground from the Fall to Trouble Funk (but the readership still loves the Grateful Dead, it seems); and a calm, serious article on the danger of crack – and the way its mystique has been inflated by those eager to sell newspapers.

It’s all made possible by heavy advertising support, from the likes of growing-aid manufacturers, peddlers of legal “diet aid” type stimulants, and all manner of non-drug products which intersect with the lifestyle.

High Times is a funny, informative, and, in its resolute matter-of-factness, quite responsible. For better or worse, its ethos is probably summed up by regular writer Ed Hassle: “Drugs can be your friend as long as their power respected. Drugs can grant visions, calm fear, expand the mind, and relieve pain. But they can also cause insanity, bankruptcy and death.”

The irony, of course, is that the Dutch system is now regarded – not least in the Netherlands itself – as dated and in need of reform itself, relying, as it does, on criminals to look after production, import and wholesale supply.

18

Cannabis: Who owns Say Nope to Dope anyway?

After a quiet spell in the news on account of, well, other stories, cannabis and what to do about it staged a modest headline revival this week. First there was this Stuff report on a journal article by Massey University researchers Marta Rychert and Chris Wilkins on how the cannabis referendum campaign unfolded.

Prime Minister Jacinda Ardern’s decision not to reveal her position on the cannabis debate during election campaigning could have been a "decisive factor" in last year’s referendum, academics believe.

The article in the Drug and Alcohol Review isn't freely available, but I've read it – and the headline claim, quoted accurately from article's abstract, isn't really backed up in the text, which declares only that Labour's decision not to campaign on the referendum (a Green Party policy) and Ardern's decision not to declare her vote (a "yes") in advance added to the "volatility" of the vote. That's it.

The authors also speculate that in financial terms the "Yes" and "No" campaigns probably cancelled each other out.

Of the 15 registered referendum campaigners, only two were clearly against the reform while 11 were supportive of the policy change, suggesting, on the face of it, that pro- legalisation campaigners outnumbered anti-legalisation groups with potential related greater allowable campaign promotional budget.

They quote their own research finding (which will have been based on  information published by Facebook itself) that "the leading pro-legalisation reform group (‘Make it Legal’) spent nearly four times as much as the main anti- reform group on social media advertising (‘Say Nope to Dope’)."

Make It Legal was prominent on Facebook especially, but it simply was not "the leading pro-legalisation reform group". Only three registered third-party promoters crossed the $100,000 thresheld requiring a return to be filed with the Electoral Commission. Make It Legal was not among them. Say Nope to Dope wasn't a registered campaign at all.

To be fair, the authors acknowledge that their article was submitted before third-party promoter returns, offering a proper insight into who spent what during the regulated campaign period. Those returns have been published now – and they're interesting.

As noted, only three promoters spent more than $100,000. On the "Yes" side there was the New Zealand Drug Foundation and its "Health Not Handcuffs" campaign, which spent $337,241.67 – right up to the limit of $338,000. On the "No" side, SAM-NZ did much the same, spending $320,300. The third big spender was also on the "No" side: Family First racked up $141,224 in expenses.

Which is where it gets intetresting, because Family First and SAM-NZ are really the same people – between them they spent $461,524.

Say Nope to Dope was founded by Family First's Bob McCoskrie and in 2017, after the referendum was announced, McCroskie declared it would be  mounting "a strong campaign" against a vote for legalisation. On June 3 last year, Family First announced it was stepping it up a notch, with the appointment of Aaron Ironside as Say Nope to Dope's spokesman. But only five days later there was another announcement, also made by Say Nope to Dope: Aaron Ironside was to be spokesperson for a new group, SAM-NZ, which welcomed the assistance of the American prohibitonist group SAM (Smart Approaches to Marijuana).

SAM-NZ had a number of organisations listed as members – including those Scientology fronts – and Family First was not among them. But Bob McCroskie – who, lets face it, is Family First – was.

Then we come to the matter of who owns Say Nope to Dope. The Say Nope to Dope website is still up and its campaign material is Authorised by SAM (Smart Approaches to Marijuana) NZ, c/- 28 Davies Ave, Manukau City 2241. And yet, here's a Say Nope to Dope ad Authorised by Family First NZ, 28 Davies Ave, Manukau City 2242.

This apparent donation of office resources is in neither organisation's return.

Anyway, yesterday, in a post gloating about the Massey article, Family First was back using Say Nope to Dope.

By this point, you may not be surprised to learn that all along, including when it was a vehicle for material from one registered promoter (SAM-NZ), the saynopetodope.org.nz domain was owned by another registered promoter (Family First).

So here you have two organisations involving the same people, working out of the same office and using the same campaign material (the URL for the SAM-NZ 'Reasons to Vote No' sheet linked above even contains the text "SAM-VERSION').

It seems that the cleaving of Family First's efforts in two was a successful effort to spend beyond the expenses cap for a single group – nearly half a million dollars versus the cap of $338,000.

That, of course, isn't all there is to it. SAM-NZ and Family First did pursue distinct strategies. SAM-NZ's main expenses were in mainstream media advertising. Family First, on the other hand, spent more money printing pamphlets – and having them translated into Tongan, Samoan, Maori, Arabic and Korean. This was pretty smart.

The biggest expense for the sole "Yes" campaign to exceed $100,000, the Drug Foundation's was $214,387 on media advertising. There was also $80,434 to Augusto for creation of TVCs, digital and print ads and social media material. It's fair to say it wasn't Augusto's best work.

There is one more thing: and that's all the money Say Nope to Dope spent as a Family First vehicle in the nearly three years leading up to the regulated campaign period. We'll  never know now much that was – but there were a lot of billboards.

No assessment of the campaigns can ignore those three years, because that's when the polls turned from being fairly favourable for reform (albeit without knowing the details, including the scope of retail sale) to very unfavourable. "Yes" got close to making up that ground as the referendum drew near, but didn't quite get there. I've expressed previously the view that that was effectively when the referendum was lost.

 –––

Another point made by Rychert and Wilkins in their article is that there was always more public support for decriminalisation than for a tightly-regulated legal market and a referendum on decriminalisation might have fared better. I think that was evident to everyone involved.

But – and this is a point that still needs explaining – the Ministry of Justice group that came up with the basis of the Cannabis Legalisation and Control Bill was not tasked with crafting the reform most likely to pass a referendum. It was asked to look at the evidence and devise a regime based on that.

Decriminalisation was canvassed early on, in the first Cabinet paper, and dismissed: it didn't restrict access to cannabis or impose controls on the quality of cannabis products and who could sell them – and it relied on a continuing criminal supply.

Unlike many other people on social media, I wasn't furious at Jacinda Ardern for her decision not to declare her vote in advance, or at Labour for failing to campaign on another party's policy. Ardern declaring would have helped, but I don't think it was the clincher.

But I have been bloody livid at Andrew Little, on his damn way out of the Justice portfolio, for declaring that the very narrow referendum loss was curtains for all drug law reform for the foreseeable, decriminalisation of cannabis included. And for him continuing to say so even now he's not Minister of Justice.

That was not what the referendum was about – and not long afterward there was in fact a key drug law reform, when the government fulfilled a promise to legalise drug-checking at festivals and other venues, a move which has already helped save lives and medical resources.

So perhaps the government might want to look closely at a UMR poll conducted for the Helen Clark Foundation and published this morning. It finds a majority in favour of decriminalisation amongst supporters of every Parliamentary party, excepting the Māori Party, where the sample size was probably too small to publish.

The poll is notable because 49% of respondents say they voted "Yes" in the referendum – that is, almost exactly the proportion (48.4%) who actually voted that way in the referendum. When you add the people who voted "No" but would support decriminalisation, that's 69% of the electorate. I mean, come on.

To save any blushes, the government could simply do what it has promised to do and fix the police discretion amendment in the Misuse of Drugs Act now that New Zealand First is out of the way – so that the default for simple possession of any drug is not to prosecute. From there, it could carve out some special provisions around cannabis – especially in the case of green fairies.

As my profile of the Northland green fairy Gandalf in Canvas last Saturday makes clear, local police very probably know exactly what he's doing, but stay their hands because they don't want to bust someone on whom hundreds of mostly elderly patients rely, knowing a judge might grant a discharge anyway. That shouldn't be the way it works – and the goverment should have the courage to change it.