Kiwis are literally dying to use medicinal cannabis. Is a change to the system bold enough? video

Nelson teenager Alex Renton was the first Kiwi to be treated with a medicinal cannabis product that hadn't previously ...
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Nelson teenager Alex Renton was the first Kiwi to be treated with a medicinal cannabis product that hadn't previously been government-approved. He died in July 2015.

If obeying the law cost you thousands of dollars, but you could circumvent it for just $100 or so, what would you choose?

This is the decision confronting terminally ill Kiwis when it comes to using cannabis.

The only way to legally obtain the drug in New Zealand is to have a "severe or life-threatening illness", and thousands of dollars to pay for a government-approved cannabis-based product - although the process for getting them is about to become easier.

Alex's mother, Rose Renton, backs a licensing system that allows Kiwis to grow and make their own medicinal cannabis ...
MARION VAN DIJK/FAIRFAX NZ

Alex's mother, Rose Renton, backs a licensing system that allows Kiwis to grow and make their own medicinal cannabis products.

The system is patently unfair, says the mother of a Nelson teen treated with cannabis oil before his death two years ago.

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"I don't think we should be dying to access a natural herb that's non-toxic, at all. I think that's an extreme view," says Rose Renton, whose 19-year-old son, Alex, died in hospital after suffering status epilepticus, a type of prolonged seizure.

MEDICINAL CANNABIS IN NZ

Since 2008, chronically and terminally ill patients have been able to apply to the government to use an approved product made from cannabidiol (CBD), a chemical compound of cannabis.

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Currently, patients need Ministry of Health approval to access the products (until February, that approval had to come from Associate Health Minister Peter Dunne himself).

But under a change announced on Friday, a decision on prescribing the drug will be left to doctors - just like any other prescription medicine.

Ministry of Health officials are working on a new regulation - a process that will take about two months - before the change comes into effect.

While the move's been welcomed by medicinal cannabis advocates, there's still a major issue for patients: the enormous cost.

Their product options are limited to Sativex, a spray which costs about $1200 per month, or Tilray, which costs about half as much.

Although the regulation change allows patients to get a prescription for a three-month supply, instead of just one month, it's unlikely many patients will be able to afford the trebled cost.

Renton succeeded in getting approval for Alex to be treated with a different, much cheaper, imported product, Elixinol, to ease his symptoms in the month before his death in July 2015.

His was the first approved use of a "non-pharmaceutical grade product"; last year, four more such approvals followed.

Data supplied to Stuff by the Ministry of Health shows approvals of applications to use pharmaceutical-grade products - Sativex and Tilray - reaching a peak, at 59. Just two applications were declined.

Up to May 18 this year, the Ministry of Health had approved 27 applications to use pharmaceutical-grade products, and declined one. It also approved a single application for a non-pharmaceutical product.

'BLIND EYE' TO ILLEGAL CANNABIS

This year's Global Drug Survey revealed most Kiwis who say they use cannabis to treat medical conditions are doing so illegally: three per cent said they use cannabis solely for medical reasons, and nine per cent use it "mostly" for medical reasons.

However, most Kiwi respondents (61 per cent) use it only recreationally, while 27 per cent said they use it mostly recreationally and sometimes for medical reasons.

"People don't want to have to go through the process and pay $1200 for Sativex when they can make their own products," says Renton, who is also on the board of cannabis reform lobby Norml. 

Dunne doesn't want to see terminally ill users prosecuted for using illegal cannabis, and believes the law "works in the main".

Police, he says, "effectively turn a blind eye" to low levels of cannabis possession.

"The problem is, every now and then you get a cop out in the regions who decides 'I'm going to enforce the law as it stands'."

Police don't characterise it quite the same way.

"The role of police is to enforce the law and the police approach to cannabis has not changed," a spokesman said.

"Police officers do, however, have discretion on how they deal with a range of matters, including cannabis offences, on a case-by-case basis."

Dunne says there's more work to be done to reach a consensus on how to apply the law.

"I think the next logical step is we might develop some formal guidelines that they can then give to their officers in terms of how to deal with such cases."

CUTTING THE COSTS

Government-approved cannabis products come from just a few exporters overseas, and aren't subsidised by Pharmac - hence the cost.

Six years ago, the Law Commission recommended carrying out clinical trials in New Zealand, using locally grown cannabis.

Dunne says he's "quite keen" on the idea, "but no one's come forward offering to do clinical trials".

"Whether it happens or not is not in my hands. It's not the government's role to go out there and say 'we're setting up trials'."

The lack of interest from researchers is largely economic: trials would cost millions of dollars, just to sell to a rather small market - the same reason why synthetic cannabis manufacturers haven't bothered testing their products to meet new requirements under the Psychoactive Substances Act.

Otago University's Dr Giles Newton-Howes, an expert in substance abuse psychiatry, suggests Dunne should fund the trials himself.

"The only way we're going to get some local information about the dope that we grow and smoke here is going to be if there's some commercial end to that."

Medical anthropologist and drug researcher Geoff Noller, who is an expert adviser on Norml's board, suggests a state-led system like that of the Netherlands, where the Office of Medicinal Cannabis produces cannabis for medical and scientific purposes, and supplies it to pharmacies, hospitals and veterinarians.

Renton's view is different again. She'd prefer a licensing system that allows Kiwis to grow and make their own products.

"There'll always be a percentage of New Zealanders that want a regulated, pharmaceutical-style product, which the government can provide them with, but there's plenty of other people that have been using it for generations that know it's safe, that just need education on how to make those products for themselves. 

"Whether it just be like a licence - we register our cars, get a fishing licence - if you apply and are a licenced cannabis grower for whatever condition, you could pay a small annual fee for that to occur, and then we have a regulated system."

 - Stuff

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