The Australian Government’s criminal negligence in the design and administration of its medical cannabis access scheme killed hundreds of older Australians last year. It is killing hundreds more this year. It will continue killing Australians until Australia’s voters compel Australia’s politicians, bureaucrats, and government agencies to make it easy for every Australian GP to prescribe medical cannabis, every Australian pharmacist to stock it, and every suffering Australian to get it.
The Disease: Chronic Pain
According to The Cost of Pain in Australia (Deloitte & Pain Australia, April 2019), 3.24 million Australians just like you suffer from chronic pain (see Figure 1, below).
The Treatment: Deadly Opioids
According to the above-cited Cost of Pain study, the most common prescription for the treatment of chronic pain is opioid painkillers, such as codeine, oxycodone, and methadone.
Unfortunately, this treatment is worse than the disease. These opioid medications, prescribed by Australia’s Medicare system, are killing Australians like flies, as shown in Figure 2 below.
Figure 1 (above): “Fatal opioid overdoses are on the rise, and most involve prescription drugs,” ABC Chart of the Day, 28 Aug 2018.
According to the Cost of Pain report, 823 Australian chronic pain sufferers died of prescription opioid overdoses in 2018.
Surely, most of these were immoral, criminal “druggies,” who deserved to die, right? Wrong. According to the experts cited in the ABC’s 2017 article “Everyday Aussies, not ‘doctor shoppers’, at heart of crisis, experts say,” Australians just like you are likely to be prescribed opioids “after having surgery, and… for injuries suffered through sport or at work.”
With opioids, the margin for error is tiny. One pill too many, and you’re dead. Your father. Your son. Your mother. Your daughter. Your granny. Dead.
The Alternative: Medical Cannabis
In 2018, Pain Australia conducted a survey of its members regarding medical cannabis. According to Pain Australia’s summary of the survey’s findings, “Many respondents explained they would prefer to use medicinal cannabis over prescription pain medications such as opioids, which carry side-effects and risk of death.”
- Are the respondents correct that cannabis is safe? Yes.
- According to a 2017 meta-study by the USA’s National Academy of Sciences, Engineering, and Medicine: “Overall, the committee identified no study in which cannabis was determined to be the direct cause of overdose death” (p. 235). That is: there is no scientific evidence that anyone, anywhere, at any time, has suffered an “overdose death” from cannabis.
- Are the respondents correct that cannabis is effective? Yes.
- The same US meta-study concluded (p. 90) that there was:
- “Substantial evidence that cannabis is effective for the treatment for chronic pain” and
- “Moderate evidence that cannabinoids… are an effective treatment to improve [insomnia] associated with… chronic pain.”
- In January 2019, the World Health Organization officially recommended rescheduling cannabis to be more widely available, and clarified that cannabidiol (CBD) — a cannabinoid found in cannabis
— was not restricted internationally and should not be restricted nationally.
- In February 2019, the European Parliament passed a resolution “calling on Member States to allow doctors to make free use of their professional judgement in prescribing regulatory-approved cannabis-based medicines to patients with relevant conditions, and to allow pharmacists to lawfully honour those prescriptions.”
- The same US meta-study concluded (p. 90) that there was:
Australia’s people appear to know more about the safety and efficacy of cannabis than Australia’s “experts.” This should be no surprise; the collective wisdom of “the people” is the basis of Australian democracy.
There’s another thing that Australia’s “experts” seem not to know.
The Crux: Medical Cannabis Saves Lives
In 2014, a scientific paper Bachhuber et al., “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010,” revealed a strong correlation between the legal availability of medical marijuana and a sharp reduction in opiate overdose deaths. The paper concluded:
Although the present study provides evidence that medical cannabis laws are associated with reductions in opioid analgesic overdose mortality on a population level, proposed mechanisms for this association are speculative and rely on indirect evidence. Further rigorous evaluation of medical cannabis policies, including provisions that vary among states, is required before their wide adoption can be recommended. If the relationship between medical cannabis laws and opioid analgesic overdose mortality is substantiated in further work, enactment of laws to allow for use of medical cannabis may be advocated as part of a comprehensive package of policies to reduce the population risk of opioid analgesics.”
That “further rigorous evaluation” was begun immediately, and its results were published in February 2018 in the scientific paper “Do medical marijuana laws reduce addictions and deaths related to pain killers?” by Powell, Pacula, & Jacobson, in the Journal of Health Economics 58 (2018) 29–42. It firmly established that easy access to legal medical cannabis reduced the overdose death rate by 25-40%.
As the authors wrote:
Using data from just the early period of these laws 1999–2010 [when medical cannabis dispensaries were unregulated, maximizing “easy access”], dispensaries reduce opioid mortality rates by about 40%, above and beyond the reduction from marijuana laws alone. The total effect is estimated to be even larger. When we consider the full time period (1999–2013) [including the later period of tighter regulation, reducing “easy access”], the estimates imply that dispensaries reduce opioid mortality rates by about 20% while the main effect of having a law is relatively small in magnitude, implying declines of about 5%, and not statistically distinguishable from zero. Importantly, together – a marijuana law with a legal, operational dispensary provision – the estimates imply a statistically significant (at the 5% level) decline in overdose death rates of about 25%.”(Powell 2018)
[Update 11th October 2019: The paper “A Pilot Study of a Medical Cannabis – Opioid Reduction Program” by Dr. Kevin Rod was published on 20th September, 2019. In its study of 600 patients taking opioids for chronic pain,
Six months after beginning [Rod’s study],
* 156 patients (26%) had stopped using opioids altogether. An additional
* 329 patients (55%) had reduced their opioid use by an average of 30%. Cannabis use among these patients ranged from 1-3g per day. There was no change in the opioid use of
* 114 patients (19%) – neither reduction nor escalation in opioid dose.
* 1 patient with poorly controlled pain and an aggravated pain condition increased opioid intake.
With that one exception, all patients expressed satisfaction with their pain control, sleep and quality of life. No opioid withdrawal symptoms were noted in follow-up appointments.”(Rod 2019)
That is, (26% + 55% =) 81% of patients in the study reduced their opioid intake by at least 30%, thus significantly reducing their risk of opioid overdose. A corresponding 81% decrease in opioid overdose deaths would have saved (823 * .81 =) 666 Australian lives in 2018. Even reducing the overdose mortality rate by 26% — that being the percentage of patients that stopped using opioids completely — would have saved (823 * .26 =) 213 Australian lives. End of update.]
You would expect that, faced with such a demonstrably-effective tool in saving hundreds of lives each year, Australia’s politicians, bureaucrats, and agencies would have rushed — rushed! — to implement policies, laws, and regulations that gave Australia’s chronic pain sufferers “easy access” to medical cannabis.
Yet, Australia’s federal and state government have made medical cannabis so hard to get that only 30,000 Australians — fewer than 1% of Australia’s chronic pain sufferers — are predicted to have access to medical cannabis by the end of 2019. The remaining 99% cannot access medical cannabis legally (except, recently, via the “Thailand Twist,” for which they can register at www.ThailandTwist.com).
Why aren’t Australian politicians and bureaucrats doing everything they can to save Australian lives?
Because they are afraid that cannabis will drive its users insane.
The Fear: Cannabis Causes Schizophrenia
This fear, simply put, is
bollocks unfounded. Despite nearly 100 research papers being published per year since 2012 on the relationship between cannabis and schizophrenia, all that has been proven is a correlation. This research has established that one of the three statements below is true, but not which one:
- Cannabis use increases the odds of developing schizophrenia.
- Latent schizophrenia increases the odds of cannabis use.
- Some underlying condition increases the odds of developing both cannabis use and schizophrenia.
The latter is entirely possible. Consider this study from 2015 which showed that smoking cigarettes was correlated with later development of schizophrenia: the more tobacco a person smoked, the higher the risk. Many factors are correlated with the later development of schizophrenia, each confusing the potential impact of the others.
Schizophrenia is no joke. According to the Australian Bureau of Statistics’ Causes of Death, Australia, 2017 (the most recent year for which data is available) “Schizophrenia, schizotypal and delusional disorders” killed 63 Australians in 2017 — Australians with families, friends, and futures just like the rest of us. Still, that number is ((63/823)*100=) 8% of the Australian deaths from opioid overdoses. Alternatively put, (823/63=) 13 Australians die of opioid overdoses for every Australian who dies of schizophrenia.
Killing 13 Australians for certain because you think 1 Australian might get schizophrenia is so willfully misguided as to be criminally negligent.
Furthermore, what little evidence there is to support the “cannabis causes schizophrenia” claim requires that the cannabis user be young. Most of Australia’s chronic pain sufferers are not young (see Figure 1, above). Australia’s GPs are quite capable of being extra-careful about prescribing cannabis to young patients, while prescribing it “easily” to older chronic pain sufferers.
Some anti-cannabis fear-mongers muddy the waters by claiming that cannabis can cause “psychosis.” That’s a scary-sounding word! However, it is defined as “perceiv[ing] or interpret[ing] things differently.” The colloquial term for cannabis-induced temporary psychosis is “getting high.” (Many Australians are rumoured to enjoy this.) Similarly, alcohol-induced beer goggles can make one perceive or interpret a potential companion differently, meeting the technical definition of temporary “psychosis.” Even eating chocolate can cause temporary psychosis. Don’t let the fear-mongers scare you.
Conclusion: The scientific literature does NOT prove that anyone, anywhere, ever, developed schizophrenia from consuming cannabis.
[Update (19 Oct 2019): People who suffer from chronic pain are often prescribed benzodiazepines (such Valium and Xanax). Benzodiazepines help patients sleep despite their pain, and to treat the anxiety that often arises from having a chronic, painful illness for which they must take potentially-fatal and highly-addictive opioids. In the 2019 study Reduction of Benzodiazepine Use in Patients Prescribed Medical Cannabis, Purcel et al. concluded that:
Within a cohort of 146 patients initiated on medical cannabis therapy, 45.2% patients successfully discontinued their pre-existing benzodiazepine therapy. This observation merits further investigation into the risks and benefits of the therapeutic use of medical cannabis and its role relating to benzodiazepine use.(Purcell 2019)
This matters, because, according to the Australian Bureau of Statistics, benzodiazepine was found in 63.1% of the Australians who died of opioid overdose, and were the second most-common cause of overdose death (at 4.0 per 100,000 vs 4.6 per 100,000 for opioids).]
The Crime: Wrongful Death from Criminal Negligence
To summarize: The Cost of Pain in Australia (Deloitte & Pain Australia, April 2019), 3.24 million Australians suffer from chronic pain, for which the most common prescription for the treatment of chronic pain is deadly opioids (often along with benzodiazepines), which killed 823 Australians in 2018.
“Easy access” to medical cannabis would have saved the lives of 25-to-40% of these 823 Australians. That’s 205-to-329 Australians just like you. Hundreds of Australians with families, friends, and futures, whose only “crime” was being injured, developing a painful illness, or growing old.
These hundreds of Australians died because the politicians, bureaucrats, and government agencies that are responsible for Australia’s medical cannabis scheme’s policies, laws, and regulations failed in their duty of care. They have been too afraid of the potential side-effects of medical cannabis to pay sufficient attention to its actual life-saving properties. They should have known about medical cannabis’ life-saving properties. They should have done everything within their power to make medical cannabis as “easily accessible” as deadly opioids. They did not do so. Every opioid overdose death in Australia since at least February 2018 (when Powell et al.‘s paper proved that “easy access” to medical cannabis reduced opioid overdose death rates) was a wrongful death caused by the criminal negligence of these individual politicians, bureaucrats, and government agencies.
Hundreds of Australians just like you suffered these wrongful deaths last year, in 2018. Hundreds more are suffering such wrongful deaths this year, in 2019. Hundreds more will suffer such wrongful deaths next year, in 2020, and in every year to come until Australia’s criminally negligent medical cannabis policies are changed to make medical cannabis “easily accessible” to chronic pain sufferers.
The Analogy: Antiseptics
Ignaz Semmelweis discovered in 1847 that antiseptic procedures reduced to near-zero the rate at which women died of childbed fever after giving birth. The “experts” of his day — highly educated medical professionals — resisted his procedures for decades. Hundreds of thousands of women could have been saved from premature and painful deaths during this time. Nuland (2003) argues that Semmelweis could have saved more lives if he had communicated his findings more effectively.
The Solution: Vote for “easy access”!
The solution to this problem is in the voting booth. Ask every candidate if they will support a bill that would stop killing Aussies by “making it easy for every Australian GP to prescribe medical cannabis, every Australian pharmacist to stock it, and every suffering Australian to get it.” If not, vote for someone who will stop killing Aussies. This is the best way for you to “communicate your findings more effectively.”