Making Medicinal Cannabis Accessible: An Interview with Senator Richard Di Natale

Currently, there’s a private senator’s bill before the House of Representatives that will provide terminally ill patients with rapid access to medicinal cannabis products. But, there are fears the Turnbull government will vote it down.

Australian Greens leader Richard Di Natale introduced the Medicinal Cannabis Legislation Amendment (Securing Patient Access) Bill 2017 into the Senate in September, and it was passed on October 19.

The bill is designed to prevent the government using a technicality to block fast access to imported cannabis medicines via the Therapeutic Goods Administration’s (TGA) Special Access Scheme (SAS) category A pathway.

The SAS allows patients to import unapproved medicines. Category A of the SAS provides dying patients rapid access to medicines, as a doctor only needs to notify the TGA that their patient will be importing them.

However, the Coalition government put in place measures to stop the dying from specifically accessing medicinal cannabis in this way. Now, they must use the category B pathway like other patients. And this requires TGA approval, which is a lengthy process that can take up to six months.

Denied respite in their last days

On November 1 last year, the TGA down scheduled medicinal cannabis from a prohibited substance to a controlled drug, which allowed patients to access it via the SAS. But, on that same day, former health minister Sussan Ley introduced amendments that blocked access to it via category A.

Senator Di Natale moved a disallowance motion through the Senate on June 13, which reversed this prohibition and allowed the terminally ill rapid access to these medicines. But, in August, the government blocked access once again using importers’ contractual conditions to do so.

The Office of Drug Control sent an email to importers warning them that they would be in breach of their contracts if they provided terminally ill patients with cannabis medicines via category A.

Another barrier

The same government that’s blocking rapid access to cannabis medicines to those with little time left, passed the Narcotic Drugs Amendment Act in February last year. It provides the framework for the legal cultivation and manufacture of domestically produced medicinal cannabis products.

This act also includes a provision to block rapid access to Australian medicinal cannabis medicines via category A. And Senator Di Natale’s bill amends this so that terminally patients would be able to gain faster access to locally produced products.

Legal, yet unobtainable

However, the process of making domestic product available has been drawn out. Only 22 licences have been issued so far. And due to this delay, the current health minister Greg Hunt established a fast track medicinal cannabis importation scheme in February.

But, despite all this, the majority of the estimated 100,000 patients using these medicines around the country can’t access any legal product. As yet, there are still no Australian made cannabis medicines available. And most GPs don’t prescribe these medicines because of the amount of red tape involved.

Sydney Criminal Lawyers® spoke to Senator Di Natale, a former GP and drug and alcohol clinician, about the government’s refusal to allow the terminally ill rapid access, the slow-moving domestic scene and the changes needed so that doctors can more readily prescribe cannabis medicines.

Firstly, Senator Di Natale, in your opinion, why is the process of making domestically produced products available taking so long?

The process is complex and convoluted, and the government is busy suppressing demand by blocking whole categories of patients who could benefit from access. The process is duplicated in many states and extremely difficult to understand.

The government has repeatedly blocked terminally ill patients from rapidly accessing cannabis medicines via the SAS category A pathway.

Why do you think the government is so set on preventing terminally ill patients fast access to these medicines during their last days?

This government is prioritising ideology over evidence. More and more, the medicinal cannabis regulations that the Coalition government has put in place look like they have been set up to fail.

When they introduced the regulation to block compassionate access to terminally ill patients, many Australians were rightly shocked.

Only the Greens are prioritising the needs of patients in accessing medicinal cannabis. The Greens moved our successful disallowance in the Senate to combat the government’s cruelty.

We’ll keep fighting for safe, timely access to medicinal cannabis until it’s a reality in this country.

Your private senator’s bill is now before the lower house. There’s been speculation that the Turnbull government will vote the bill down.

What sort of support do you think the legislation has?

This bill was made necessary after the government chose to ignore the Senate’s disallowance motion and threatened importers out of supplying under category A.

Category A patients are those whose doctor has found are reasonably likely to die within three months.

We know there are members of the government in both houses who are seriously concerned about the Minister for Health seeking to make it harder for those patients who are terminally ill to access medicinal cannabis.

I call on them to cross the floor and vote in support of our legislation in the House of Representatives.

In November 2014, you introduced the Regulator of Medicinal Cannabis Bill into parliament.

Medicinal cannabis advocates state that your legislation would have implemented a much better system for accessing locally produced medicines.

How did your proposed framework differ from that of the federal government’s system?

We wanted to set up an independent regulator for medicinal cannabis, as with every other jurisdiction in the world that has moved to regulate medicinal cannabis.

The government chose to send it to the TGA and now we are seeing what a mess this has become. All the while, patients continue to suffer.

To counter the delay in the availability of domestic product, the health minister set up a fast track importation scheme in February.

Yet, despite the first batches of imported medicine entering the country in May, most patients cannot access this product.

As the federal government made special provisions for the imported product to arrive in the country, why are patients still being denied access to it?

The fast track only meant that certain medicinal cannabis products could be imported into Australia, but patients still need to have a prescription written by a doctor and be approved by the TGA before they can access them, as well as adhering to the relevant state requirements.

And lastly, there’s a petition currently circulating online that’s calling on the RACGP to support legislation to streamline the process for GPs in prescribing cannabis medicines to their patients. It garnered close to 15,000 signatures within the first week.

An increasing number of doctors are showing interest in prescribing these products, but the red tape surrounding the process is daunting.

What sort of provisions do you recommend be made in order for medical practitioners to be able to provide their patients with these beneficial medicines?

Doctors are rightly confused about medicinal cannabis due to a lack of education and the mess that the government has created with regulation.

We need better doctor education and greater support for those doctors who want to prescribe.

In some states, GPs have been told they are ‘insufficiently qualified’ to prescribe medicinal cannabis and that they must be supervised by a specialist. This is an affront to GPs and just plain dumb.

If GPs can prescribe far more dangerous drugs like opiates, then they should be able to prescribe medicinal cannabis.