Hard News by Russell Brown

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Hard News: Kia kaha, Helen Kelly

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  • Sacha,

    I've seen for myself the difference between use of (legal) opiates and (illegal) cannabis in late-stage cancer. The current regulatory situation is a farce.

    I am so impressed with what Helen Kelly is doing for others right to the end. Such an amazing life of contribution. Thank you.

    Ak • Since May 2008 • 19686 posts Report Reply

  • George Darroch,

    She's a good woman.

    If the holdup isn't the Minister (let's assume that for a second), is it the Ministry, or interference from other parts of the government? I don't want to presume anything here, but it seems that someone is managing risk (to the government, not to the public) in a way that is rather callous.

    As for the idea that people would illicitly use Sativex when perfectly good recreational cannabis is widely available - it would be just as ridiculous as banning cough medicines because they contain alcohol.

    WLG • Since Nov 2006 • 2264 posts Report Reply

  • Ross Bell,

    I like Helen's blog, and yours too Russell. It's worth noting that the legal barriers aren't solely because it's cannabis... the same barriers exist for any other unapproved medicines.

    We've done a brief Q&A to clarify some bits around medical cannabis.

    Wellington, NZ • Since Nov 2006 • 168 posts Report Reply

  • Russell Brown, in reply to George Darroch,

    As for the idea that people would illicitly use Sativex when perfectly good recreational cannabis is widely available – it would be just as ridiculous as banning cough medicines because they contain alcohol.

    Some of them contain rather more than that – and pose a much greater risk of harm than Sativex.

    I do realise that the advice to Pharmac concerned public spending priorities and that the committee didn’t see enough evidence of Sativex’s effectiveness in treating spasticity (although I’m not sure it had taken into account the broadly positive American Academy of Neurology review in 2014).

    That’s fine and that’s what advisory panels are for. But in speculating on potential for abuse and diversion, I think the committee went beyond its own expertise and was simply wrong. You do have to wonder if there’s institutional resistance here – I have heard murmurings of that with respect to Dunne’s advisors.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Sacha,

    #notalldoctors

    Clinical Leader of Pain Management at one of our DHBs argues the case in favour of doctors prescribing cannabis with appropriate scope and controls - via commenter Annie Helm at Te Standard.

    His last para makes a good point:

    There is an ethical dimension to this. Given that we have an available, effective treatment for a disabling condition where no other treatment
    exists, not to prescribe may be considered to be unethical, even negligent.

    Ak • Since May 2008 • 19686 posts Report Reply

  • Sacha, in reply to Russell Brown,

    in speculating on potential for abuse and diversion, I think the committee went beyond its own expertise

    reckon

    Ak • Since May 2008 • 19686 posts Report Reply

  • Sacha,

    Story picked up on Stuff - and good on them for actually linking to the source blogpost. Unscientific reader poll results also interesting.

    Ak • Since May 2008 • 19686 posts Report Reply

  • George Darroch, in reply to George Darroch,

    “Associate Health Minister Peter Dunne has said the Government will not be swayed by “emotional nonsense” colouring calls for wider access to medicinal cannabis.”

    Link.

    Okay.

    I can only hope that his comments are taken out of context here.

    WLG • Since Nov 2006 • 2264 posts Report Reply

  • Shane Le Brun,

    With regards to Sativex, Pharmac got a completely different result on cost effectiveness than say. Link:Italy

    We also are inundated with patients seeking access, at MC Advoacy NZ, we have brain cancer patients talking to Manuel Guzman and his team, the word leaders on research of cannabis for brain tumors, and their advice and support to the patients have been soundly ignored by the oncologists, kids looking at their 3rd lobe removed from the brain, and the surgeons not prepared to try Sativex or an MC product instead, (non invasive experimental medicine vs repeated failed brain surgery?). Those are the extreme cases, but there is also the issue where doctors will not discuss sativex with the patient as they think its too expensive for the patient, that is not the doctors call to make and is causing unneeded suffering. Due to the wide support for MC most crowd funders for sativex are quite spectacular, one achieved 20k in 2 days just this weekend!!

    Since Mar 2015 • 46 posts Report Reply

  • Russell Brown, in reply to George Darroch,

    Okay.

    I can only hope that his comments are taken out of context here.

    The quotes were reported from a Radio NZ interview – Kathryn Ryan if I recall correctly:

    Dunne said he relied on clinical advice when deciding whether to grant an exemption, with the Ministry of Health providing a recommendation for each case.

    Pharmac was considering whether to subsidise Sativex, a medicinal cannabis mouth spray which costs about $1300 a month, but had not yet made a call.

    Dunne rejected calls to allow the use of raw cannabis for medical reasons, saying the Government’s policy was “not to decriminalise the cannabis leaf” while there was not sufficient evidence for its medical value in an unprocessed form.

    “[To say] that people puff the weed the way they like and all will be bliss – that is nonsense.

    “We’re talking here about medicinal products that have to be properly tested, properly regulated, the dosage assured so that people aren’t being exposed to risk.”

    Dunne said the Government’s focus would remain on clinically tested and approved medicines that were safe for use, while continuing to allow applications for exemptions.

    “That is really where the argument begins and ends – all the other stuff is extraneous, emotional nonsense."

    I understand he feels he has to back the process, but he did not cover himself in glory in that interview. He lost the plot.

    He later said he would welcome New Zealand holding medical cannabis trials – a few days after he’d dismissed the possibility of trials because New Zealand is too small. Which could be true –Ed Gane got trials for the new Hep C antivirals here basically because he did the principal work in describing the virus 20 years ago.

    On one level, it’s all perfectly proper. But at the heart of this is the case for a deviation from process in the name of harm reduction on one hand – and National’s 100% political “no decriminalisation” line in the sand on the other. I really think that the best hope for change is making the issue politically awkward for Key. Dunne won’t, and probably can’t, do it on his own. In Australia, it's taken new legislation.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Rosemary McDonald, in reply to Russell Brown,

    the best hope for change is making the issue politically awkward for Key.

    Sunk, then.

    Key is immune from shame, embarrassment, censure, criticism, accountability, etc.

    Waikato, or on the road • Since Apr 2014 • 1344 posts Report Reply

  • Alfie, in reply to Sacha,

    Attachment

    Unscientific reader poll results also interesting.

    I'd say. Over 6,000 votes so far and only 5% entrenched. Public opinion has indeed turned.

    Dunedin • Since May 2014 • 1386 posts Report Reply

  • Russell Brown, in reply to Alfie,

    Gah. That question mixes up decriminalisation and legalisation and appears with a story about medical cannabis. It's hard to have productive discussions when you don't know what you're talking about.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Sacha, in reply to Russell Brown,

    “We’re talking here about medicinal products that have to be properly tested, properly regulated, the dosage assured so that people aren’t being exposed to risk.

    The inability of even seasoned decision-makers to properly assess risks and benefits is astounding. What does he think cannabis can do to patients? Panadol is hugely more dangerous.

    National’s 100% political “no decriminalisation” line in the sand

    Yep, it's all about politics - not the evidence or what would benefit people's wellbeing the most.

    Ak • Since May 2008 • 19686 posts Report Reply

  • Alfie, in reply to Russell Brown,

    If Fairfax had run that poll five years ago, I suspect the results would be very different.

    However confused and unscientific the poll may be, it surely provides a small snapshot of public opinion at this point in time. And you'd have to agree that on the general subject of cannabis law, NZ opinion has moved drastically in recent years.

    I'd like to think that the numerous positive stories coming out of Colorado, and more importantly the total lack of negative reports, are having an impact on public perception here.

    Dunedin • Since May 2014 • 1386 posts Report Reply

  • George Darroch, in reply to Alfie,

    I’d like to think that the numerous positive stories coming out of Colorado, and more importantly the total lack of negative reports, are having an impact on public perception here.

    I think we may eventually be in the position of having the experience of legalisation and decriminalisation in the United States showing New Zealand the possibilities for doing things here.

    Which is very different to how I would have imagined things fifteen or even ten years ago.

    WLG • Since Nov 2006 • 2264 posts Report Reply

  • George Darroch, in reply to Russell Brown,

    “We’re talking here about medicinal products that have to be properly tested, properly regulated, the dosage assured so that people aren’t being exposed to risk.”

    Dunne said the Government’s focus would remain on clinically tested and approved medicines that were safe for use, while continuing to allow applications for exemptions.

    Dunne's managerialism here is rather pointy. People are being exposed to very high levels of pain, which is a negative outcome, losing the ability to live functional and independent lives, and are being dosed on debilitating opoids. It's disappointing, but this appears to be where the bright line is.

    Key is very much a follower, and if Jerry and Molly or whoever on commercial radio are asking him lots of questions about it he'll answer along the lines of "we'll consider it", poll it heavily for downside, and then make the safest possible decision for his party.

    WLG • Since Nov 2006 • 2264 posts Report Reply

  • Russell Brown, in reply to George Darroch,

    Dunne’s managerialism here is rather pointy.

    It is.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Alfie,

    Helen Kelly lists the criteria involved with applying for government permission, including this one which must have been dreamed up by somebody taking dumb pills.

    4. patient (must be) hospitalised when treatment is initiated (wtf!)

    It doesn't matter how much pain a person is suffering, or whether alternative treatment would improve their quality of life. If they're not hospitalised, they just don't qualify. That's ludicrous.

    Dunedin • Since May 2014 • 1386 posts Report Reply

  • Russell Brown, in reply to Alfie,

    It doesn’t matter how much pain a person is suffering, or whether alternative treatment would improve their quality of life. If they’re not hospitalised, they just don’t qualify. That’s ludicrous.

    Do you know if the Medicines Act would have to be amended to get rid of ludicrous provisions like that – or is it just a matter of changing the regulation?

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Russell Brown,

    In unsurprising news, Bob McCoskrie is an arsehole.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

  • Sacha, in reply to Russell Brown,

    I doubt it's in any other laws, given routine home-based hospice care involving strong painkillers these days.

    Ak • Since May 2008 • 19686 posts Report Reply

  • Alfie, in reply to Russell Brown,

    Do you know if the Medicines Act would have to be amended to get rid of ludicrous provisions like that – or is it just a matter of changing the regulation?

    I don't know personally, but according to Helen's TS post, there are eight criteria to be met when applying for a non-pharmaceutical grade product. While most of them are near-impossible to meet, especially for a sick or dying person, I'd say item 4 (hospitalisation) could be dropped overnight if the political will existed.

    Dunedin • Since May 2014 • 1386 posts Report Reply

  • Kumara Republic, in reply to Russell Brown,

    In unsurprising news, Bob McCoskrie is an arsehole.

    George D:

    If the holdup isn't the Minister (let's assume that for a second), is it the Ministry, or interference from other parts of the government? I don't want to presume anything here, but it seems that someone is managing risk (to the government, not to the public) in a way that is rather callous.

    As for the idea that people would illicitly use Sativex when perfectly good recreational cannabis is widely available - it would be just as ridiculous as banning cough medicines because they contain alcohol.

    If it's not Judge Laura Norder (who counts McCoskrie among her supporters) who's holding back reform, then it's quite possibly Big Pharma, Big Booze, or Big Chemicals. Or a combination of both.

    In any case, being prohibitionist on weed while being libertarian on booze at the same time is an obvious red flag.

    The southernmost capital … • Since Nov 2006 • 5418 posts Report Reply

  • Russell Brown, in reply to Alfie,

    I don’t know personally, but according to Helen’s TS post, there are eight criteria to be met when applying for a non-pharmaceutical grade product. While most of them are near-impossible to meet, especially for a sick or dying person, I’d say item 4 (hospitalisation) could be dropped overnight if the political will existed.

    Hmmm. Perhaps I should have a look at the Act. It might be useful to have a checklist of unreasonable requirements that should be amended, and to see what's actually in the law.

    Auckland • Since Nov 2006 • 22754 posts Report Reply

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