As support for the legalisation of recreational cannabis grows in Australia, Cannabiz editor-at-large Rhys Cohen analyses what it would mean for medical cannabis patients.
In 2013, the legalisation of recreational cannabis was supported by approximately 26% of Australians aged 14 years and older. Since then, that level of support has on average grown by roughly 2-3% every year. The most recent data from 2019 estimated popular support had reached 41%.
Given a long enough timeline, it seems likely that net support will hit and exceed 50%. And if support continues to grow at the same pace it has for the last decade or so, we might see majority support for the legalisation of recreational cannabis in Australia as soon as 2025.
Of course, this trajectory might slow, stall or go backwards. Although for a whole bunch of reasons – global and domestic – I don’t think that’s likely. And support is necessary, though not sufficient by itself, to affect policy change.
But eventually, at some point, I am confident that cannabis will be legalised for recreational consumption in Australia.
Depending on when and how this happens, recreational legalisation may have negative impacts on Australia’s medical cannabis framework. And I’ll get to that in a subsequent instalment. But I’ve been thinking – are there ways in which medical patients might actually benefit from recreational legalisation?
Ensuring quality medical care
In 2017, even dying of cancer wasn’t a good enough reason to get access to medical cannabis. Thankfully that is no longer the case – if you have the money (and you don’t live in Tasmania), you can now get a prescription.
Some clinics have started bulk billing visits and even offering free interstate telehealth consultations, reducing the costs associated with getting a prescription, while some product prices are approaching black-market levels.
This is great for affordability and access. But cheap and quick doesn’t always equal good, especially when it comes to the medical needs of complex care patients. As it gets quicker and easier for people who want cannabis to get a prescription for it, the more perfunctory these clinical services will become.
Which is fine for otherwise reasonably healthy patients, or the non-medical cannabis consumers looking for quality controlled products. But it has the potential to compromise the quality of medical care many patients need.
I support the legalisation of recreational cannabis because prohibition causes more problems than it solves. But I have mixed feelings about recreational users accessing cannabis through the medical system.
I don’t want us to end up in a situation where the only clinics I can recommend to my ailing parents, who might benefit from medical cannabis, are ones that pro-actively call patients to recommend they try the newer, stronger strain that’s just hit the shelves. And yes, that actually happens.
Legalising recreational cannabis would help us keep some distance between medical and non-medical services, which is a good thing. All the enthusiastic, well-intentioned cowboys could turn their prescription mills into the businesses they always dreamed of – real, recreational cannabis companies.
Consumers could get the quality control and legal access they deserve without having to frame their use as clinically necessary.
And patients with complex needs could visit medical clinics which would no longer have to concern themselves with catering to increasing numbers of young men asking for flower prescriptions.
Prescription cannabis isn’t for everyone
Medical cannabis is a very broach church. Some patients are offended at the very suggestion that they should supplement their CBD isolate with small doses of THC. For whatever reason, the thought of becoming even mildly intoxicated from THC scares the hell out of some people who have spent the last decade on hardcore opiates and antipsychotics. These people are reasonably well served by the prescription cannabis model.
On the other end of the spectrum are those who would never in a million years consider taking a synthetically produced medicine of any kind. People who feel that modifying the cannabinoid content of plant extracts is not only medically pointless but barbaric, verging on unethical.
There are also those whose clinical needs are so challenging and particular that it is impractical or impossible for them to get satisfactory clinical outcomes from the current prescription cannabis framework. The Peek, Taylor, Cleaver, Carter and Lambert families spring to mind, but there are many more.
Not to mention those people who, through bad luck and circumstance, can’t afford prescription medicines if they’re not on the PBS.
Legalising the personal cultivation of cannabis may not be the best solution to all of these challenges. But it seems like one of the least-bad options.
For those capable of growing their own plants, it would be an immense relief to not lie awake at night dreading a knock on the door or a full-on raid and the confiscation of life-saving medicine.
And for those who lack the space, skill, mobility or inclination to grow, it would open the possibility of grower/buyer clubs and other compassionate, community-based, not-for-profit models of supply.
Medical-only home-grow is theoretically possible, but I suspect legalising personal cultivation is unlikely to happen outside of some broader process of recreational cannabis legalisation. That’s because there’s no way to easily distinguish home-grown cannabis from illicit cannabis, unlike prescription cannabis which is easily verifiable (prescriptions, labelled containers etc).
If home-grow is legalised, recreational use would be legalised by default.
The other possible benefit to medical patients from the legalisation of recreational cannabis would be the normalisation of its existence and use. There are many out-and-proud prescribed medical cannabis patients. But there are many more who are embarrassed and anxious about what people might think of their medication.
And worse yet, those people who can’t bring themselves to even consider medical cannabis because of the social stigma.
It is not an exaggeration to say that many people have endured unnecessary pain and suffering because of the ways in which cannabis use is portrayed in Australian society.
Legalising cannabis for recreational purposes would force people to confront their prejudices, and might lead to a more informed and reasonable community understanding of cannabis use – both medical and non-medical.
Mitigating the drawbacks
Legalising recreational cannabis will be difficult, and whatever framework we end up with is guaranteed to be imperfect (if not borderline broken) from the start. Some of those issues will be about impacts to the medical system, and there are valid reasons for medical advocates to be concerned.
Assuming we are destined (at some point in the future) to legalise recreational cannabis, the time to start thinking about these issues is now.
Because the more front-of-mind these concerns are when the policy design process starts, the more likely it is we will be able to mitigate or even avoid some of them altogether.
In the next instalment, I will attempt to sketch out the key concerns as I see them, and suggest some ways in which we might design a fully legal cannabis framework that benefits consumers and patients.
- Is Rhys right? Would legalising recreational cannabis have benefits for patients? Have your say in the comment box below.