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MedCan - Narcotic Drugs Amendment Bill 2016

Speeches in Parliament
Richard Di Natale 25 Feb 2016


I rise today to speak in support of the Narcotic Drugs Amendment Bill 2016.

Dan Haslam was 20 years old when he was diagnosed with stage 4 bowel cancer. Just think about that: a 20-year-old boy diagnosed with bowel cancer with a terminal diagnosis in the prime of his life with a world of possibilities ahead of him. Dan went through hell. He spent years enduring chemotherapy treatment that made him nauseous. He lost weight. He was unable to eat. It impacted every aspect of his life. Dan developed something called anticipatory nausea. Nausea in and of itself is an awful symptom. It is debilitating. Those people who experience chemotherapy say that, of all of their symptoms, often it is the nausea that is the worst. Anticipatory nausea is where just the thought of going into having chemotherapy triggers nausea. So, without the drug itself, simply the notion that you are going to sit down and have a toxic drug injected into your arm will trigger nausea.

Dan was so unwell and he lost so much weight that it appeared that the chemotherapy would no longer be used. Then quite by accident Dan's family heard about medicinal cannabis. It is interesting. Dan's father is a law enforcement officer. His mother, Lucy, heard about it. Of course, like any desperate parents they did what they could. They thought this was a last resort. They tried medicinal cannabis. Initially, Dan smoked it, and the effects were profound. Dan had an immediate response. His nausea settled, he had more of an appetite and it helped to give him some quality of life in those final few years.

Today marks one year since Dan's passing. It is a year today since Dan left us, and so it is incredibly fitting that we are here today marking the passage of this bill, standing in support of legislation that Dan and his family helped to drive forward. I know that Lucy Haslam wanted to be here today. Lucy, this would not have happened without your contribution. Unfortunately, things move quickly sometimes in this place; far too often they move slowly. On this issue, we are debating a piece of legislation that we thought might be in this parliament next week. I am sorry you cannot be here today. I know you wanted to be here and I know you will be watching from Tamworth. To you I say on behalf of the Australian Greens, on behalf of all of the people in this parliament: thank you for everything you have done. I want to let you know that your family's grief, your family's pain and suffering, have not been in vain. This is a legacy that Dan will leave here in this parliament.

It is all too sad that there are many people right across the country who have to endure the same sort of pain and suffering that Dan and his family have had to endure or to be treated like criminals if they resort to what is now regarded as an effective medicine and an effective treatment for something like nausea, and indeed many other conditions, which I will come to in a moment. It was on the back of the Haslam family and their wonderful advocacy. I am always amazed by an individual who is confronted with such grief, pain and suffering who is able to turn that around and use it to make a positive contribution, to have the strength and the courage and the vision to be able to harness that grief in a way that makes an enormous positive contribution on something like this. It always amazes me. I do not think I would have the strength in those circumstances.

On the back of Lucy's family and the stories of families just like the Haslams, the Greens decided that we would introduce legislation to the federal parliament, legislation based on ensuring we had the production, manufacture, supply, use, research and importation of medicinal cannabis. That legislation is the genesis of this bill. But we recognised that this could not be seen as a partisan issue. What we are seeing today is this parliament at its best, when far too often we see this parliament at its worst. I acknowledge Melissa Parke and Sharman Stone, who are the co-conveners of the Parliamentary Group for Drug Policy and Law Reform—Melissa Parke is a Labor member; Sharman Stone is a Liberal member. Together we decided that this would be a priority for our group. We also acknowledged that we needed to introduce the legislation into one of the houses of parliament. We decided on the Senate and we sought co-sponsors for that legislation. I acknowledge Senator Urquhart for her contribution and her moving words just now, Senator Leyonhjelm and Senator Macdonald. Senator Macdonald and I are on opposite poles of the political spectrum but there are moments in this place when you put aside your partisan differences and recognise that it is important to work in the common good, in the national interest, to try and get something done.

I acknowledge Senator Macdonald and his involvement with the inquiry by the Senate Legal and Constitutional Affairs Legislation Committee that looked into this legislation. That inquiry into the Regulator of Medicinal Cannabis Bill had hearings in Brisbane, Canberra and Melbourne and heard from a range of people. We heard from experts—academics, doctors, scientists—and patient groups, but most importantly we heard from patients themselves. We heard evidence about the effectiveness of medicinal cannabis. Emeritus Professor Laurence Mather said quite clearly:

… this evidence inarguably demonstrates cannabis to be a useful medication, and ought to be available to … patients in need.

We heard from Dr Alex Wodak that the evidence is very clear that this is a useful medication.

There are many claims made about the effectiveness of medicinal cannabis. To be frank, some of them are still unproven. I suspect that some of them will not hold up to the scrutiny of evidence. It is not a cure-all for everything. However, it is a very effective treatment for a range of conditions and there is no reason why it should not be treated as medicine just like any other. We know that it is effective for chemotherapy induced nausea—you heard Dan's story. We know that it is effective for muscle spasms that are a consequence of multiple sclerosis. In fact, there is a medication approved for that use. We know that there is evidence for its effectiveness for particular types of epilepsy, particularly among young children. There are miraculous stories about the benefit associated with use of that drug for those young kids, many of whom are not developing appropriately and are having seizure after seizure after seizure, causing incredible heartache within families right around the country. We know that for many conditions there is good evidence about this drug, and there is no reason why this drug should not be treated like any other medicine.

People are naturally concerned. They have heard stories about the impact of psychosis associated with the use of cannabis. We heard from Professor McGregor about some of the issues associated with that. Much of the psychosis associated with the recreational use of cannabis is likely to be attributed to the fact that because this is an illegal drug with very highly potent forms with high THC and low CBD we are seeing potential associations with psychosis for recreational users. But where we can have controlled production for medicinal purposes, where we have a higher ratio of what is called CBD, we know that that may be protective against psychosis. Interestingly, we heard from the inquiry that CBD, a component of cannabis, is now being researched as a treatment for psychosis.

We heard about the effectiveness of the drug and about its potency in responding to things like nausea and muscle spasm. But nothing can replace the words of patients about their experience with using that drug. We heard about the heartbreaking story of a young mother who saw her child having seizure after seizure, not responding to a cocktail of pharmaceutical anticonvulsants yet getting miraculous relief from medicinal cannabis. She spoke out about that publicly and what was she confronted with? A knock on the door from the police and an interview with the department of human services assessing her fitness to be a mother. Think about that. A mother who is providing her child with medication being interrogated about whether she is fit to be a mother because she is providing her child with what is an illegal substance.

That is why this bill is so critical. It gets us on the path to treating this effective medicine as a medicine. We also need to recognise that this bill has serious limitations. It is an important piece of the puzzle but it is not the missing piece of the puzzle, as it has been described. It is an important first step but there is a long way to go before this medicine finds its way into the hands of patients. That is ultimately the test of whether any legislation is successful.

As someone who suffers from chemotherapy induced nausea, multiple sclerosis and the muscle spasms that come from that, can I go to my doctor and be prescribed this medicine? That is ultimately the test. This legislation will not get us there on its own. It is an important reform but there is much more work to be done. It has taken a long time, almost two years, but we are relieved that the government has decided that it is time for a national approach. So we do welcome the passage of this legislation.

But what needs to be done now? Cannabis in all its forms, medicinal or otherwise, remains an illegal drug. I will say that again. Medicinal cannabis, as the law now stands, is an illegal drug. The technicality is that it is a schedule 9 drug—alongside cocaine, heroin and other illicit substances. That is where medicinal cannabis is classified in the classification scheme of all drugs. We need to change that. I understand that the TGA is currently going through a review process to look at the rescheduling of cannabis for medicinal purposes. That is a good thing and it is long overdue. When we first interrogated the TGA about that possibility we were told that it was unlikely to happen. But I understand that there is now a review process, hopefully with the outcome of changing the scheduling around medicinal cannabis so that it is no longer an illegal substance.

We do need to ensure that the TGA does its work but there are also a whole range of questions around the supply chain. While this legislation creates the framework to grow and manufacture the drug, there is nothing to outline what happens in terms of the supply chain of that drug. Where does it go? How does it get there? What is the role of community pharmacies? Will this drug be dispensed through community pharmacies? We do not know. Will it be dispensed through hospital pharmacies? We are not sure. Or will there be some other process? That work still needs to be done.

Once this drug is made available—we hope through community pharmacies—then how will it be made available to patients? Will it be prescribed as per any other drug with a normal script? At the moment, it appears possible that there will be a special access program for particular patients and that doctors will need to achieve some sort of authorised prescriber status. But we are not sure, so that detail needs to be worked through. At the moment, this legislation allows us to grow and manufacture the drug but it is silent on the role of community pharmacies and the medical profession in terms of prescriptions. I understand work is being done there, but we do not know how much it will cost. As Senator Urquhart said previously, costs cannot be a barrier to access for this drug. We do not know what strains will be approved for use and so on. There is much more work needing to be done.

So in the spirit of making sure this was not a partisan issue we approached the government and said that, if we are to make progress on this, we need to see the establishment of an independent advisory body to provide some advice and input to the relevant departments who are proceeding through the next steps. And, to their credit, the government and the health minister have agreed to the establishment of that independent advisory body. I think that is important. It allows those people who work in this space to ensure progress is being made. The advisory body will have an independent chair and members of the states and territories. The Victorian government, the New South Wales government and the Queensland government have all been very important in helping to put pressure on so that we get a national framework because it is critically needed. We are going to see scientists with expertise in cannabis pharmacology and toxicology on that advisory body. We will see community pharmacy on that advisory body and also people with expertise in prescribing pain management and end-of-life care. There will be people on that advisory body with expertise in the horticulture aspects and law enforcement. Most importantly, there will be patient representatives on that advisory body. That is an important step. We acknowledge that the government has supported that initiative and we want to thank the government for ensuring that that happens. So this is significant progress but there is much more that needs to be done.

I am very proud to be part of a political party that for many years has had the courage to stand-up and advocate for this reform long before it became the flavour of the month, long before it was an issue that dominated state and federal parliaments. I want to pay special tribute to one of our state MPs, John Kaye, who is unwell at the moment. I hope you get better soon, John. John Kaye was instrumental in having this matter referred to the upper house of the New South Wales parliament for inquiry and ensuring that the matter was debated in the New South Wales upper house. This gave impetus to many of the reforms that we are seeing in the New South Wales parliament.

I want to finish by congratulating the Haslam family for their tireless work. Your advocacy on this issue has been inspirational. The nation owes you a great debt. Many people right across the country will one day benefit from this medication in the same way they benefit from many other medications that are provided to them. They will not be made to feel like criminals. They will owe you a great debt. So thanks again to Lucy and the Haslam family in Tamworth. Your contribution here will be remembered always.

Ultimately, we will not rest until this final test is met: when someone goes to the doctor with a condition for which we know medicinal cannabis provides significant relief, will their doctor be able to prescribe it in a timely way so that they can get relief? That will be the conclusion of the debate that has started today. Along with many other Australians, we will welcome that day.

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