31 January 2018

Calls grow for unified access to cannabis

Chronic Disease Clinical

More GPs and patient advocates are venting their frustration over state-based rules that are blocking access to medicinal cannabis for conditions such as chronic pain and nausea.

Until just a few years ago, Dr Teresa Towpik said she was a sceptic opposed to marijuana in any form. Now, she believes doctors and regulators should take account of “observational evidence” from patients and carers.

“As doctors, we need to be a bit cautious and conservative, but we need to be courageous as well,” she said.

The GP, who practises in the Blue Mountains west of Sydney, has been unsuccessful in her attempts to prescribe a medicinal cannabis product for a patient with chronic pain.

She does not endorse illicit use of cannabis, however, saying patients who resort to the black market risk missing out on proper medical management and could be exposed to products of dubious quality.

Dr Towpik says she is speaking out and sharing her research in hopes of reducing the mystique around the therapeutic use of cannabis.

RACGP President Dr Bastian Seidel has come out in favour of a unified system of access, instead of the array of state regulations which require GPs to get endorsements from specialists on top of federal approval.

“It’s time for all health ministers to commit to a nationally consistent regulatory framework that informs access and prescribing of medicinal cannabis. Patients and practitioners deserve transparency. Anything else is politics,” Dr Seidel said.  He was responding on Twitter after federal Health Minister Greg Hunt revealed government hopes to create a world-leading export industry from medicinal cannabis products.

“If I were a patient I would wonder, does the government want me to move countries to access the product?” Dr Seidel said in a media interview.

Lucy Haslam, whose son Dan found relief from cannabis before his death from cancer three years ago, said an Australian family had moved to Canada to secure a medicinal cannabis supply for a sick child.

“Many sick people are in desperation,” Haslam said. “In Israel, people who need medicinal cannabis get the products and they are supervised, and (the authorities) build the evidence from the data. In Australia, people are stuck with the black market because the government insists on double-blind randomised controlled trials.

“People are already using it, because it works for them. Why ignore those people and leave them in harm’s way, using product of untested quality?”

She is asking doctors to help counteract the “scaremongering” around medicinal cannabis, which she says is a hangover over from US propaganda in the 1930s.

Sydney GP Dr Brad McKay said the RACGP should press for a resolution of prescriber authority for GPs, describing the current situation as “a shemozzle”.  He said he had spent months jumping through hoops with NSW Health seeking approval for a medicinal cannabis product for a patient who was about to undergo chemotherapy. The patient had used an illegally obtained product to control nausea during an earlier bout of chemo treatment.

“They strung me along for two to three months, only to tell me finally that (the product) was not even available,” Dr McKay said.

Fewer than 400 patients in Australia are believed to have been prescribed medicinal cannabis, including children with severe epilepsy.

In Canada, where GPs can prescribe medicinal cannabis products, more than 200,000 patients are approved users.

Dr Towpik says her research shows a long history of cannabis use for a range of including chronic pain, epilepsy, multiple sclerosis, and neurodegenerative disease.

“I see a lot stories where patients with chronic debilitating pain were taking cocktails of everything you can imagine – benzos, antipsychotics and anticonvulsants,” she said.

“They say cannabis has changed their lives. For them, that is evidence.”

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