The Royal Australasian College of Physicians says it is premature to form conclusions regarding medical cannabis and is concerned about risks associated with expanding access in the absence of standard regulatory requirements.
In an article published in the Medical Journal Of Australia, The RACP says it understands the increasing demand in the community for cannabis medicines, but says “effective medical leadership” is required to inform public discussion and compassionate access until the necessary research has arrived at solid conclusions.
“These processes include pharmaceutical, animal, pharmacological and clinical research, recommended under national medicines frameworks upheld by the Therapeutic Goods Administration (TGA) in Australia and the New Zealand Medicines and Medical Devices Safety Authority (Medsafe), as well as by legislation such as the Narcotic Drugs Act 1967 (Cwlth),” say the authors, who include Jennifer H Martin.
Professor Martin argued back in 2016 that there was no rush for medical cannabis to be brought into widespread use.
There certainly hasn’t been any rush in Australia, a situation that has angered suffering patients and advocates. While the demand is there, only around 500 Australians at this point in time have legal access.
Professor Martin is also leading the Australian Centre For Cannabinoid Clinical And Research Excellence, which received almost $2.5 million in funding last October.
In the article, parallels are drawn with opioids, stating treatment of persistent non-cancer pain with opioid medicine began with little supportive evidence – but some would argue that is an apples to oranges comparison given the differences between the two.
“… the RACP position is that a balanced, well defined, compassionate yet precautionary approach is necessary for legislation and clinical practice.”
The precautionary principle is a great thing – in principle. It advises in the absence of scientific consensus, those supporting an action in a situation where it may have even a suspected risk of causing harm must provide solid proof it won’t. But for Australian patients in ongoing pain or suffering other conditions for which they cannot find relief, such caution doesn’t provide any sort of comfort.
The authors warn medical professionals are bound professionally and legally to treat patients based on an impartial evidence assessment and the ethical commitment to first do no harm.
However, harm could be perceived as preventing a patient receiving a treatment offering (to date) a comparatively good safety profile that may help when all else has failed or where conventional medicines are inadequate or cause suffering – just so that due process can be observed in order to satisfy the non-suffering establishment.
The full article can be viewed here.