A Bittersweet Victory For Chronically Ill Patients

A bittersweet victory for chronically ill patients. When Australia legalised medical cannabis in 2016, it was a victory for chronically ill patients. But, it has become bittersweet as they battle for access.

A new Bill to make it easier for medical cannabis importers to have a stock on hand will go to the Australian Senate. Greens leader Dr Robert di Natale believes the Bill will pass. Its intention is to make it easier for Aussie patients to access the medicine they need to help them with quality of life.

Introducing this Bill, di Natale accuses the government of ‘ignoring the will of parliament’. When the government legalised medical cannabis in 2016 it did not make provision for doctors to prescribe some patients with terminal conditions. They have to apply for permission under Category A of the Therapeutic Goods Administration (TGA) special access program.

A Bittersweet Victory For Chronically Ill Patients

Medical cannabis access is only through Category B. You must also have a letter of authorisation from the TGA. Patients also need approval from the government of the state they live in. This can take up to several months. A long process for very ill patients trying to access medicine to help them.

In June, the Greens moved a motion in the Senate to stop the removal of medical cannabis from Category A. They voted 40 to 30 in favour of the motion. But, the federal government’s Office of Drug Control defied the motion. It wrote to medical cannabis importers. The letters warned that supplying a patient under the Class A scheme was a breach of their licence conditions.

Federal government defies Senate vote

Di Natale is a general practitioner. Outraged he accuses the government of defying the will of the Senate. He said the federal government had no authority to defy the will of the Senate. The government has threatened to cancel importing licences if they supply under Category A.

The new Bill is the Greens Medicinal Cannabis Legislation Amendment (Securing Patient Access) Bill 2017. It is to prevent the government using contractual agreements to block importing medical cannabis for Category A use. Di Natale is sure the Bill will pass based on previous voting numbers.

Government bureaucracy removes patient quality of life

Mills Oakley partner, lawyer and scientist Dr Teresa Nicoletti said the government’s letter to importers was awful. Nicoletti has more than 20 years’ experience in pharmaceutical law. The customs regulations are clear. Anyone with the relevant paperwork and licence, must have permission granted when applying to import a Category A drug. She said currently the government was ignoring the legislation.

Nicoletti is a strong believer in the law. She said the government was blocking patient access to medical cannabis even though it is against the law. The government is in direct violation of the law. The duplication for doctors to apply to the TGA and to the state makes it harder for the patients to get access. This is an added burden to patients that is not necessary. It is wasting time.

Although no one has tried to import under Category A, Nicoletti believes they would win if there was a court challenge. Her interest in medical cannabis is not only a legal one. Her mother has Alzheimer’s disease and cannabis has given hope in treating patient symptoms.

Nicoletti said her father died in a lot of pain and she wished she could give him medical cannabis to help him. She said he was taking so much conventional medicine that any more would kill him.

A tough decision, yet Nicoletti could not break the law to get medical illegal cannabis for him. She had to watch her father die suffering pain. Conventional medicines failed him.

‘Clayton’s’ cannabis laws

Australian politicians appear to be doing and saying all the right things. The problem is, that although they are celebrating the new medical cannabis laws, these are ‘Clayton’s’ cannabis laws. They look good, taste good, sound good, but they are not the real thing. Or, in other words, all talk and little action.

Law Reform Foundation president Dr Alex Wodak said stories like those of Nicoletti’s father are tragic. He said that while the government is saying the right things, the problem is the system. There are many hurdles for patients and their families and the system does not help them. Then when patients say the system is difficult the government acts insulted.

His belief is that recreational cannabis needs legalising to remove the stigma. This would make cannabis more widely acceptable.

Wodak does not believe everyone who applies for medical cannabis should get approval. He said the government needs to take a more flexible approach based on compassion.

Fighting for access to medical cannabis

While the politicians pat themselves on the back for a good job, people in the real world are fighting for access to medical cannabis. For Lanai Carter, this is an ongoing nightmare. Her son Lindsay (18), has intractable epilepsy and a brain tumour. Conventional medicines do not control Lindsay’s seizures. Many times, she has taken him to the US to access medical cannabis although it is now legal here. Carter is trying to raise funds to take her son back to the US for help.

Carter said the purpose of the TGA Category A rating was to give patients urgent access to people who are chronically ill. Applications through Category A do not need state health department approval. She said that only worked if the states showed respect for the process. But, the state process added delays the process further.

Queensland Medical Cannabis

Carter, from Queensland, still gets medical cannabis under Category B. She said the alternative is more difficult. She said her son’s doctor applies for a new prescription as soon as his medication arrives. But, there is still be a gap of a few months between running out and replacement medical cannabis arrives. During this time Lindsay has no medication.

Lindsay has up to 20 life threatening seizures a day without the medical cannabis. They put him at risk of sudden death, suffocation, brain injury and other complications that put him at high risk. The cannabis also helps his pain, triggers his appetite and controls nausea. Carter said Lindsay had lost 40 kg since his diagnosis. The medical cannabis has helped him gain 7 kg and his weight is stable.

It is hard enough dealing with chronic illness without government bureaucracy making it harder.

Medical cannabis becomes a bittersweet victory

Australian National University clinical senior lecturer Dr David Caldicott said the government has not made it easy. It is not easy for patients or their doctors to access medical cannabis. He wrote the first medical cannabis course for doctors. It covers cannabis history in Australia, medical evidence, the regulatory system, potential side effects and how to prescribe medical cannabis to patients.

Caldicott said ‘hundreds’ of doctors had been through his course. Cannabis is not a subject usually covered at medical school. Doctor also have difficulty accessing it for their patients. He said he was trying to establish a middle ground for the medical cannabis debate based on scientific and medical evidence. This debate was addressed overseas and Australia has overcomplicated the whole process.

Australian Governments Show Respect For Legislation

So, what was once a victory is bittersweet for chronically ill patients trying to access medical cannabis. Until the governments start working together and show respect for legislation, it is a slow road to change. Too slow for some.