Hey there Guys,
This week a report issued by reform group Australia 21 has shared the thought that it’s time for Australia to lift its prohibition of illicit drugs. You can download and read the report here: Australian Illicit Drug Policy Report. While I find the report compelling and certainly thought provoking I have to wonder where the line will be drawn. Will all substances be allowed? If only some are allowed how will they be chosen? How will the substances be regulated?
While this is uncharted territory in Australia there is some evidence growing in other parts of the world. Take for example marijuana and its use in America. For interest’s sake I think it’s useful to look at two of the current models to be able to compare and contrast different ideas, such as the laws in California vs Canada.
Currently both California and Canada have allowances for people to be able to use marijuana for medical purposes after recommendations by a doctor. While this post is not designed to highlight the medical uses of marijuana, there is clear evidence that THC, the active ingredient in marijuana has been helpful for some medical conditions such as pain, muscle spasms from MS and other movement disorders, and nausea and wasting in HIV.
In California the Senate Bill 420 of 2003 makes the possession or cultivation of marijuana legal when used for medical purposes to treat a “serious medical condition”. As noted at the 420 magazine website, serious medical condition includes:
Acquired immune deficiency syndrome (AIDS);
Anorexia;
Arthritis;
Cachexia;
Cancer;
Chronic pain;
Glaucoma;
Migraine;
Persistent muscle spasms, including, but not limited to, spasms associated with multiple sclerosis;
Seizures, including, but not limited to, seizures associated with epilepsy;
Severe nausea;
Any other chronic or persistent medical symptom that either:
Substantially limits the ability of the person to conduct one or more major life activities as defined in the Americans with Disabilities Act of 1990 (Public Law 101-336); and
If not alleviated, may cause serious harm to the patient’s safety or physical or mental health.
If you meet these criteria a doctor is able to offer a “recommendation” which basically states you have a medical issue that meets the criteria for which marijuana may be a useful treatment. There is no control on how much marijuana is used by the patient, it’s up to the patient to decide what they need. Clearly this system is open to abuse from many angles. I know of one patient who spends more than $2000 a week on his “medicine” and I have to wonder if, at that level of use, it is purely for the back pain he stated to get the recommendation.
If you have ever visited Venice Beach in California you can see a bustling industry of doctors employing sprukers on the street. I have been asked by a clipboard toting blond if I had any of the problems on this list. If you reply with a yes you can be taken straight to the doctor for your recommendation.
Frequently there are collectives close by you can take your recommendation to buy your first does of legal “medicine”.
Currently I am not able to find if there are limitations on doctors from being involved in the sale of marijuana via these collectives. Marijuana supplied at collectives is not screened at a state level for strength, suitability or potential contamination.
Canada has a very difference stance when it comes to medical marijuana.
While similar medical conditions are included in Canada’s legislation, family doctors have a very limited scope to be able to prescribe marijuana. If a person’s need for marijuana is outside of these parameters then a specialist consultant is required for the prescription to be allowed. Full details of Canadian marijuana use can be reviewed here at Health Canada.
Different also is that in Canada, a license to posses marijuana also includes a prescription or a recommended daily use amount. If your marijuana is supplied by the health department you will only receive the dose that was recommended by your doctor. If you prefer you can grow your own marijuana or have a designated grower for your supply.
Marijuana supplied by Health Canada is carefully monitored for strength and strains as well as irradiated to ensure no fungal contamination helping ensure safety for consumers.
From my medical perspective I can see strengths in the Canadian system. For me the Californian legislation is too open to abuse both by users and prescribers. If we are going to take use of marijuana for medical reasons seriously we need to be serious in its administration. I do not doubt there are many who have benefited from the California reform. I do worry though that the legislation is not being used in the spirit of which it was created.
If Australia was to consider drug reform I hope they look to Canada for a system that may be able to help reduce abuse.
What are your thoughts guys? Please leave your comments in the boxes below.
Yours in good health.
Dr George
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