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IN JULY 2016, Bríd Smith TD and Gino Kenny TD moved the Cannabis for Medicinal Use Regulation Bill 2016.
It is appropriate that on the day of the Bill going into “detailed scrutiny” in the Oireachtas Health Committee that we set out the reasons why the Bill needs public support in order to pass the remaining two stages of the seemingly interminable Dáil process.
In short the People Before Profit Cannabis Bill will save lives and ease the suffering of tens of thousands.
An effective treatment for chronic pain
The Barnes report to the UK parliament last year confirmed what many people in Ireland already know, that cannabis is an effective treatment for those suffering chronic pain and illnesses like MS, intractable epilepsy and the symptoms of cancer or chemotherapy.
The Bill is the only way the majority of people who could benefit from cannabis can have legally protected access to quality controlled cannabis products.
The Cannabis for Medicinal Use Regulation Bill provides for the regulation of cannabis for medicinal use and to do this proposes to establish a Cannabis Regulation Authority to regulate distribution by issuing licences under the Act.
It also provides for a Cannabis Research Institute to improve the level of public knowledge and to develop research on the medicinal use of cannabis.
A legally protected, secure supply
Under the Act patients will be able to access from a pharmacy, with a doctor’s recommendation, a legally protected, secure supply of a quality-controlled cannabis-based product, that is effective, and safer than many authorised products, especially for pain relief.
The current government policy in the “Programme for a Partnership Government” states that: “We will support a health-led approach rather than a criminal justice approach to drug use.”
However, the government-sponsored alternative to the Bill the “Compassionate Access Programme” is neither compassionate nor will it provide access for the vast majority of people who could benefit from cannabis-based treatments as it excludes people suffering chronic pain without a credible explanation.
The existing government programme has restricted access from all but a handful of patients. This is sadly well illustrated in the case of Vera Twomey and her daughter, Ava, who has Dravet’s syndrome, and suffered up to 300 seizures a day before Vera started using a cannabis extraction as a medicine for Ava.
Health Minister Simon Harris has refused to authorise access for Ava and continues to criminalise other child and adult patients using cannabis-based treatments.
HPRA guidance is unreliable and biased
The government claim they are supported by the Health Products Regulatory Authority report on the subject.
Unfortunately for them the HPRA guidance is unreliable and biased because it did not use any expert advisors with practical experience of cannabis for medicinal use and because the reasons given by the HPRA for restricting access are not applied consistently to other drugs, and do not take into account the serious risk of death and dependency caused by the existing authorised drugs such as opioids and benzodiazepines.
Existing prescription drugs are a growing concern as a cause of death and dependency, but the government and the HPRA are deliberately ignoring this concern.
No overall increase in recreational use has been associated with the legalisation of cannabis for medicinal use in the US and youth cannabis use for recreational purposes is actually falling there.
The government has rejected, without explanation, the progress in other EU countries and the United States where the benefits of medicinal cannabis are being seen. These benefits include not only pain relief and a reduction in seizures, but a reduction in the use of more toxic drugs, and a reduction in deaths from overdoses which happen frequently with opioid painkillers and benzos but never with cannabis.
Cannabis will improve health of overall population
Increased numbers of patients using cannabis-based products instead of more toxic alternative authorised medicines will result in a net improvement in the health of the population as a whole.
The Minister has left potentially hundreds of thousands of people suffering from chronic pain out in the cold by excluding them from accessing cannabis for medicinal use.
In the US the introduction of medicinal cannabis has seen drug overdoses and deaths reduce and drug sales of more dangerous drugs fall. Some of these drug companies whose sales are affected are lobbying against medicinal cannabis and making financial contributions to political groups opposing legislation.
According to a report in the Guardian newspaper last October the makers of well-known opioid painkillers Vicodin and Oxycontin are prominent financial supporters of anti-cannabis lobbies.
We can trust doctors to advise their patients
Doctors and pharmacists should be trusted to advise their patients, as for other more toxic medicines, of the risks and benefits and to recommend caution with populations at risk such as with children. There is nothing in the Bill which prejudges professional judgement or which attempts to influence how doctors or pharmacists carry out their professional duties.
What has to happen now is for the Cannabis for Medicinal Use Bill to go to Committee stage in the Dáil without delay. The government position of claiming concern for safety while ignoring the dangers of existing treatments, excluding the majority of patients and obstructing the Bill with unnecessary delays requires a strong public protest.
It is time to put “People Before Profit” and to back the Cannabis Bill. As Vera Twomey said last week: “Nothing else will do”.
Gino Kenny is the proposer of the Cannabis for Medicinal Use Regulation Bill 2016 and People Before Profit TD for Dublin Mid-West. Dr Peadar O’Grady is the People Before Profit Health advisor and is a child psychiatrist.
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Legalise control and tax
@bmul: you can’t work and therefore can’t pay tax if you’re on cannabis.
@Ian Moloney: bullshit plenty working now who smoke
@Ian Moloney: why can’t they work? And how would that stop them paying tax? The unemployed are still expected to pay VAT and people are taxed when collecting job seekers or injury/illness benefit.
@bmul: I hope they’re not driving my bus.
@Karen Wellington: collecting benefits isn’t really work.
@Ian Moloney: I don’t smoke tried it once years ago didn’t like it but that’s my choice others should have the choice if they do
@Ian Moloney: I didn’t say it was, I’m just trying to correct you by explaining, in what I thought were simple terms, that unemployed people pay taxes too. I also pointed out that using medicinal cannabis wouldn’t preclude user from working. I would also hope bus drivers aren’t taking opioids while working.
@Ian Moloney: I can’t work if I’m not ‘on that demon cannabis’
@bmul: you’re really bs ING me if your telling me you’d personally employ someone who is stoned.
@Ian Moloney: I have employed people who smoked and those that drank but not stoned or drunk when working that’s a sacking
@bmul: cannabis remains in the blood for over a week. I hope you provided generous annual leave allowances.
Ian just because alcohol is lefal dies it mean everyonegoes to work drunk? No.
I know literally hundreds of people who work hard, are productive healthy members of society and in a lot of cases high achievers. Your preconceptions are misfounded and illinformed.
@john doe: I hope you are not at work typing .
Ian I just have fat fingers and a small keypad, how about you answer the valid points i made and save us from your limp wit
@john doe: the article is about cannabis not lefal alcohol.
Ian the point I made is very relevant to the discussion. I framed it using the alcohol analogy because I felt it might help you to understand as you clearly have no idea what you are talking about regarding cannabis.
But you are very good at your spelling. Well done, gold star for you today.
Personally I can’t stomach the fake outbursts and cheap pr stunts staged by many far lefties but on this issue they have a point. The puritan like attitude of FG/FF/LAB etc on this issue is equally sickening.
This isn’t a left right issue its a common sense one. Right now you can get cannabis in any village in Ireland but god only knows the quality of how it is produced and processed. If politicians were concerned about public health they would legalize and regulate this herb.
@John Fergus: If the world was run solely by the left it would spin out of control.
If it were up to the right it would stop spinning altogether.
There is an option in between. Common fcuking sense.
@John Fergus: but that would be the sensible thing to do and the church going from folk would get upset
@Cillín Ó hEadhra: agreed …….but it seems common sense is not so common anymore.
@John Fergus: Here you don’t be coming on Journal pointing out things like that!
@John Fergus: the plant grows itself. Sunlight and water should be sufficient.
@John Fergus: you were right on the first phrase……
@Ian Moloney: And I’ll gladly help it along, just don’t ruin my life and career because I’m not a drinker.
Right about opioids. A family member has been put on oxycontin, the lowest dose at the moment to control pain from cancer. All of a sudden, symptoms which were never there before are appearing since starting the drug. I looked it up and common side effects are
constipation,
nausea,
stomach pain,
loss of appetite,
vomiting,
sleepiness,
tiredness,
drowsiness,
dizziness,
lightheadedness,
weakness,
itching,
headache,
dry mouth,
sweating
Would they ever hurry up and legalise medicinal cannabis.
Are you aware that nearly every drug has a list of horrible *potential* side effects?
A potential side effect of paracetamol is liver failure and death, would you call it unsafe?
Oxycodone is a useful analgesic when used properly, its main flaw being potential for addiction.
Cannabis (specifically THC) hasn’t been demonstrated by any scientific standard to be an effective analgesic, and certainly nowhere near the level needed for cancer pain.
Please, stay in the realm of facts if you want to defend the use of cannabis which certainly has medical uses.
@Malachi: I can tell you now that as soon as this drug was started, they were not potential side effects, she actuallyexperienced them. Nausea, vomiting, weakness, tiredness, loss of appetite appeared which were not there two days previous. The nurse handed us a prescription for two different constipation medicines. I ask her why. She said oxycontin causes constipation and she was right.
@watersedge: tell your family member to get tablets from the doctor that help to protect the stomach while she’s taking those God awful things. I can’t remember the name of the tablets I took but they were Proten or something like that. They definitely helped and she just has to eat before taking them, it makes all the difference.
@jane: Thanks. Pantoprazole is probably what you mean and she is on them plus trying her best to eat before taking them but still no joy. Too much of a coincidence that she is getting all these symptoms since starting the oxycontin even though the dose is the lowest. They are good for pain but I think they jumped in too quick prescribing them long term as it was an infection which caused the pain and it is cleared up now.
I sound like I am contradicting myself. They put her on them at the start as they thought is was a small lesion from the cancer pressing on a nerve but found out it was an infection. I’m not happy they have just decided to keep her on them now anyway in case she gets a pain in the future instead of waiting until she actually needs them and so she is stuck with all these side effects.
@Malachi: it is very effective for pain relief.
@watersedge: they really are awful. I would agree with you about not leaving her on them, she’ll start to get a resistance to them and then she’ll have to increase the dosage if she does have pain.
Malachi. The point is that the side effects of cannabis are not nearly as bad, as you rightly point out if not used correctly even paracetomal can kill. Wheras cannabis cannot.
So if it provides some sick people releif of any kind and is less harmful than most over the counter drugs, just let them have it, in a regulated monitored fashion..
so what if they also get a bit of a buzz from it, that is why most people are opposed to it, the buzz, nothing to do with safety really.
@john doe: “The point is that the side effects of cannabis are not nearly as bad, [...] paracetomal can kill. Wheras cannabis cannot.”
Cannabis use has side effects too, like any drug. It’s not going to kill you by overdose, but neither will smoking cigarettes – it’s long-term effects we’re dealing with here.
“if it provides some sick people releif of any kind and is less harmful than most over the counter drugs”
It does provide *some* sick people effective relief for their specific conditions – which is what the HPRA approved its use for in their report. What is the objection? We have no idea whether long term cannabis use is “less harmful” than ‘most OTC drugs’. Indeed, most OTC drugs have a great safety record when used properly.
Interested to know how many of the advisors hold shares in big pharma companies.
@Séa Graham: CTN’s out again.. So tell us how many shares have they? Asking a loaded question is a standard technique of the deluded CTN.
“A legally protected, secure supply of a quality-controlled cannabis-based product, that is effective, and safer than many authorised products, especially for pain relief”. So that would be a synthetic substitute developed by the same companies who gave us Fentanyl then? The government should not be allowed to police the body politic of an adult individual of sound mind so they can monetize people like commodities for private exploitation. The pharmaceutical companies already play fast and loose with people’s lives and the government should protect us from exploitation, not direct us towards it. “We will support a health-led approach rather than a criminal justice approach to drug use.”, which is why the majority of drug busts in the headlines over the past few months have been cannabis seizures? No cannabis, no users, no problem. The drug war is a lie for corporate profit, people who are sick or have sick children should take whatever measures they can to treat the symptoms of that illness, as has proven to be the case with cannabis in many instances. The government aren’t going to help, they’re just going to spin more rhetoric and hyperbole, while doing nothing to relieve people’s immediate suffering.
@tommy il give you fifteen mins in my pain,one dose of incontenice and that tune wouldn’t be long changing
Minister for Death Simon Harris
I knew an ex-cop who prided themselves on their law-abiding character always and even with Stage 4 refused to avail of offered CBD and THC oil until the very last, having finally been assured by three doctors and several former colleagues that it was Ok. It brought the poor sufferer some immediate surcease in terms of enhanced appetite, sleep, and bowel movement, while remaining compos mentis, all of which the various “ethical” poisons, the morphine derivatives and analogues destroy.
I knew another, a chemist, who absolutely despised the morphine based drugs and synthetics, and managed their pain through THC and paracetamol almost to the last. Again, compos mentis until the final eight hours.
Cancer is cruel enough. We shouldn’t make it crueller yet thru kowtowing to Big Pharma.
Mr. Kenny, what authority do you have to say that the HPRA report/decision was biased?
The HPRA evaluated the current haul of scientific evidence on the medical use of cannabis and based their report on that.
What does ‘practical experience’ have to do with clinical trials and meta-analyses? It seems you don’t understand how the regulatory body for medicines is supposed to function.
Indeed, if practitioners did have experience with the drug’s use, they’d be more likely to be biased either way based on limited data rather than conclusive evidence.
@Malachi: There are hundreds if peer reviewed studies on Cannabis as an effective analgesic.If you bothered to look.Somehow though , methinks you did’nt.
@Diarmuid Doran: paracetamol is an effective analgesic. Your post is meaningless unless you quantify its strength, specificity etc.
@Ian Moloney: My apologies Ian but could you direct me to the section where I could find pointers on writing meaningful posts ? I so much want to meet your aporoval.
@Diarmuid Doran: which is why the expert panel look at meta analyses of ALL studies, examining the quality of the studies, balancing the efficacy and the safety to produce a risk benefit analysis that properly reflects the appropriate use of any given drug. The HPRA know what they’re doing.
@Pharmy: I’m sure they do.I’m sure none of them have been tainted by previous employer history.Pharmy , on foot of your knowledge , Ill completely change my viewpoint.Tell me , have you had that ” Pharmy ” account for long ?
Pull the other one chap , its wooden.
@Diarmuid Doran: Those who can’t argue with the message attack the messenger, it is the last refuge of the closed minded and the ignorant.
@Malachi: Is it necessary to prove it works. Lots of drugs don’t work for everybody. If it’s not working take em off it and try something else. It’s pretty non toxic, so what’s wrong with the California model. Anyone can get a medical cannabis card. I don’t hear about all the chaos and lawsuits against the state. Which you might expect if this was a dangerous insufficiently tested drug. Let people grow it and try it doe themselves with medical support if needed. Anyone that wants it now can already get it. And keep up the rigorous testing at the same time.
@Diarmuid Doran: Try reading the hundreds of peer reviewed articles you mentioned.
@Pharmy: and what about the swine flu vaccine that they licensed without testing?
@Mark
Is it necessary to prove it works?
Yes. The government (taxpayer) will be paying for the medical card prescriptions – I don’t want to pay for things that don’t work.
@Pharmy: Even studying the plant has been severely restricted for years, which points to an obvious connection with money.
@Malachi: yet the HPRA are going to allow a new epilepsy drug to be licenced in ireland, can’t think of the name of it at the moment, which has serious side effects for children using it, including heart problems and personality changes.
@Pharmy: Dont give me the Ad Hominem crap pharmy.Im way too long in the tooth for your mischief believe me.My namecis there if you wish to speak to me with your real name.Ive nothing to hide , have you ?
@Malachi: I dont think it has to be done that way. See above for why not. What’s wrong with the California model? Do existing drugs work all the time from everybody. Some of our money is already being ‘ wasted ‘ on prescriptions that later have to be changed.
Yes but there should be ample scientific evidence a drug is more effective than placebo for a drug to be approved and paid for by the taxpayer.
I’d much rather we had prescription drugs on the market that are sometimes ineffective (but are proven to work through scientific scrutiny) than drugs like cannabis that do not have any such evidence base supporting their use (except for select conditions).
I am in favour of the legalisation of cannabis for recreational use – but its use as an approved medical product is quite a different matter.
@Diarmuid Doran: What is your standard of evidence? The HPRA reviewed all of the literature on cannabis analgesia and concluded that the evidence did not support its use for that purpose.
Indeed the report acknowledged that some evidence indicates that cannabis can be effective for analgesia, but if you’d read it, you’d have seen their reasoning for not approving cannabis for that purpose;
“The data generally suggested an improvement in pain associated with cannabis products. When these clinical trials are combined, the overall estimate of benefit is moderate and there is no effect on patient’s self reported quality of life. The symptoms of pain are subjective, and the majority of clinical trials that have been conducted have been shown to be subject to a moderate risk of bias (where repeated errors in data collection have led to incorrect estimates). These biases mean that the treatment effects that have been reported in clinical trials of cannabis for chronic pain should be viewed with caution, and that the evidence-base in terms of benefit remains uncertain. In addition, cannabis products were associated with a greater risk of side effects, including serious side effects, when compared to other pain medicines. No studies have evaluated the
long term safety of treatment with cannabis products. Current evidence suggests that larger more definitive clinical trials are needed. This approach is consistent with the views of pain specialists and medical professional bodies who have cited concern about the use of cannabis and cannabinoids in the management of chronic pain, in the absence of proven benefit to risk data.”
http://health.gov.ie/wp-content/uploads/2017/02/HPRA-Report-FINAL.pdf
@Malachi: You’re annoying me.My standard of evidence if you really want to know Malachi is excruciating pain from Stage 4 Colon , Liver , Lung & Lymph cancer , terminal by the way. Does that satisfy you , you know all prik?
From the ‘food’ that we are being sold to the ‘medicine’ we are being prescribed we are being killed off by these corporations….cancer comes from the food we are eating….that is fact….
@Paul Parker: This must be CTN night out. This insane comment is CTN squared.
Much cancer is idiopathic. Fact.
It’s not about Harris or Kenny or any of those puppets in the dail, it’s your huge multinational drug companies based in Ireland , employing 1000′s that tell the government of the day what they would like in law, no debating, end of !!!
Same reason Ireland has nearly highest price in Europe for all pharmaceuticals, follow the money !
@Cathal Flood: Correctamundo. But that just sounds too crazy, lefty, hippy, conspiracy theory ish for some people. And the mere thought of losing market share to a plant kicks the lobby into top gear. St. Johns wort comes to mind. Surprised I can still buy Echinacea over the counter.
It’s a natural ingredient from our planet ffs. If alcohol can be legal!
Free the weed its a natural medicine from the ground
Those who promoted this bill are either wilfully or negligently ignorant of the science and practice of medicine. There are easier ways to promote the availability of cannabinoids for medicinal use within existing legislation. The real agenda here is recreational use.
@Pharmy: but the co_ author is a Doctor?
@Pharmy: The real story here is alcohol is far more problematic and is totes legal. Legalise cannabis, let people see if it works for them. If not no harm done. And yes people will have legal access to a much safer recreational drug too. What’s wrong with that. What is the benefit of prohibiting it? I could kill myself with Panadol a million times easier than do serious harm with cannabis. Unless I accidentally choke on my brownie or something.
@Pharmy: not for Vera Twomey’s daughter. It’s medicinal cannabis she needs and she cannot get it through existing legislation.
@Pharmy: and btw, I very much doubt the child would be smoking it. It would probably be dispensed in an oil form or capsule form like any other medicine.
Someone has a vested interest in keeping it out and are dong a very good job of trying to blur the line between medicinal cannabis and recreational cannabis and confusing the issue. And before anybody decides to point out they are the same thing, I know they come from the same plant, it’s the purpose they are used for that differentiates them
Medicinal cannabis is needed to help control certain conditions…..it won’t ever cure them unfortunately. People who need medicinal cannabis don’t have a choice.
Recreational cannabis i don’t really give two hoots about. That is each individual personal decision to use or not.
@Pharmy: the Misuse of Drugs Act contains four Schedules or lists of active agents (drugs). Each Schedule has different levels of restriction on the prescription, sale, possession & use of the drugs listed. Over the years drugs have been listed, delisted & rescheduled. A Bill went through the Dail last year coming into effect this month which rescheduled a number of drugs. Why wasn’t cannabis or specific cannabinoids included, there is sufficient evidence to merit it. The TDs who put forward the ‘Medicinal Cannabis Bill’ should have been aware of this. Once rescheduled cannabinoids could be licensed like any other medicine.
@Pharmy: Medicines licensed in other countries could be recognised & sold here. Medicines licensed via the European system could automatically be sold here. Licensing is important because it ensures that every tablet / drop / spray contains what it is claims to contain. If this cannot be guaranteed then over or under dosing results. Doctors need to know how much they are prescribing for a patient in order to balance desired effects with side effects in a way that is suitable for that patient. This is especially true for children.
@Pharmy: To summarise: a Bill that would allow for the licensing of medicinal cannabinoids (at no additional cost to the tax payer) was passing through the Dail at the same time as TDs proposed a Bill with (purportedly) the same purpose, but with the addition of new & expensive monitoring systems. The new bill is in fact more similar to the licensing of recreational drugs (alcohol & tobacco) … and they both turned out so well.
Anyone pushing a Bill through the Dail should know this, which suggests wilful / negligent ignorance as previously stated. Negligent ignorance implies incompetence. Wilful ignorance implies another agenda. Take your pick.
@Pharmy: Negligent ignorance , a bit like’ burying your head in the sand’ .
@Pharmy: Do you think alcohol and tobacco should be prohibited?
Is this the same Peadar O’Grady?
@jane: was it protium?
I was hoping for an unbiased, objective review. In this country I guess hope is my mistake.
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Decriminalise this drug now, then all the elitist fannys will have to concede that it has enormous potential for a positive impact when legalised. Look, it is going to happen. You are withholding the inevitable Simon Harris. Your damage is not beyond repair, be on the right side of history.
Voices of opposition are regurgitating the big pharma line. You could probably work out who gets big pharma perks just by listening to their babble around dangers of driving, the reactions with other meds, language being used is not their own, especially when they stutter and urmmm their way through a statement they obviously didn’t write themselves. The professor from Galway did a superb job as did the doctor. If they use cannabis products for the illnesses stated in the Barnes Report, big pharma will not be happy. Ireland has kissed the ass of big pharma, and been allowed free reign. People are not so naive, this is 21st century, and we have a voice.
The censorship is unbelievable here.
Someone disagrees with you – censor them.
Medical cannabis is available on prescription now in Canada – along with many other countries. An ageing and increasingly frail Leonard Cohen made use of it successfully to help him with severe pain during his last months. He was able to continue living in his home and recording songs until he passed on. If it’s good enough for Leonard it’s good enough for me.
have your say