Victoria Legalises Medical Marijuana

Victoria has become the first State to legalise the use of medicinal cannabis, with the passing of the Access to Cannabis Bill 2015 on Tuesday.

The Bill will give children with severe epilepsy access to medicinal cannabis as early as 2017, with the State government establishing a strictly controlled cannabis cultivation trial.

Medicinal cannabis will initially be made available to patients who suffer severe epileptic seizures, muscle spasms resulting from multiple sclerosis, severe pain and nausea arising from cancer or HIV/AIDS, and chronic pain verified by two specialists.

Health Minister Jill Hennessy has welcomed the change, saying, “It’s absolutely heartbreaking to see families having to choose between breaking the law and watching their children suffer – and now … they won’t have to.”

The new law

The laws are a response to last year’s recommendations by Victorian Law Reform (VLR). They will be strictly regulated by an Office of Medicinal Cannabis, which will oversee the manufacture, supply and access to cannabis.

While the details of the scheme are yet to be finalised, the VLR recommended that only licenced cultivators and manufacturers would be permitted to produce the drug. Products would be sold at pharmacies under arrangements based on the methadone program.

Benefits of medicinal marijuana

The new legislation comes after the announcement of a small trial in February into the effects of synthetic cannabis on a group of Victorian children whose condition had not improved after trying three different anti-epilepsy drugs.

The Austin Hospital in Melbourne undertook the trial, providing a synthetic form of cannabis to children, without the psycho-active component THC, while monitoring their progress against a similarly suffering control group given a placebo.

Director of paediatrics, Professor Ingrid Scheffer, said that desperate parents had been illegally buying cannabis products for their suffering kids, or growing their own, with no way of knowing whether it was safe and effective. “There’s absolutely no checks and balances. We don’t know what they’re getting. We don’t know whether it has a lot of THC in it which could be damaging their child’s brain,” Professor Scheffer said.

NSW plans to trial medicinal cannabis by the end of this year. NSW Premier Mike Baird recently announced a clinical trial into the effects of medicinal cannabis on 330 chemotherapy patients suffering from nausea. The announcement was the third of its kind in the State, with previous trials focusing on terminally ill patients and children with severe epilepsy.

Similar to the Victorian trial, children with severe drug-resistant epilepsy in Queensland will also be treated with medicinal cannabis. “[It is] an opportunity to show medicinal cannabis can be a safe and effective addition to existing treatments,” Health Minister Cameron Dick said of the new treatment trials.

The science

Dr Alex Wodak, president of the Australian Drug Law Reform Foundation, says that a recent review of existing evidence has found 82 favourable and nine unfavourable controlled trials in respect of medicinal cannabis.

The therapeutic benefits relate to the way that the drug stimulates the pain relief endocannabinoid system. This system is different to the endorphin system that is affected by other pain relieving treatments, such as morphine type opiates or anti-inflammatory drugs. The endocannabinoid system can help reduce chronic and nerve-related pain.

The difficulty for medical cannabis, however, is that prohibition has presented an obstacle to research. While most available evidence is positive, the scientific community has not been able to sufficiently test the drug to determine its longer term effects.

Many patients have exhibited side-effects such as dizziness, fatigue, nausea and hallucinations. There are also concerns that it may increase the risks schizophrenia in young people.

The largest study ever undertaken on cannabis and epilepsy was presented at last year’s American Epilepsy Society’s annual meeting in Philadelphia. 313 children from 16 different epilepsy centres around the United States were given the cannabis compound cannabidiol. After a three-month period, 261 reported a fifty percent reduction in convulsive seizures.

Another study, published by the American Academy of Neurology, involved giving medicinal marijuana to 213 sufferers of epilepsy. Over the course of 12 weeks, there was a 54% decrease in the number of seizures – but around 10% of participants reported experiencing side-effects such as diarrhoea and drowsiness.

Emeritus Professor of Anaesthesia Laurence Mather, from the University of Sydney, believes that the side effects of cannabis alternatives are much worse. “People can die from morphine, they stop breathing; people can die from paracetamol because it buggers their livers, people can die from NSAIDS because it buggers their kidneys, but cannabis doesn’t do any of these things,” he said.

It is hoped that the Victorian reforms will see a reduction in the crippling symptoms of conditions such as epilepsy, especially in children.