AMA Transcript - AMA President, A/Prof Brian Owler, ABC News Radio, 17 September 2014

Subject: Clinical trials of medical use of cannabis for terminally ill patients

 COMPERE: Terminally ill patients are to be given access to marijuana under medical trials to be conducted in New South Wales. The State Government has approved the trials, with Premier Mike Baird announcing yesterday that a working party was being established to report back on the issue by the end of the year.

For a medical perspective on the New South Wales move, Marius Benson is speaking here to the AMA National President, Brian Owler.

MARIUS BENSON: Brian Owler, would the AMA welcome the move in New South Wales to have these clinical trials of the medical use of marijuana for terminally ill patients?

BRIAN OWLER: The AMA does welcome the announcements for further clinical trials. I think we have to be careful about the way that we approach medicinal use of cannabis. It probably requires a more national strategy, rather than just a state-by-state approach which seems to be happening at the moment. And while people are talking about the use for terminal illness, we know that there are other indications - multiple sclerosis and neuropathic pain, epilepsy - and all of these conditions are being talked about by various political leaders. I think we need a much more consistent approach across the country and some coordination of the approach about regulating marijuana or cannabis as a medicine rather than as a drug.

MARIUS BENSON: And how much is known about cannabis as a medicine? Is there enough, in fact, known to consider allowing it already, or are trials needed across the whole band of the proposed uses?

BRIAN OWLER: Well, there are some areas where we know that cannabinoids as a pharmaceutical preparation have already been approved, but there are other areas, such as epilepsy, where there are large clinical trials underway in the United States, for instance, that have been endorsed by the FDA, and so we probably need to wait for some of those trials to come through, and while I think proponents of the move to decriminalise marijuana point to various trials, I think, you know, the validity of some of those trials varies.

So I think we need to take some of the politics out of the debate at the moment. The way that we regulate medicines in this country for clinical indications is through the TGA, and I think we need to keep using those mechanisms, having experts look at the evidence that exists, whether there's a gap, conduct a clinical trial, use those existing mechanisms to regulate the availability of cannabis, not crude cannabis that can be grown at home, but the pharmaceutical preparations that are actually already available, and even looking at putting those on the PBS for particular indications.

MARIUS BENSON: Is the jury already in, to some extent, on this, that some uses are known so that it can be used already?

BRIAN OWLER: For multiple sclerosis, for instance, there is enough information that the TGA has already approved that, so we don't really need to conduct further clinical trials. I think we need to look at the way that the medicine is available and the sort of preparations that we use. I mean, the AMA doesn't support, for instance, people growing marijuana at home and using that for medicinal purposes. I think we need to regulate the availability.

We also don't want to be in a situation where we decriminalise possession for certain conditions and then we have to have people going and trying to either grow it themselves or go and find a local drug dealer so that they can actually access the product. So we need to use and look at this as a medicine and make sure that when people are using it, they're actually using the right preparation, so that we actually protect them from harm.

And I draw the parallel with morphine. Morphine is a controlled substance. We use it every day. Certainly in my clinical practice, we use it every day and we wouldn't dream of being without it. But we, of course, don't let it out on the street. We don't have people using it in an unregulated fashion, and I think we have to take some of the emotion out of this debate and look at marijuana or cannabis in exactly the same way.

MARIUS BENSON: Brian Owler, thank you very much.

BRIAN OWLER: My pleasure.

17 September 2014

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