A conservative lobby group is seeking support for new, cheaper medicinal cannabis for chronic pain relief.
Dazed and confused, like a teenager at her first party, New Zealand seems stuck in a moral morass over medical marijuana. Parents in one ear, contemporaries in the other. Shall I inhale or not? What will the consequences be? Stuck between demonisation and canonisation of the whacky woo woo weed. Few doubt that change, as Sam Cooke said, is gonna come. Certainly if international experience is anything to go by. Not to mention domestic polls, which put support for medical marijuana at 75 per cent. Pro-cannabis supporters are stepping up their campaign, but the final impetus for a policy shift may spring from a more unexpected quarter.
Nichola Smith is a nurse from the 'Naki who loves animals and looks for everyday blessings. Kat Le Brun, by her own admission, is a "grumpy" Christian student teacher from Nelson, and Jacinta, a tiger mother with a quickfire voice. What do they have in common? Pain. Not bang-your-thumb-with-a-hammer pain, but the sort of pain that lasts as long as you do. Chronic pain. The sort of pain that you have to accommodate. Like a bad marriage choice in a country without divorce. It's there last thing at night and when you wake up in the morning.
There's another four-letter word that brings them together - dope. They don't much like it. They don't believe it should be used recreationally. They don't want it universally legalised. God forbid. If they had the choice they would never smoke it themselves. No way. What would they say at prayer meetings or the PTA. They could be the most unlikely bunch of cannabis campaigners ever. Yet, Kat, Jacinta, and Nichola are the very people for whom this intractable debate matters the most. They have skin in the game. Skin which feels as if it's been "pierced with a thousand hot needles" assailed with "burning knives", "freezing ice buckets", "electric shocks" and "glass shards". Expressions of incredible pain which they've found marijuana helps to alleviate.
Last weekend, the pro-marijuana lobby decided to spark up outside police stations around the country. Unfortunately it was spring. It rained a lot, especially in Auckland and Hamilton. Not many people turned up. Soggy joints were passed round, pipes smoked, vaporisers fumed. Foul weather stripped the pro-cannabis massive to its core. Kat, Jacinta and Nichola weren't there, despite the fact that legalised medical marijuana was top of the protesters' manifesto.
There is a growing feeling among some patients that the likes of Norml and the Cannabis Party are hijacking their cause. Using the medical arguments to serve a bigger goal of making marijuana legal for everyone. "They're getting in the way and holding back progress for those who need it for medical reasons," says Kat. She seethes with a not-in-my-name resentment. "That's what the Government is looking at, these stoners, the bad side of it. I just wish they'd be quiet."
Quiet is something Kat and her fellow chronic pain sufferers are not going to be. Not anymore. "It does upset me," says Jacinta. "I believe we have to focus on the medical at this stage. It might be selfish but it's all getting muddled up. We need to look at one issue. This is too much for the politicians to deal with."
This conflation of medical marijuana and general legalisation may be one reason why New Zealand seems stuck, while our neighbours and allies are moving quite fast. Medical marijuana is legal in 25 states of the United States, half the country. In Australia, Victoria and ACT are preparing to join the party.
Ross Bell from the NZ Drug Foundation says after all these years railing against the evils of marijuana our Government is in a bit of a quandary. "They think they are the drug warriors. Medical marijuana is confusing them, 'we should do something but we don't know what'. Something's not computing. They don't know what to do to meet the needs of the 75 per cent." He thinks the medical marijuana movement has a bit of an image problem. "They typify the stereotype of the loser stoner. My advice, buy a suit."
Patient frustration at the fringe nature of the movement has birthed a new conservative pressure group. It's called MCANZ. Medical Cannabis Awareness New Zealand. The co-ordinator is Kat's husband Shane Le Brun. A classic IT guy. Lanyard round his neck. Soft-bodied with a fierce mind. Certainly doesn't look like a marijuana campaigner.
"It's been a long journey. Before my wife was injured we chucked flatmates out for drug use once upon a time. Now the tables have turned," says the former soldier and National Party voter. Kat slipped on ice at a Montessori school and ruptured two lumbar discs. After nine months she was put on heavy opiates for the pain. After two years she was operated on. "The surgery removed the mechanical aspect of her pain but the nerves are permanently fried," says Shane. "The pain does not abate."
Shane says his wife has had 30 to 40 visits to the emergency department just for pain relief. One evening, rather than call the ambulance again, they went to their neighbour's place. "She was a woman in her 50s with bad back pain and she medicated with cheap cask wine and marijuana." The neighbour offered Kat a toke. "In quarter of an hour Kat's pain went from an eight to a three. Her head was a little cloudy but she maintained a conversation.
"I slept properly for the first time in five years. I said to Shane I actually feel rested. That was quite crazy for me."
Shane: "Her mood for the next few days was much more bearable. You know, happy wife, happy life."
Despite the obvious benefits, Kat didn't make a habit of smoking cannabis. As a churchgoing Christian and mum, she feels she just can't. Not until it's legal.
"It makes me mad when it could help so many people."
Nichola Smith, a 36-year-old nurse from Inglewood has the excruciating CRPS (Chronic Regional Pain Syndrome). "It's the worst form of pain known," she says. "This is a beast. You've got to look for any relief."
Relief from the pain, and relief from the side effects of the opiates used to treat it. The dry mouth, blurriness, dizzy spells, headaches vomiting and nausea. Not to mention the unmentionable. Constipation. In the words of one patient you are so bunged up that the neighbours can hear you screaming three doors down. Dignity? Forget about it.
Like Kat, Nichola's tried marijuana and finds it transformative. "It works and it's a crime that it's not available to us," says Nichola. But just like Kat she refuses to turn herself into a criminal. "I have quite strong values. I don't want to blur the lines."
In the blurry world of right and wrong all these women have had more experience with hard drugs than any of the dodgiest-looking characters on the protest. Tramadol, OxyContin, morphine. You name it. Nichola is even taking heroin substitute methadone. She longs for medical marijuana to be legal. "That'd be incredible. I'd be burning all my drugs my methadone and fentanyl patches."
Technically speaking a legal form of medical marijuana is available in New Zealand. It's a mouthspray called Sativex. But at approximately $1200 a month it is out of most people's reach. The other thing about Sativex is that it's almost impossible to access. Nichola tried and was knocked back. Shane says fewer than 40 people have managed to get prescriptions.
Jacinta, another nurse, is one of them. Her daughter developed juvenile arthritis at the age of 11 and was put on a heavy course of opiates for the pain. "We all despaired about what was happening," says Jacinta. It's taken her three years for the family to get medical sign-off for Sativex for her daughter.
"I've been through four specialists. They all said no. They were concerned about their peers and being ostracised by their professional bodies." While not a cure, the marijuana medicine has wrought a "moderate improvement", Jacinta says conservatively. It means she has been able to return to her studies. Like Nichola, Jacinta is opposed to legalisation for recreational use. "Marijuana needs to be prescribed just like any other drug."
Medical cannabis first started developing a mainstream following in the US when trials on multiple schlerosis patients and children with epilepsy showed encouraging signs. Here, the Ministry of Health remains sceptical. A report to Health Minister Jonathan Coleman obtained under an Official information request says "there is a lack of robust clinical data and evidence of patient benefit".
Kat, Nichola and Jacinta's daughter have carried out their own personal trials and believe it works for chronic pain. For them anyway. Not a cure or anything but a great alternative to opiates. "It means pain relief that doesn't affect me in a bad way," says Kat. "A natural solution without all these massive side effects."
With one in five kiwi adults suffering from chronic pain, Shane believes there are thousands out there who could benefit from medical marijuana. But he's careful not to suggest that it's a panacea, "like some hippies do". "At one end conservatives say it gives you schizophrenia and is so addictive and horrible. Then you've got those who say it will cure all ills and you never need another drug again. The truth lies somewhere in the middle."
Revelations that Martin Crowe and Paul Holmes used marijuana to mitigate the effects of chemotherapy has no doubt bolstered public opinion in New Zealand. Since 2003 the number of people in favour of medical marijuana has doubled.
"We have people like Sir Paul Holmes using it in his dying days," says Shane. "You don't have to be a hardcore lefty for that to strike a chord."
Nelson activist Rose Renton is another reason medical marijuana has been in the public eye. "I am a mother of seven," she says, then corrects herself. "Six alive, one as a spirit." Her son Alex Renton died last July in a hospital in Wellington. He had an unknown neurological disease. Rose fought for six weeks to be allowed to give him cannabis oil. It was approved just before his death. Does she think it helped him in the final analysis? "I know it did because I'm his mum and if anyone knows Alex it's me. He found peace at the end." We talk in the memorial park in Stoke where her son's ashes are scattered. The garden, with its heavily pruned rose bushes, is colourless and winter-bare apart from a rash of yellow daffodils. "As a mother you honour your child, I did that by respecting Alex's wishes." Rose says that months before his illness the strapping young rep rugby player got interested in the health aspects of marijuana, telling Rose: "If anything happens to me my medicine is cannabis, mum."
Rose has 13,500 signatures on a petition calling for a referendum on medical marijuana. "If your doctor recommends that cannabis can alleviate and support you then it should not have to be government-approved." At $1200 a month Rose thinks the price of the legal product Sativex is "obscene". "The amount of cannabis in Sativex is worth $50-60. That's corruption." Rose believes people should have the right to make their own medicine. She says since she started campaigning she's been contacted by a lot of people wanting to grow their own. "When elderly people ask you for seed to grow it next to their broccoli you know you have a wave of change."
Shane agrees there's a lot of compassionate cultivation going on. "Some people will just grow and do it on the sly to self-medicate."
But as Ross Bell warns, if you are treating kids with seizures you probably don't want just anyone boiling up cannabis oil, you probably do want pharmaceuticals. MCANZ is supportive of Rose Renton's work, but as a conservative charity can't support home-growing. He says they don't want to be regarded as "Cheech and Chongs", the duo famous for stoner comedy. "As the only patient-led group playing within the rules we hope to be taken a little more seriously. All we care about is getting medicine into patients hands and getting rid of the background noise."
To that end MCANZ is trying to make two cannabis-based medicines from a Canadian company called Tilray available for patients. But there are hoops. First they have to be assessed by the Ministry of Health, then personally signed off by Associate Minister of Health Peter Dunne.
Earlier this year the ministry deferred an application from Trade Union leader Helen Kelly for a cannabis product to help mitigate pain and nausea. She has terminal cancer.
The MCANZ applications are expected to land on Dunne's desk in the next few weeks.
In the meantime, Kat and Shane are contemplating a second baby. They hope medical marijuana might be available by the time it arrives. Their first child was born addicted to narcotics because of all the painkillers Kat had been prescribed. "What my son went through because of the medication ... For two weeks he had to go through withdrawals. I would not wish that on anyone. That's what opiates do." She sobs on Shane's shoulder. He is used to comforting her. They are sharing this personal story in the hope the decision makers will listen. "They should come and sit with us and see what goes on with our families on a daily basis," says Shane. "There's so much suffering our people go through. All behind closed doors. The only way is to open it up."
Q&A: Medical marijuana
What is medical marijuana?
A pharmaceutical grade cannabis medicine or raw/partly processed marijuana used for medicinal purposes.
Is it legal in New Zealand?
It is illegal to grow, possess or sell marijuana for medicinal purposes. There is one pharmaceutical, Sativex, available.
How do you get Sativex?
Patients must apply to the Ministry of Health with the signatures of a GP and specialist.
Are there any other legal products?
MCANZ is applying to the Ministry of Health to get approval for two more pharmaceutical grade products from Canada.
Which countries have legalised medical marijuana?
These countries have partly or fully legalised medical marijuana. Canada, Holland, Columbia,Czech,Uruguay, Romania, France and 25 states of the United States.
Which medical conditions is cannabis used for?
Medical marijuana is used to help with common conditions such as cancer, epilepsy, multiple schlerosis, glaucoma and chronic pain.
24 September 2016
The New Zealand Herald