New medicines derived from cannabis plants are likely to be the outcome of legislation to regulate the cultivation of the plants in Australia.
The Victorian Government’s recent report on medical cannabis and the media release of October 17 by Federal Health Minister Sussan Ley propose to allow the commercial growing of marijuana and manufacture of cannabis products under legislation similar to that that allows poppy cultivation and the production of opiate-derived medications such as morphine.
Amid fears that these changes will open the gate to allowing recreational use of cannabis, it seems that the reason for these changes are based on more pragmatic considerations. Many pharmaceutical products are derived from potentially toxic and poisonous plants and health authorities and governments worldwide have taken an active interest in providing standardised plant-derived medications. Many of these products are highly effective and very profitable for the discoverers and Australia hopes to cash in on this by legalising the use of this plant for research and development of products.
At the same time, it is hoped that the changes will placate a very vocal group and silence a persistent campaign to allow individuals who suffer from serious illnesses, including epileptic children and cancer sufferers to use these products. The legislators have made it very clear that cannabis will not be allowed to be cultivated by individuals or that any products that are smoked will be allowed.
To date the evidence that cannabis-derived products have significant therapeutic effects has not been very persuasive. Claims that they can be used to treat a wide range of conditions, including muscle spasms caused by epilepsy and multiple sclerosis, chemotherapy-induced nausea, Crohns disease and poor appetite caused by HIV, are not well established.
On the one hand, there are big problems with cannabis use, such as its addictive potential and links to mental illness including psychosis. It can cause hallucinations, and reduces motivation and impairs driving. On the other hand, the human cannabinoid system is complex and an understanding of the benefits of cannabis-derived products is in its early stages.
Researchers say that there are 10 major cannabinoids found in the plant and some seem to hold medicinal promise. But they know virtually nothing about other cannabis compounds and only a few pharmaceutical companies around the world manufacture cannabis-based products.
Cannabis is just one plant that is yet to be fully researched and exploited. At present over 100 plant-derived drugs are used worldwide and they come from fewer than 90 of the 250,000 plant species that have been identified. Plant-derived medications include quinine, aspirin, atropine, digoxin, morphine, paclitaxel, pilocarpine, reserpine, scopolamine, topotecan and vincristine. They are prescribed mainly as anti-allergic/pulmonary/respiratory agents, analgesics, and cardiovascular drugs, and for infectious diseases.
Some of the most potent medications have come from plants and hence it is believed to be important to protect biodiversity.
The intention of the proposed legislation seems to be to develop a legitimate pharmaceutical industry with the potential to export products worldwide. The proposers of the legislation have specifically said they will not allow individuals to cultivate cannabis for their own use or sale because it is an uncontrolled dose, it is too easily diverted, and it prejudices those who do not or cannot grow it. At the same time it is proposed that cannabis medicines must meet the standard of every other medicine in Australia.
Moreover, it will be strictly controlled as poppy cultivation is now under the Narcotics Control Board and the relevant United Nations Conventions that allow for prohibited drugs to be produced for research and scientific purposes. They would be in compliance either relevant UN conventions.
Supply of unregistered medicinal cannabis products for clinical trials and specific patients would continue to be managed in accordance with current provisions under the Therapeutic Goods Act 1989. The Government would also have to set up an Office of Medicinal Cannabis to oversee the manufacturing, dispensing and clinical aspects of the scheme.
At the same time any move to extend the sale of cannabis needs it be strenuously resisted. Australia has grown poppies since the early 1970s under agreements with three pharmaceutical companies that export opiate-derived products around the world. This goes almost unnoticed. The evidence is that the controls that are in place have not led to any diversion into the illicit drug market and in all this time there has been no indication that any government was going to allow heroin production for recreational use.
The same thinking seems to be applicable to the development of a cannabis pharmaceutical industry in Australia. It seems more likely that the promoters of legalising cannabis for recreational use who saw the legalising of medicinal cannabis as a strategic ploy along this path may well be thwarted by the present proposals.
Dr Ross Colquhoun is an executive member of Drug Free Australia and research fellow, and a member of the Drug Advisory Council of Australia (daca.org.au).
A recommended recent publication for the facts on cannabis is How to Quit Cannabis by Jan Copeland (Allen and Unwin, 2015). See page 21 below.