Restrictive medicinal cannabis laws see black-market boom

Paul Bibby

Pete hadn’t had a good night’s sleep in two years.

The pain would roll in every night between midnight and 3am, forcing him out of bed to stretch and walk for an hour and sometimes keeping him up for the rest of the night.

Finally, the normally law-abiding local decided to try some cannabis oil he’d been given by a friend.

‘I actually slept through,’ he says.

‘I’d always been a bit sceptical about that stuff but it definitely worked.’

As the victim of a car accident caused by an outrageously careless P-plater, Pete hoped he would be able to take advantage Australia’s new medicinal cannabis laws and ease his chronic pain without risking prosecution.

But the doctors shook their heads.

They couldn’t prescribe medicinal cannabis, they said, and even if they could, not a single local chemist stocked what he needed.

‘It was extremely frustrating knowing that there was something out there that could help me but not being able to get it,’ he says.

‘It just didn’t make any sense.’

Welcome to the weird and not-so-wonderful world of Australia’s medicinal cannabis laws.

Despite the state and federal governments purportedly making medicinal cannabis legal, they have in fact created a web of rules and regulations so restrictive that accessing it is virtually impossible.

The many locals like Pete whose lives are dramatically improved with a few drops of cannabis oil each night have been left with no option other than to go to the black market.

And they are doing exactly that.

The unofficial medicinal cannabis market is flourishing across Byron Shire and beyond.

Numerous unregistered suppliers have stepped in to meet the needs of thousands of sick and suffering locals who have been frozen out by the government’s regulations.

All are potentially at risk of prosecution but have been left with little choice.

‘I live with constant anxiety that I’ll be pulled over for a roadside drug test,’ Pete says.

‘I could potentially end up losing my licence and getting a criminal conviction… which I really can’t afford to do.’

Red tape

Medicinal cannabis campaigners such as Lucy Haslam believe the government’s regulations have been deliberately set up to prevent access.

‘They want to make it as hard as they can,’ she says.

‘There’s no other explanation for the hurdles they’ve put in the way of sick and injured people getting help.

‘All they’ve succeeded in doing is forcing people to use the black market.’

Australia’s medicinal cannabis regulations impose hurdles at every stage of the process, from cultivating and manufacturing the product to prescribing and dispensing it to patients.

The result is that across the country only a handful of chronically ill patients in the last months of their lives have been given access.

In the 14 months since the new laws came into effect, around 150 people across the entire country have legally obtained medicinal cannabis.

‘That’s a disgraceful statistic given there are literally tens of thousands of people who could benefit from using these products,’ Ms Haslam says.

Obtaining a prescription

Only one medicinal cannabis product has been approved by the Therapeutic Goods Administration (TGA), the medical watchdog that allows medications to be legally distributed in Australia.

To legally obtain any other product, patients must apply to the government on an individual basis.

If the product contains THC – the element that gives cannabis its dissociative effect – approval is needed from both the state and federal governments.

However, even if it doesn’t, such as the mild but highly effective medication known as cannabidiol, a patient must still get through the arduous federal application process.

These applications must be completed by a specialist with specific expertise regarding the condition involved – local GPs are completely locked out of the process.

Patients must also establish why medicinal cannabis should be used rather than another drug that is already on the TGA register such as an addictive opiate-based painkiller.

The assessment process at both state and federal level is notoriously tough and often inconsistent.

Of the 64 applications for access to medicinal cannabis made to NSW Health between August 2016 and October 2017, more than 40 were sent back for further information. Eighteen were rejected entirely.

Ms Haslam says she recently learned of a patient with an aggressive form of dementia who was denied access to cannabis oil despite showing significant improvement during a brief trial.

‘The family fought for six months to get access but were just blocked at every turn,’ Ms Haslam says.

‘They were rejected for not having a specialist write the application, then when they got one they were told he was based too far away.

‘The head of the NSW Health board eventually wrote to them and recommended that the patient be given benzodiazepines – a highly addictive tranquilliser used to treat anxiety and sleep problems.

‘It just seems like they’re hell bent on saying “no”, no matter how needy the patient is.’

Huge cost

Even if a patient is granted permission, the huge cost of obtaining the pharmaceutical-grade medicinal cannabis that the government allows into the country is so high that only the rich can afford to maintain treatment.

Someone suffering severe epilepsy pays around $100 a day to access the cannabis medication legally, while the cannabis treatment for Post Traumatic Stress Disorder (PTSD) costs $50 a day.

None of the products is covered by Medicare.

Big pharma

Part of the reason for this extreme cost is that, despite having excellent cannabis growing conditions, Australia is yet to produce a single drop of legal medicinal cannabis.

To grow or manufacture medicinal cannabis in NSW requires separate licences under both state and federal legislation.

The expensive, time-consuming and stringent nature of the licensing process means that small, local producers are effectively locked out of the process.

Most of the 22 companies who have been granted a licence since cultivation for medicinal purposes was ‘legalised’ in October last year are large pharmaceutical companies, many of them foreign owned.

One example is the application for a huge medicinal cannabis cultivation operation in Casino by Canadian pharmaceutical giant PUF Ventures.

The head of the Nimbin Hemp Embassy, Michael Balderstone, says the licensing process has been ‘set up for big corporations’.

‘The big winners will be big pharma,’ Mr Balderstone says.

‘All of our local growers who have been producing cannabis for decades and have a huge amount of knowledge and awareness of what the community needs have been basically locked out of the process.’

Little wonder, then, that Byron’s underground medicinal cannabis market is flourishing.

Underground

The phone is running hot, but it’s just an ordinary working day for north coast medicinal cannabis provider Jason (not his real name).

‘I’ve stepped back from the frontline now but I used to get literally hundreds of calls a day,’ he says.

‘I’d be getting calls in the middle of the night and pretty much just be doing triage for most of the day – figuring out who’s most in need.

‘The demand from the community is constant and overwhelming.’

As we talk, a young man sidles up and quietly asks Jason for ‘some medicine’.

The patients making use of Jason’s services do not fit the ‘drug user’ stereotype, ranging from millionaire CEOs flying in on private jets, to local single mothers bringing in their sick kids.

They present with everything from tick bites to end- stage cancer and dozens of other conditions in between.

Many carry referral letters from licensed doctors, oncologists or naturopaths, and have been quietly pointed in Jason’s direction.

‘The state they’re in could be anything from a mild state of anxiety to the full-blown awareness of imminent death, so a big part of the job is counselling,’ Jason says.

Good results

The north coast’s underground medicinal cannabis market would be a potential gold mine for medical research if established laboratories and universities weren’t so busy pretending it wasn’t there.

Jason has seen the results of medicinal cannabis treatment for dozens of diseases and conditions and is convinced that it works, if used in the right way.

‘What’s clear to me is that it works if it’s used as part of an holistic treatment plan that involves diet, lifestyle and frame of mind,’ he says.

‘There are a bunch of health outcomes that are directly attributable to these products.

‘We’ve saved people and we’ve lost people. I believe that in certain circumstances it can cure cancer, but we never tell people that’s definitely going to happen.’

Jason freely admits that quality control can be a challenge.

Without the assistance of large laboratories, he is unable to rigorously test his products to the level he’d like to.

However, by sourcing it from countries where medicinal cannabis is more widely available, Jason believes the quality is consistently high.

As much as Jason and others would like to have access to professional laboratories for testing purposes, he does not support the moves by big pharmaceutical companies to strip medicinal cannabis back to a single cannabinoid element designed to treat specific conditions.

‘In any given cannabis plant, there are dozens of different cannabinoids and terpenes and other elements,’ he says.

‘They all react with each other and with the body in different ways. By isolating one cannabinoid we’re potentially losing the complementary benefits of the whole plant.’

He believes the influence of big pharma is an opportunity missed for the North Coast and particularly the Byron Shire.

‘We’ve got the soil, the climate and the knowledge, but we’re going to end up with giant hydroponic greenhouses run by foreign pharmaceutical companies pumping out sterile medications.’

Prosecution

He believes many people will simply ignore the mainstream medications and continue to frequent businesses like his.

And he will continue to serve them, regardless of the risk to himself and his staff.

‘It would be wonderful for people to have a better person than me to help them,’ he says. ‘But until there’s some good sense and maturity, it will continue to fall to people like me who choose to run the real risk of prosecution and doing something that could put me away.’

‘I look at my kid every morning and think about folding the whole thing up.

‘The only thing that stops me is the kids I’ve seen, bleeding from their ears, who are on meds that aren’t working and may well end up killing them.

‘Everyone knows someone who has something distressing that could be improved by taking medicinal cannabis.

‘Why are we still prevaricating on this issue and making it so hard for people?

It’s a question being asked by many across the region. But for the time being, business will continue as usual.