Lucy Haslam on medicinal cannabis

This blog is a bit longer than our usual, but as medicinal cannabis is an issue of immense interest to so many, and Lucy Haslam was so generous with her time, we felt it important we didn’t cut it short! Read on to know more about Lucy Haslam’s position on medicinal cannabis.

Medicinal cannabis has been a hotly debated topic over recent years in Australia, with many Aussies supporting legalisation at least for some illnesses. While progress over the last decade has been somewhat slow, it has notably picked up speed in the last two years. Various State Governments are now planning drug trials, and the Federal Government is considering the policy and administrative implications.

One of the most prominent media supporters in this debate is Lucy Haslam, a firm advocate for medicinal cannabis legalisation. Last month, ABC’s Australian Story covered the medicinal cannabis movement, and featured Ms Haslam s personal fight for legalisation, after cannabis helped to alleviate some of the side effects of chemotherapy for her son, Daniel.

At NCPIC, we aren’t in the game of policy or advocating for or against legalisation, but we know a lot of our readers and website visitors are very interested in this question. We watch pro and anti-legalisation websites, social media pages and groups with interest, and note the messages from each often vary, particularly with regards to what they would legalise, why and how.

The Australian Story article was engaging and interesting, and like many of you, it left us wanting to know more from Ms Haslam what she stands for, what she hopes for and what she s working towards. Lucy Haslam was generous enough to take the time to answer some questions for us, providing further detail and some interesting insights. Please note, this article was personally approved by Ms Haslam prior to being published.

Q. Understandably, you advocate for legalisation of medical cannabis on compassionate grounds before trials are completed, so those in need now, don t miss out on a drug that might offer them some relief. In this sense, are you advocating for open medical legalisation or legalisation for a select group of illnesses and symptoms? If the latter, do you have some examples?

I am advocating for a fairly tightly regulated scheme to avoid the situation that has occurred in many places such as the USA where the term medical use is so broad that it is really a guise for recreational use. I believe for people who have profound suffering, it is a human right to access a product that may possibly relieve that suffering. It should be done under medical supervision. Risks vs benefits should be a consideration (this should be kept in perspective and not exaggerated at either end) and with follow-up to determine the benefits and side-effects (wanted or unwanted). To me, this will be the best form of study because it fulfils patient needs and also adds to the body of information which may be helpful for others.

Some examples where I think there is pretty clear evidence of the value of medical cannabis are chemotherapy-induced nausea and vomiting, Multiple Sclerosis, intractable epilepsy, movement disorders (eg Tourette Syndrome, Parkinson s), HIV Aids, Cancer, Neuropathic pain, Alzheimer s, PTSD & Crohn s Disease. I am sure there are more but as I said I think that it should be limited to serious disorders.

Q. The story made a brief mention of legalisation in the USA. Do you envisage a similar framework for medical legalisation to places in the USA? If so, do reports of some people abusing the system (ie not necessarily needing the drug medicinally but obtaining medical approval to use it) concern you? Would you prefer tighter regulation in Australia?

As above, I think tighter regulation is a better option. It is interesting that regulations are now being tightened in many US states retrospectively. I personally like the Israeli model where it is tightly controlled yet open to many patients (20,000+) with a wide range of serious conditions. The patients are well supported and monitored.

Q. A lot of your message is about making sure cannabis is affordable, which likely means plant cannabis. Obviously pharmaceutical products will be more expensive, but if it is proven some synthetic products (eg with concentrated levels of a particular cannabinoid) are more effective than plant-based, is their use something you would support equally/more/less than plant-based cannabis?

I strongly support plant based medicine. Apart from being cheaper, the entourage effect (which is still largely a mystery) seems to play an important part in the effectiveness of medicinal cannabis. I find it strange that humans have this preoccupation with synthetic products where they are considered to be superior to a natural product.

Q. Once cannabis is legalised for medical use, are you an advocate for further and ongoing research?

Absolutely, that goes without saying. I think the benefits of cannabis are going to be discovered over many years and in the future we will be wondering why we were so narrow minded to have vilified it for so many decades.

Q. What does your group in Tamworth plan to study? From our perspective, we re really keen to see what you do and how you set it up, as there are no gold-standard studies using whole plant as yet, and high quality research in this area would be very valuable.

There are many areas of interest, and genetics will play a large part in the Tamworth project. We have a breeder who has been working with cannabis for over thirty years and who has strains available which have disappeared during the years of recreational domination. Other areas of interest will be extraction methods, delivery devices, shelf life. Of course this will also be examined and integrated with a Compassionate Access Scheme. The CAS will be my personal priority.

Q. As mentioned, one of the toughest things we encounter is people neglecting conventional medicines in lieu of medical cannabis, based on anecdotal evidence it may be the right decision, it may not. Do you have advice for people in this situation? Particularly those with serious illnesses that may be life threatening who may see it as a cure?

I have no expertise to advise patients, but my experience with medicinal cannabis has taught me that conventional medicine is not the answer to everyone s needs. Humans are unique and individual and if they are dissatisfied with one medicine they should try another. Also they should be aware that there are risks and benefits of cannabis as with any medication.

In the case of someone with terminal illness, maintaining hope is very important and for Daniel cannabis helped with that too, even though it didn t cure his cancer. I have certainly met many people who have had positive cancer responses and when you think about it, many people die regardless of whether they have conventional treatments or not. There is no magic bullet so people must choose what is right for them with their psychological needs being considered as importantly as their physical.

I think the term anecdotal is a horrible dismissive term used all too often by medicos to discredit patients personal experience.

Dan s experience was that cannabis stopped him vomiting, made his nausea better, encouraged his appetite, helped him maintain his weight through treatment, alleviated his severe mouth ulcers and helped ease his pain and dependence on opioids, and above all gave him hope.

If doctors want to be dismissive and call this anecdotal then so be it, but they are supposed to want what is best for their patients and not just what they think is best.

The years of prohibition have stifled meaningful objective research into cannabis with enormous amounts spent on researching harms and little spent looking at benefits. There is a lot of work being done around the world and the use of cannabis as a cancer treatment will be an emerging area of exciting research. But if you have cancer now that is not responding to current available treatment, the idea of trying cannabis methods [we have removed the brand name of the method to avoid advertising] may be judged by others as desperate or reckless. But to a terminally ill patient, it may be a reason for some optimism where previously there was none.

Ms Haslam did also take the time to look at our website. She noted her feeling that the content seems aimed at discrediting cannabis. This point is one we are certainly no strangers to, and one frequently pointed out by those in the pro-cannabis (whether medicinal or not) camp. As an organisation established long before the medicinal cannabis debate really ramped up in Australia, NCPIC is born of a time when the focus around cannabis in this country was purely on preventing uptake of recreational use due to potential harms.

As a Centre, we are growing and evolving as the conversation around cannabis in Australia also evolves. Our main challenge is finding a balanced position between raising awareness about potential harms and preventing uptake in young people, and not discouraging further investigation into the potential uses for medical cannabis.

We aim to always rely on the strongest research available. Many pro-cannabis advocates have rightly pointed out that while high-quality research into the possible positive applications of cannabis is increasing (and quite rapidly), various restrictions in the past have meant this sort of research hasn t yet largely been undertaken.

With this in mind, we continue to evaluate new research and studies as they arise, and present findings from the most high-quality studies. Our medical cannabis page is a prime example of this, where we note the promising findings for treating side effects of chemotherapy, spasticity in MS patients and some forms of epilepsy, focused on severe childhood epilepsy not responding to other treatments. We aim to update our materials as new high-quality research is presented.

Ms Haslam raised an interesting point in noting the importance of hope for people suffering serious illnesses. We absolutely agree hope is vital, and quashing it can be detrimental. But given there are claims that cannabis treats or cures hundreds of different illnesses (some which may be true, some false and part of other agendas), we do have concerns for the well-being of some patients who use cannabis in lieu of other medications when there is not clear evidence to support its effectiveness. We agree with Ms Haslam, that any use should be done under strict medical supervision.

Cannabis, in general, is a challenging and controversial area because there is so much historic information pointing to positives, and in contrast, so much high quality research currently pointing to harms (though some positives are starting to peek through). As an organisation we support compassion and empathy, and in that way, the work of advocates like Lucy Haslam. But as an evidence-based organisation, we continue to encourage high-quality and thorough research studies of this drug both its positive and negative effects now and into the future, regardless of it legal status.

Thanks again to Lucy Haslam for her time, openness and generosity.