You are here
Medicinal Cannabis: United in Compassion Symposium
Tuesday 24 May 2016
Ms DAWKINS (Bass) - Madam Speaker, attending the United In Compassion symposium at the Hemp, Health and Innovation Forum in Sydney on 14 and 15 May was a revelation. The expo and lecture series was heavily attended and was opened by the New South Wales Premier, Mike Baird. It was noted by Mr Baird that Ruth Forrest MLC and myself were in attendance. I ran into New South Wales Greens Jeremy Buckingham through the day.
The complex characteristics of the plant were outlined by Justin Sinclair, a scientist with a Masters in Herbal Medicine from the University of Sydney. It is his speech I would like to outline because I believe it gives some valuable background to the morphology, common myths and misconceptions, the entourage effect, broad spectrum use, scientific evidence and patient-centred individualised medicine, which are the cornerstones to understanding medicinal cannabis.
Cannabis has spread throughout the world from central Asia about 10 000 years ago. Archaeologists have unearthed evidence to suggest it was used as a food and medicine in the Neolithic period. It is the unfertilised head of the female plant which holds the medicinal properties. The seeds are a foodstuff and the stalks are one of the most effective fibres used throughout human history. As we know, they are potentially a high lucrative food and fibre industry for Tasmania, unfortunately hampered by road blocks put in place by national regulation.
In dispelling common misconceptions, Justin spoke to these items. One is that cannabis lowers your intelligence. Use can cause short-term memory impairment which is reversed upon stopping use. In fact, cannabidiol or CBD exhibits neuroprotective activity. He said there are certain cannabis phytochemicals which can be used to assist Alzheimer's disease.
Two, all cannabis makes you feel high or stoned. This is entirely dependent on the phytochemistry of the specific strain of plant. There are many strains of the plant which do not have any or very low THC and are high in cannabinoids, which have psychoactive effects.
Three, cannabis is a highly addictive drug of dependence. Cannabis dependency does exist, as does dependency on many other substances, including the frequently prescribed medications tobacco and alcohol. The individual's make-up and the strain of cannabis used has a powerful effect on whether habitual use is formed, so while people are able to form dependency on cannabis, it is not considered as powerful as many other drugs.
Four, cannabis is a gateway drug. There is a growing body of work to show that, while cannabis use can be linked to other drug use, there is also ongoing work on individualised medicinal cannabis treatment being used to break the addiction cycle of harder drugs. There is a suggestion that for those who find themselves in a situation where broad drug use is a part of their life, rather than cannabis being a gateway drug, it is one of just a suite of drugs. Remember that progressive countries have entered the war on drugs and have responded to illegal drug use by best addressing it within the health and social framework.
Five, using cannabis can cause psychosis. The common misconception here is put simply in a February 2016 report by Ksir and Hart, which states that:
Evidence reviewed suggests that cannabis does not in itself cause a psychotic disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with vulnerability to psychosis.
Six, cannabis use is harmful. Data specifically relating to cannabis-related harm is hard to find. We know that driving a vehicle could be dangerous if people are using high-THC cannabis. There is evidence linking harm to a wide range of factors, of which cannabis use could be one, along with dangerous alcohol consumption.
Justin went on to discuss the complexities of the endocannabinoid system and the chemical construction of the human brain and interaction between systems and the plant. There are more than 100 different cannabinoids present in the plant which have very different properties and capacities. The chemical interaction with each other is what has become known as the 'entourage effect' for its therapeutic benefits. This is where the single dose comes into question. Practitioners who are using medicinal cannabis now to good effect are concerned that by attempting to synthesise the complex cannabinoids into a single dose, the entourage effect would be lost, thus reducing its efficiency. Full spectrum use, sometimes called 'whole plant use', is an important aspect to the entourage effect.
The delivery method also contributes to the effectiveness of the treatment. Edibles, tinctures, vapours, capsules, suppositories, topical use and vaporisers all deliver different attributes for different conditions. Tinctures and oil have slower onset but are more likely to be supported than smoking or the more expensive vaporisers. Patient‑centred medicine, which provides the right strain to the right patient with the right dosage form and the correct dose, is often a work in progress for the practitioner and the patient. An interesting aspect of what is essentially a herbal medicine is that while tailoring the best dose for the patient, changes can be made without any harm to the patient. If the patient is too drowsy the THC level is decreased, while for those with insomnia it can be increased.
The take-home message from the speech is that there is nothing to be scared about this ancient plant use. Both indoor and outdoor methods should be used for cultivation. Organic cultivation wherever possible is preferred. The use of naturally occurring species wherever possible and no GMO crops should be supported. The use of dried flowers and full spectrum plants over synthetic cannabinoids would always be preferred.
It was an enlightening experience, with the expo running adjacent to the symposium holding dozens of stalls on the cultivation and use of a myriad of products now lawfully available for purchase, with a tent full of low-THC hemp on show front and centre. I truly hope this is a sign of the further relaxing of a prohibition which has done nothing but put decent people on the wrong side of the law. I congratulate Lucy Haslam, Troy Langman and the United in Compassion team for an insightful and well-run event.