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Doctors should lead drug debate: experts

NZ Newswire logoNZ Newswire 21/12/2016
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Kiwi doctors need to be at the forefront of the debate around medicinal cannabis, two Wellington experts say.

Until now the push has been largely consumer driven while doctors have remained largely silent, according to Giles Newton-Howes and Sam McBride in an article published in the New Zealand Medical Journal.

Currently doctors are able to prescribe cannabis-based products to patients in New Zealand, but require ministerial sign-off to do so.

Dr Newton-Howes, who works at the University of Otago's psychological medicine department, says there are issues accepting cannabis as a medication for a variety of purposes.

"If they do not engage in this debate, the medical profession will risk having to respond to requests after the fact, as opposed to helping shape policy now," he says.

"All doctors should have an interest in this, from primary care physicians to sub-specialists in neurology, psychiatry and associated fields."

His joint article with Dr McBride, from the Capital and Coast District Health Board, makes a series of recommendations for medical practitioners, including that they steer clear of legal debate and that cannabinoid used in medicine be called medicinal cannabinoids rather than cannabis.

They also warn against medicinal cannabis being smoked.

"It is hard to justify a place for smoked medication, in light of the serious public health harms related to smoking and availability of other methods of delivery," their article says.

But both doctors remain wary about the success of medicinal cannabis in treating medical conditions.

Outside a limited range of conditions, including Parkinson's disease, Huntington's disease, Tourette sysndrome and epilepsy, there is "little current evidence to suggest that cannabis has any medical role".

"This created ethical and practical problems for physicians who may be asked for an intervention with little or no evidence over a treatment that is well evidenced," the pair argue.

Support for medicinal cannabis is growing in New Zealand.

Labour leader Andrew Little earlier this year confirmed his party would move to legalise the drug for medicinal purposes "pretty quickly" if they win government at next year's election.

The Green Party announced earlier this month that it too would back the move if they form the next government.

But the government is opposed to major changes to the current system, which requires associate health minister Peter Dunne to sign off on applications to prescribe cannabis-based products.

Mr Dunne, the United Future Party leader, asked officials to assess current guidelines in March this year and said feedback was "unanimously supportive" of the current system.

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