Excessive Regulation Keeps Illegal Cannabis Markets in the Black!

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Since 2012 many American states and Canada legalised use and sale of recreational Cannabis. An expected benefit of legalisation is establishment of a legal Cannabis market to eliminate the black-market. Even though legal options are available for Cannabis producers and consumers, the black-market is still thriving. The reasons behind the persistence of the Cannabis black-market are complex but one main argument is, legalised states have failed to establish a regulatory framework which effectively keeps producers and consumers in the legal market. Instead, strict regulations and the high cost of compliance have created an environment favourable to big players, driving small-scale businesses to the black-market. Published in July 2019 the study, Effects of Regulation Intensity on Marijuana* Black-Market After Legalisation (the Oregon study), found excessive US state regulations may be the reason illegal Cannabis markets continue to exist post-legalisation. The research looked at data from the first two US states to end Cannabis prohibition, Colorado and Washington.

“The qualitative analysis of news reports reveals that regulation is one of the main reasons that people stay in the illicit market. The comparison of marijuana* crime trends in Colorado and Washington shows mixed findings. While -offence rates in Colorado largely remained steady over the years, those in Washington increased dramatically after the implementation of more intensive regulations”.

Meanwhile, in ‘Cannabis-legal’ California, in July 2019, Riverside County Sheriff’s Department served search warrants on 56 illegal Cannabis cultivation sites. Spearheaded by 390 law enforcement personnel, whose mission was to combat the ongoing problem of illegal Cannabis cultivation sites throughout California, the raids resulted in:

  • 47,939 Cannabis plants confiscated
  • 2,132 pounds of processed Cannabis
  • 47 tons of Cannabis plants disposed
  • 2 Butane Honey Oil Labs located
  • 71 firearms
  • 49 arrests

Illegal cultivation is far from just a California problem, however. If Oregon halted Cannabis production today, the state would not experience a shortage; it has a six-year surplus! But, US states that legalised recreational Cannabis with the intent of re-imagining the vast underground market as an above-board business to bolster state economies via transparent dealings have been disappointed as, to date, the US Federal Government has refused to budge regarding Cannabis’ status as an illegal Schedule 1 substance. One of the tenets of legalising Cannabis is stemming the proliferation of black-market suppliers and reducing negative effects of the ‘war on drugs’, particularly on minorities. These positive impetuses have yet to flourish as a result of the illegal status of Cannabis at US federal level leaving Cannabis-legal states to operate as islands. Taking legally purchased Cannabis from a legal to an illegal state is not only illegal, but confusing and a recipe for complications, leaving Cannabis-legal states vulnerable in an environment extremely hospitable to black-market activity.

US states that legalised production have inadvertently made it easier for illegal producers to hide in plain sight where the line between legal and illegal operations blurs. Black-market growers in legal states destabilise the market as legitimate companies pay taxes and jump through every legal hoop and cannot compete. This creates frustrations for law enforcement and cuts into the legal trade. But putting the genie of legalised recreational Cannabis back in the bottle simply isn’t feasible for operational, financial and political reasons in North America. With the proliferation of attendant illegal operations it is however becoming clearer that some form of US federal legalisation is inevitable. In legal states, growers, sellers and consumers have legitimate channelsto produce, trade and obtain Cannabis, and as such, illegal avenues should diminish, yet research shows they havent disappeared. A 2018 report found 18% of Cannabis consumers in California purchased Cannabis products from an unlicensed seller.

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An association between how intense state Cannabis-related regulations are and the extent of the remaining illegal market has been investigated. In Washington (from June 2016) and in Colorado (from November 2015 and January 2017 [in 2017 Colorado lawmakers passed new rules regarding labelling and packaging of Cannabis flower and trim, concentrates and other products]), most people grew or sold illegally due to “strict regulations and the high cost associated with the compliance … ‘over-regulation’, ‘cost of compliance’, ‘high taxes’ … Other reasons for staying in the illegal market included market fluctuations and organised crime. Washington’s crime rate increased after the state introduced more regulations. “In 2014 and 2015, marijuana* crime rates/100,000 residents were around 26. This number increased to >28 incidents in 2016. In 2017, 2,628 -crimes were reported, making the annual crime rate 35.96/capita”. Colorado did not see any significant short/long-term changes to its Cannabis-related crime rates after they implemented new regulations. 

“Although the findings are not conclusive, the results of Washington data show regulation intensity may be one of the main factors that influences or explains the persistence of illegal Cannabis transactions after the legalisation”, and, “The fact that Washington’s black-market kept growing after the implementation of more complex and sophisticated regulations at least indicates a correlation between regulation intensity and the increase of the black-market …”, the Oregon study stated.

Similar findings were not reported in Colorado suggesting “the magnitude of illicit marijuana* activities may be affected by regulation intensity …”. These results raise questions about “possible adverse effect of intensive regulations to researchers and policy-makers”. If one of the goals of Cannabis legalisation is to eliminate the unregulated market, it’s important lawmakers consider the implications of unnecessarily strict rules and focus on creating an “equitable and accessible market that allows the coexistence of both large and small businesses. The cost of compliance to regulations should be reduced to remove the barriers of establishing a legal -business”, the study concluded, and, “future policies should also pay more attention to cracking down on persistent illegal growers/ sellers and organised crime groups unwilling to participate in the legal market”.  Thus, the question may no longer be, should the US legalise Cannabis federally, but, howA path forward needs to be found. Cobbling together a pastiche of laws inevitably bolsters black-market activity as quasi-legislation at state level provides neither a check nor balance. The most likely next step for US public health, stemming black-market activity and generating maximum revenues is comprehensive national legalisation, sooner rather than later.

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In Australia, Cannabis legislation remains incredibly complicated despite changes to the Narcotic Drugs Act in 2016, to purportedly allow Cannabis to be legally grown for medical and scientific purposes. The uptake of ‘medicinal Cannabis’ has been slow, with access incredibly difficult due to long waiting periods, high costs and uninformed doctors. Canada legalised Cannabis, 17 October 2018, with ‘medicinal Cannabis’ available since 2001. However, the Canadian Civil Liberties Association reported in 2018, “The way the Federal Government has decided to pursue legalisation of Cannabis is concerning. Many Canadians think … Cannabis will be legal – maybe not legal like buying milk or eggs – but something akin to alcohol, or tobacco. The belief is Cannabis will be a tightly regulated substance that people of a certain age are pretty much entrusted to use as they see fit. This is a mistake. There are a raft of new criminal offences … The fact you have a patchwork of provincial, territorial and municipal laws and by-laws that interact with the federal criminal prohibitions means something that’s perfectly legal at home may be a crime when you’re visiting your friend in another city”.

“As of 2016, the Australian Institute of Health and Welfare estimated that some 10.4% of the total population used Cannabis and that the tolerance for regular use had risen from 9.8% to 14.5% between 2013 and 2016. It is not completely unrealistic that the number of recreational users could double as a percentage of the population over the next decade, although this would be tempered by the fact that many users are likely to remain light or occasional users”, said Prohibition Partners Head of Insights, Alexandra Curley. In January 2018 the Australian Federal Government announced plans to become the fourth country in the world to legalise ‘medicinal Cannabis’ exports. Shares soared for the >20 Cannabis producers on the Australian Stock Exchange (ASX) and Cannabis Jobs Australia estimated by 2028 there would be 50,000 Cannabis jobs in Australia. The climate makes it the perfect place for growth with a potential for two crops a year in areas with high sunlight.

“Australia boasts an optimum climate for growing some strains of Cannabis that are expensive to produce in more established markets such as Canada. This, coupled with anticipated changes to the law, will create an environment that will enable the region to capitalise on strong growth within the industry. That’s going to make Australia a very attractive proposition to investors”, Alexandra Curley, Prohibition Partners.

The bill that would legalise Cannabis for personal use in the ACT could be passed next week.

However, growers are unable to use the outdoor environment according to Barry Lambert, chairman of Ecofibre, an industrial hemp company. “On the growing side, we can only grow it indoors … Compare that to where we (Ecofibre) grow in the US … outdoors under the Kentucky sun”, he said. According to Statistics Canada, close to 5.4 million Canadians will buy Cannabis over the next 12 months. The US is also a growing market for exporters where sales grew by 30% in 2016 to US$6.7 b, without it being legal nationwide. The US now makes up 90% of the Cannabis stock trade, which can only go up with federal legislation. But Mr Lambert said there was no market in those countries for Cannabis exporters. “Who are they going to export it to? America, you can buy it over the counter at a fraction of the price. Canada, it has been legal for some time to sell Cannabis and they are trying to export it”

HLB Mann Judd (Accounting and Financial firm) partner Marcus Ohm says there are a lot of uncertainties in the industry. “Australia is at an early stage in relation to the regulatory environment relative to other jurisdictions … countries vary on whether marijuana* is illegal, permitted for medicinal purposes or permitted for recreational and medicinal use. Australia has eased some aspects … but compared to the US (state level) and Canada (federal), Australia has narrower applications”Mr Lambert said, “I personally haven’t invested in any other company … and I see no reason why I would …”, further stating most of the companies on the stock exchange are not making money, but spending it. “Australian companies will find it very hard ever to make a dollar … There’s no revenue and they’re spending millions …”.

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President of the Australian Industrial Hemp Alliance, James Vosper, said, “There is a lot of investment in the industry but there have been some issues with people getting access to medicines so therefore the number of people being treated in Australia isn’t as high as it could be”Mr Lambert said legalising ‘medicinal Cannabis’ in Australia did absolutely nothing for promotion of the industry. There are two reasons. One … no demand for the product because the rules around getting the product are unworkable … no doctor understands it because they aren’t trained … until 2016 it had been illegal. Secondly, there’s been no research in this country because it’s been illegal. So, doctors don’t know about it, therefore they don’t prescribe it”Mr Lambert said the US system allowed for ‘medicinal Cannabis’ to be sold over the counter, a system Australia needed to adopt. Without that the industry was dead before it even began.

“We don’t believe that the prescription system works. And, therefore, those medical Cannabis companies are going to find it very hard or impossible to be successful and that their solution is adoption of the American system”, Barry Lambert, Ecofibre.

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Others remain more optimistic, with Mr Vosper saying the future looked bright. “I think Australia has a great future in this industry. The whole world is moving towards an organic model and Australia has half of the world’s organic farmland. Put that with a great reputation for products and you have a great future in the medicinal Cannabis industry”The Australian Capital Territory (ACT) government passed laws in September 2019 that essentially fully decriminalised Cannabis under certain and very specific conditions.  When the legislation comes into effect on 31 January, 2020, it will be legal, under ACT law, for adults in Canberra to grow, smoke and own small amounts of Cannabis (50 grams). But the Commonwealth has laws of its own in this area and those laws explicitly prohibit possessing any quantity of Cannabis (with the exception of ‘medicinal Cannabis’, a completely separate thing). Introduced by Labor backbencher Michael Pettersson in 2018, to legalise possession of 50 grams of Cannabis for adults, the ACT Government stated, 

“It is important to note that, even after the passage of this bill, possessing and growing Cannabis will carry a degree of risk arising from interactions between territory and Commonwealth law”. Mr Pettersson said, “In order to reduce harm and stigma, we need to make sure that people can feel free to come forward and get help. In order to do this, we need to remove the penalties and charges associated with the possession and use of small amounts of Cannabis …”.

Across the ditch (from Australia) in New Zealand, Cannabis is classified as an illegal ‘drug’ under the Misuse of Drugs Act 1975 and possession, use and supply are subject variously to penalties ranging from fines to many years imprisonment. The Helen Clark (former Prime Minister of New Zealand and member of the Global Commission on Drug Policy) Foundation, released a report setting out the case for legalising and regulating Cannabis. The prospect of invoking criminal sanctions has had little impact on people’s behaviour as longitudinal studies indicate by age 25, 80% of New Zealanders had tried Cannabis at least once. Simply, prohibition-based policy approaches have not eradicated and will not eradicate Cannabis consumption and supply in New Zealand or anywhere else where use is established. The New Zealand Referendum due in 2020 will be to legalise and regulate. Decriminalisation is not expected to be an option.Image result for new zealand cannabis

Helen Clark herself stated, “The time has come for New Zealand to face up to the widespread use and supply of Cannabis in the country and to legalise and regulate it accordingly. No useful purpose is served by maintaining its illegal status. A “yes” vote in the 2020 referendum will be positive for social justice and equity, contribute to reducing the country’s excessively large prison population and enable those health issues associated with Cannabis to be dealt with upfront. These are the reasons why I support legalisation”. However, in legalising and regulating in New Zealand, it will be important not to create another ‘big tobacco’ or ‘big alcohol’. Both industries fought and continue to fight efforts to reduce harm they cause, including regulation of access, product promotion and taxation aimed at disincentivising use.

503e589cab97b59cc53421127b6291af_400x400On the weighted score for harms of drugs in the United Kingdom developed by scientist David Nutt, former chair of the Advisory Council on the Misuse of Drugs and colleagues, published in the Lancet in 2010, Cannabis is assessed as immensely less harmful to those who use it and to others, than is alcohol. Various other rankings concur Cannabis use is significantly less problematic for individual health than either tobacco or alcohol. The classification of drugs  pursuant to international drug conventions, however, is based on more cultural and political factors than scientific evidence. Those classifications have scarred the lives of countless millions of people worldwide, caught up in the criminal net cast over what is deemed to be illegal ‘drug’ possession, use and supply. It is not surprising, therefore, a growing number of jurisdictions have been moving away from the prohibitionist approach promoted by the international conventions.

Countries and individual states/provinces/territories have legalised possession, use and supply of Cannabis. Other jurisdictions have decriminalised personal possession and use. President of New Zealand’s criminal lawyers’ society supports legalising Cannabis for personal use and says existing law criminalises too many people. Len Andersen, Criminal Bar Association President, said banning Cannabis created demand for more harmful drugs, including synthetic ‘cannabinoids​’, implicated in at least 70 deaths. Mr Andersen said prohibition put otherwise law-abiding people who chose to use Cannabis “in the position of constant illegality”. The Association said its membership comprised 700 practising criminal lawyers across New Zealand. “I think most members would support legalisation of Cannabis for personal use”, Andersen said. An amendment to New Zealand’s Misuse of Drugs Act directed police only to prosecute those using ‘drugs’ when there is ‘public interest’. The New Zealand Federal Government has been clear it wants to take a health and well-being-based approach. Drug law reform, including legalisation of Cannabis, helps meet both objectives.

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The ‘war on drugs’ has failed. In Australia, 35% have tried Cannabis, but this choice could earn a criminal record, just for having a small amount of Cannabis in your possession (or system). This ‘tough on drugs’ approach causes enormous harm, driving people away from getting help and exposing them to a dangerous black-market. From Uruguay to Spain, New Zealand to the US and Canada, countries around the world are realising prohibition causes more harm than it prevents. Cannabis use is a health issue, not a criminal one. Legalising Cannabis use would reduce harm, increase protection for vulnerable people and break the business model of criminal gangs. World-wide, the Cannabis ‘cake’ should be big enough for everybody; corporates, government/s, home-growers, not-for-profits and the most-oft-forgotten sick and suffering, to get a slice. It’s all in how you carve it up, and it could and should be, equitable. The world has seen enough of the double-standards, mass-hypocrisy and worst of all, ignorance of science fact, because it is not profitable. It is way past time to put people before profits and free Cannabis from the constraints of prohibitionistic regulations and the out-and-out lies that have besmirched this wonderfully efficacious herb for far too long! Save lives and legalise!

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Adapted from Heavy Regulations Allow Illegal Marijuana Sales to Persist, Study Argues with Effects of Regulation Intensity on Marijuana Black-Market After LegalizationStemming the Cannabis Black-MarketTHE BLUNT TRUTH, Cannabis prohibition doesn’t work anywhere. It’s New Zealand’s turn to legalise itLaws to legalise cannabis for personal use in the ACT could pass next weekCannabis laws bound for the courtroom to work out whether ACT or Commonwealth is rightLegalise weed, criminal lawyer group president says and Legalise It

*marijuana – Cannabis sativa is the correct botanical term for the plant, the term marijuana is a North American colloquialism, at best.

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Australian Legal ‘Medicinal Cannabis’, Overpriced and Difficult to Obtain

It is estimated that close to a million patients are now seeking access to ‘medicinal Cannabis’ in Australia. Australian government figures show around 20,000 patients now have approvals for access to legal ‘medicinal Cannabis’ products. The Medical Cannabis Users Association of Australia Inc. (MCUA) reports many patients are still having to turn to the ‘black’ market or are self supplying because, access to and cost of, the majority of legal ‘medicinal Cannabis’ products is way beyond their financial reach. This is happening in Queensland, for example, partly because public hospital policy does not permit its doctors to prescribe Cannabis-based products.

The MCUA states the rate of approvals has increased substantially with a mushrooming of corporate clinics set up to move products that had been languishing on warehouse shelves because General Practitioners (GP’s) were refusing to prescribe ‘medical Cannabis’. These clinics have the sole purpose of prescribing corporate ‘Cannabis’-based products and have become the gateway to moving these over-priced, often longitudinally untested pharmaceuticals off the shelves. It appears these clinics are given ‘special treatment’ in this highly regulated environment as the MCUA noted when CEO of ‘medical Cannabis’ company, THC, David Radford said on Sky News;

“… We are working with individual state governments to get their approvals (for clinics) … not the same as a health clinic that you go through so we are not expecting the same regulatory hurdles …”.

The current modus operandi of the clinics when communicating with ‘patients’ is an offering of either/or teleconferencing and face to face consultations with doctors who it is being alleged have no prior experience using or prescribing ‘Cannabis’-based medicine in a clinical situation and who also have had limited training via educational videos and ‘medical Cannabis’ company backup. Some patients have said to the MCUA that consultation processes have been amateur in approach. In some cases, no medical history of the patient was recorded and prospective patients weren’t even asked about current medications or allergies they might have. As to consultation fees the MCUA report these can vary enormously between clinics.

The majority of ‘medical Cannabis’ patients do not receive a Medicare rebate and on average, patients are charged fees by third parties of around $200 to apply to the Therapeutic Goods Administration (TGA) online (a process for which there is no fee attached if one registers directly). Other costs,  it is reported, vary from <$100 to >$1,000 for an initial consultation and an application for ‘medical Cannabis’. Due to the increasing number of complaints about these clinics the MCUA is conducting a patient satisfaction survey asking about patient experiences overall with the delivery model set up by the Australian Federal Government. Responses to their survey have been consistent throughout with +45% of patients saying they are paying up to $500-$1,000 a month for products.Image result for australian medical cannabis products

Most survey respondents are on Centrelink payments because of their illness and some have got themselves into debt with family or friends to enable them to purchase the medicine. Almost half of the prescriptions written have not been filled. Peter Crock, CEO of the Cann Group and Chairman of Medicinal Cannabis Industry Australia reinforces this scenario.  He said on ABC radio that, “All medicinal Cannabis is being imported … that is what is keeping prices high … and people are taking the opportunity to make super profits on the way through”. Many survey respondents say they have had more than one approval with 20% saying they have had more than five approvals. The dissatisfaction rate with the delivery system is consistently 86% .

Patient experiences gathered via the survey include the following;

  • One MCUA member reported being charged $700.00 in consultation fees and product for her fathers palliative medicine. The product was delivered in November 2019, a six week supply of Cannabis oil with an expiry date of October 2019. They were told the family GP would need to sign off on the prescription and treatment would not begin until the Clinic doctor saw the GP because the state owned aged-care facility could not give out-of-date medicine. The woman’s dying father was denied medicine to make his passing easier. 
  • Another wrote they were worried their Cannabis clinic was ‘taking them for a ride’. Their first prescribed medicine was bought as two 25 ml bottles to avoid an extra $50 for shipping. The first script cost $633.30, the next $330.30 due to the distributor lowering the cost. After three months the ‘patient’ had to pay the clinic to write a new script, which needed to be approved again by the TGA. When the clinic couldn’t get the same product they had to re-apply for TGA approval and supplied a different product altogether at a cost of $540.00 for two bottles (50 ml). The cost to use on a daily basis was initially (February 2019) an average of $15.20. When the price dropped it reduced the daily cost to $7.92 and now the ‘patient’ is paying $16.20 daily. 
  • One said she recently applied for the ‘legal version’, knowing full well it was beyond what she could afford after the initial appointment cost $200.00. Subsequent scripts, she was told, would cost $59.00. It would be $80.00 for a follow-up appointment and $59.00 whenever there was an adjustment to dose or product. Requiring two products, one at $660.00 a month and the other at $300.00 a month, needless to say, she could not afford to fill the scripts and believes this circumstance to be discriminatory against people on low incomes. 
  • And one, with Multiple Sclerosis (MS), Fibromyalgia, Rheumatoid Arthritis (RA), degenerative spinal conditions (previous high impact crush injury – L5/4/3), a dislocated neck (C4/3), Scheuermann’s Kyphosis Scoliosis, Complex Regional Pain Syndrome (CRPS), high blood pressure, diabetes, Sarcoidosis, Chronic Obstructive Pulmonary Disease (COPD), is going blind because of the MS. This 36 year old, on a Total and Permanent Disability (TPD) Pension, 18 months ago was looking at being an invalid, possibly under palliative care but that simply was not an option as they had children. They researched and made Full Extract Cannabis Oil (FECO). According to them it was the only reason they did not become wheelchair-bound and paralysed. For $350.00/ounce of black-market Cannabis they could make 250 ml of oil. They used 50 ml ($70.00 worth) a month. Image result for FECO cannabis productsBefore the illegal oil, they took 19 ‘pills’ every morning, 20 at night and another ten throughout the day. They no longer take opioids or other pain-killers except the Cannabis oil which healed the broken back and dislocated neck, when they were told they’d never walk again. They sought approval for legal supply through a prescription, because they go to hospital regularly due to lung and kidney issues, but the hospital won’t let them use their oil because it’s not ‘legal’. They now have a script for legal supply but the bottle of oil is waiting at the pharmacy as they cannot afford it. It’s a THC/CBD blend, 25 ml for $300.00. The doctor said that was the dose for one month. With no way to maintain that cost the ‘patient’ has no option but to continue to make their own oil and run the risk of being raided and prosecuted. Which they were; arrested and charged when caught by police for sending a bottle of home-made medicine to a fellow sufferer. 
  • Another paid $110.00 for two consultations, first with a nurse to see if they met the criteria and second with a doctor to go through the application. They were told they would hear back within a week. After four weeks, they emailed the clinic and got no response. They called the mobile numbers and found they were disconnected, so they wrote a bad review online and looked into reporting the clinic as a scam. The clinic contacted them and asked them to remove the review. In exchange the clinic said they would pay for half the prescription. The full cost was beyond the ‘patient’, so they agreed and drove 1½ hours (round trip) to collect it. The ‘patient’ very quickly worked their way to the maximum dose, without any noticeable impact and was not prepared to spend $385.00 every five days on something that did not work. They were told they would have ongoing follow up care from the team, that they were not going to have to go through the process alone, the entire team was behind them. They never heard from the clinic again. 
  • And yet another at a popular access clinic felt badly treated after commenting about the high cost of the consultations and product. The clinic pharmacist said if they couldn’t afford it to go back to their GP! The ‘patient’ complained to the practice manager and got nowhere. Left without any oil since June, the clinic didn’t care they were not coping, in extreme pain and couldn’t afford to keep paying for consultations, approval applications and the outrageous cost of the oil which they felt was very diluted and not effective at the low dose prescribed. They repeatedly told the clinic they couldn’t afford $450.00 every three weeks on a Disability Pension. They noted that the system is not working and nobody seems to want to help.

Image result for australian medical cannabis productsThis is a small sample. There are many such ‘horror’ stories and MCUA has witnessed firsthand how the system has failed the ill and suffering. There needs to be a review with public input and recommendations made to facilitate a quicker more affordable delivery system. MCUA President, Deb Lynch, is currently waiting for a trial date after being arrested and charged for self-supply following many attempts to acquire a prescription through Queensland (Qld) Health, whose doctors have been advised not to prescribe Cannabis under public hospital policy. Being on a disability pension, there is no way she can afford the costs involved in getting a script from one of these corporate Cannabis clinics.

The MCUA is still seeking patients who have been through the legal process to fill in their Medical Cannabis Access – Patient Satisfaction Survey (2019) which will be forwarded to the Federal Senate, via the Australian Labor Party (ALP) Senator Anne Urquhart, along with their current petition asking for a full review of the delivery system put in place by the Liberal/National Party (LNP). Cannabis is a herbal remedy and trying to squeeze it into the pharmaceutical delivery model will mean that the hold-ups will continue and prices will remain high as companies who have spent millions to get into the market are not turning a profit. The MCUA is asking anyone with an opinion to comment on their petition asking for this review.

The MCUA is contactable via their website.

Image result for australian medical cannabis productsAdapted from Australian Medical Marijuana Patients Find It Difficult To Get and Medical Cannabis Rip Offs result in patients charged with self supply

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Mobile Drug-Testing Devices Doubtful Accuracy and An Australian Cannabis Enquiry Needed

In Australia, thousands are prosecuted every year for Cannabis use while driving. Research at the University of Sydney Lambert Initiative for Cannabinoid Therapeutics suggests the devices currently used return both false positives and negatives. This new research calls into question the reliability of the two devices used for mobile ‘drug’ testing (MDT) in New South Wales (NSW) and other Australian states. These devices were used in the prosecution of almost 10,000 Cannabis users for ‘drug driving’ in NSW in 2016 (the last year for which data are available).

Professor Iain McGregor is the Academic Director of the Lambert Initiative.

Professor Iain McGregor, Academic Director of the Lambert Initiative

The study, published in the journal Drug Testing and Analysis, found that the devices frequently failed to detect high concentrations of tetrahydro-cannabinol (THC). False negative rates were 9% and 16% for the two devices but they also sometimes gave a positive result when saliva THC concentrations were very low or negligible (false positive rate of 5% and 10%). “Detecting impairment due to Cannabis use is an important goal in promoting road safety but using saliva tests to do this appears fraught with issues”, said Professor Iain McGregor, Academic Director of the Lambert Initiative for Cannabinoid Therapeutics and senior author of the study.

The study, led by PhD student Thomas Arkell, was part of a larger study  looking at the effects of vaporised Cannabis on drivingIn the same way breathalysers can detect whether a driver has a blood alcohol concentration of more than 0.05%, these devices are meant to detect whether a driver has more than a certain defined amount of THC in saliva. If so, the test should come back positive. Study participants were occasional Cannabis users who consumed two different types of Cannabis or placebo Cannabis on three separate test days.

Participants had saliva tested at baseline and regular intervals after Cannabis consumption using the Securetec DrugWipe and the Draeger DrugTest 5000 – the same types of devices in use around Australia for MDT. The study tested 14 participants on two devices where the participants had vaporised placebo Cannabis, THC-dominant Cannabis, or Cannabis containing equivalent concentrations of THC and cannabidiol (CBD). In all, there were more than 300 separate tests taken. Participants were also tested for driving performance on a state-of-the-art driving simulator. rdt3

As well as using the two MDT test devices, the researchers collected separate saliva samples in order to measure exactly how much THC was in each participant’s saliva at the time of each test. This ‘confirmatory’ test used a highly accurate laboratory mass spectrometer. “What we found was that these test results often came back positive when they should have been negative, or conversely that they came back negative when they should have actually been positive”, Mr Arkell said. 

The study also found measures of accuracy, specificity and sensitivity of the two devices fell below levels recommended by EU authorities. The rationale for mobile drug testing is based on the success of the RBT program pioneered in Australia. But while there is a very clear link between alcohol intake, blood alcohol content measured in a breathalyser and intoxication, THC levels in saliva do not reliably reflect Cannabis intake or ‘intoxication’.

“We should instead be focusing on developing novel methods for detecting drivers who are actually impaired by Cannabis. The two devices used by police in MDT were never designed to measure impairment. Authorities in other jurisdictions, such as Canada, remain far more cautious in their use of such devices”Professor McGregor said. Professor McGregor also said that when people use THC capsules or suppositories, neither of which leave traces of THC in the oral cavity, users have zero THC in their saliva, but can be heavily ‘intoxicated’.rdt2

Additionally, people tested in this study would often feel too impaired to drive two hours after vaporising Cannabis but would give a negative saliva test with the two devices. Conversely other people in the study presented with negligible levels of THC in their saliva and no driving impairment, but tested positive with the MDT devices at the detection thresholds used in the study.  There is also the issue of passive smoking, Professor McGregor said that at least two overseas studies had shown people passively exposed to the Cannabis smoke of others can exhibit salivary levels of THC that would generate a positive test result.

The number of mobile ‘drug’ tests being conducted each year continues to rise, with NSW Police planning to conduct 200,000 of these tests in 2020. Study lead Mr Arkell said; “Given that these tests can cost at least $40 each, and potentially lead to serious life-changing penalties for drivers, it is imperative that these concerns around reliability and accuracy are addressed”. 

Michael Balderstone, President, Australian HEMP Party and Nimbin HEMP Embassy, noted in the September 2019 Nimbin Good Times “There’s a more reliable occupancy rate in jails than hotels and the new Serco prison near Grafton, on track to open next year and employ 600 people, is sure to be a safe investment for Macquarie Bank and the others up to their neck in this sordid business … they created Cannabis cautioning to stop young people getting criminal records and lessen minor pot charges filling the courts”. 

“That enabled the likes of Scomo to argue, ‘We’ve dealt with Cannabis, unless you’re a wicked drug dealer, you just get a caution, a slap on the wrist’. And now it’s a new level of political cunning we’re hearing regularly. ‘We’ve dealt with medical Cannabis, it’s legal now’. Omitting to tell us you have to be almost dead to access the legal mediweed and it’s incredibly ridiculously expensive. And all imported! And you’re not allowed to drive if you use it”.MardiGrass2015

“99% of Australian Cannabis users are unaffected by the medical Cannabis legislation, but politicians act like they’ve dealt with the issue. Reviewing the Cannabis laws has been totally swept aside by the medical debate and barely one percent of users are even helped by the changes, Meanwhile ice is on a rampage. They just don’t get it, and why would they? It’s like having teetotallers in charge of alcohol regulations”. 

Michael Balderstone further told the Nimbin Good Times, why we need a Cannabis enquiry; “The Sex, now Reason, Party … came to visit and pick our brains about the Victorian government’s ‘Inquiry into the Use of Cannabis in Victoria’. Fiona (Patten) is the chair of the Legal and Social Issues Committee. The actual  wording of the Terms of Reference reads … 

On 30th May 2019, the Legislative Council agreed to the following motion: That this house, requires the Legal and Social Issues Committee to inquire into, consider and report, by no later than 2 March 2020, into the best means to:
• prevent young people and children from accessing and using Cannabis in Victoria;
• protect public health and public safety in relation to the use of Cannabis in Victoria;
• implement health education campaigns and programs to ensure children and young people are aware of the dangers of drug use, in particular, Cannabis use;
• prevent criminal activity relating to the illegal Cannabis trade in Victoria;
• assess the health, mental health, and social impacts of Cannabis use on people who use Cannabis, their families and carers;
• and further requires the Committee to assess models from international  jurisdictions that have been successful in achieving these outcomes and consider how they may be adapted for Victoria”.

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“We mostly talked about models for the future, something we’ve been dreaming about in Nimbin for decades. These are my suggestions … First up let’s acknowledge prohibiting Cannabis causes more trouble than it prevents. Pretty much everyone agrees on that, it’s just what do we do next. Or, how do we get out of the mess? So first step, stop hunting pot users and if you must, treat it as a health issue”.

“Police have better things to do and it will start reversing Aussie ‘drug’ trends which are very much about not getting busted so don’t use weed, it stinks and its bulky and you have to smoke it … the easiest bust by far. Pills and powders are a cinch to hide in comparison. Then, critically, I would legalise home growing. We can argue forever about how many plants, but it’s significant California and Colorado both allow six plants. More would be great so try for ten … ”.

“Then comes the most difficult bit of regulations, supply. I’m all for the Hemployment model. There’s 100,000 jobs out there waiting to happen and there’s also plenty of Centrelink recipients that can do a complete turnaround and become taxpayers. Fuck giving the few grow and supply licences to the same old, rich, few. In Canada … seven of the 10 licensed producers are partners with global pharma giants”.cropped-medical-weed.jpg

“I’d put a ceiling on … supply licences so Big Pharma and the like are out of the picture and … let’s licence quantity. So every pound you sell is taxed as well as checked for mould and contaminants. A licence to sell a maximum of 100 lbs say at current prices, will give Aussie expertise which has been accumulating for fifty years now a chance to partake. A Dispensary licence is another matter but let’s get it out of the chemist and into the hands of people who know the subject”.

Watching North America try countless regulatory models over more than 20 years now, we have a unique opportunity to learn from their mistakes. California has had legal medical pot since 1996 and it’s just no big deal on the entire west coast of America now. Two years ago I watched suited businessmen queue with long haired hippies to buy joints or deals at any amount of dispensaries. It was so simple and so obviously no big deal for anyone”.

“Driving also can be no big deal. Most people are safer drivers with their usual ‘drugs’ inside them. Millions taking pharmaceuticals every morning first thing; pilots use speed to make sure they stay awake. Regular Cannabis users as well as heroin or methadone users are the same as pharma users. They’re all going to be safer with their usual medications on board. Road safety has to be about impairment, and police can easily and quickly tell if someone is impaired”.

r1312451_18074843“While they’re doing the breathalyser test they can get an idea of someone’s state of mind and if they want to look further then asking a driver a few questions or to hop out of the car and walk in a straight line will take less time than  waiting for the saliva stick to show up or not. ‘Drug’ test people then if you think they’re impaired and save fifty bucks on every little blue licky stick also. We can’t have machines doing everything for us, or we’ll turn into idiots”.

Background – Use of roadside saliva tests in Canada for impairment in question

 

Lies Used To Justify Restrictive Cannabis Policies

‘Drug’ policy, like any other public policy, should be informed by science, not by political agenda or financial gain. When shown to be factually wrong, ineffective and/or counter-productive, it should be reexamined and changed. This has not been the case with the Cannabis plant. Sadly, there is a great deal of unscientific propaganda still floating around. This is nothing new, stretching at least back to Pope Innocent’s witch hunts in the 15th century. And still, much of modern scientifically inaccurate, wrong and just plain false neo-prohibitionist propaganda is propagated by those with a vested interest in generating unwarranted fears about Cannabis. The list of those with a horse in the race (e.g., whose bottom line is helped by spreading misinformation), whose job and/or profit benefits from ignoring the medicinal benefits of Cannabis is long. It includes but is not limited to so-called addictionologists, prison guards, narcotics officers, police and sheriffs (in the United States), owners and builders of private prisons and elected officials.

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The therapeutic index (the larger the TI, the safer) of Cannabis is estimated to be somewhere between 4,000:1 to 40,000:1. We don’t really know what it is because no one has ever died from an overdose of natural Cannabis. This is because there are few or no CB1 receptors in the brain stem so there is NO respiratory depression from cannabinoids. Respiratory depression can be caused by many psychoactive drugs such as benzodiazepines, alcohol, anti-depressants and opiates. By comparison, lithium, a commonly used treatment for bipolar disorder, is 1:2. As most people who have tried Cannabis (estimated to be more than one-hundred million US citizens) know, the effects can often be quite pleasant and the side effects, such as they are, are mild and less often seen in people with serious medical conditions. Like all therapeutic agents, Cannabis has acute side effects for some, which may include anxiety, paranoia, dysphoria and cognitive impairment. These side effects appear to be dose related and tend to occur in naïve users. Because of all of this, in 1988 US Judge Francis Young, DEA’s Chief Administrative Law Judge, after a two-year rescheduling hearing, recommended rescheduling Cannabis to Schedule II, adding, “Cannabis was one of the safest therapeutic agents known to man”. Obviously, that still hasn’t happened.Image result for US federal government’s IND program cannabis

Chronic Effects

We can thank the US federal government’s Independent New Drug (IND) program, instituted in 1978, for teaching us there are no troubling chronic effects from regular long-term use of Cannabis. A 2004 study by Dr Ethan Russo and Mary Lynn Mathre, RN, performed a battery of tests and physical exams on several long time IND patients who had been using government-supplied Cannabis for over 25 years. They found these long-time medicinal Cannabis patients to have had no adverse health effects from decades-long respiratory consumption of 7.5-9 lbs (3.4-4+kg) of Cannabis per year. We have plenty of data to demonstrate the safety of Cannabis. Not only the government’s IND program but also epidemiology studies demonstrate there are no proven long­-term adverse effects of Cannabis use.

Addiction to Cannabis? NO

Propagandists will say Cannabis can be addictive. Cannabis addiction does not exist because it is a misuse of the word “addiction”. There is a dependency risk to Cannabis, however, and that dependency risk is one shared with other medications and/or recreational substances. As substance abuse experts Drs Hennigfield and Benowitz pointed out years ago, the dependency risk of Cannabis is less than coffee. The 1972 report of the Nixon Marijuana Commission also debunked the idea that Cannabis is addictive.Image result for addiction to cannabis less than coffee

Cognition/IQ – No Effect

Another common fear is the possibility Cannabis use is linked to adverse cognitive effects. Studies that purport to show these effects are poorly done. A prime example is they do not control for important variables such as use of drugs, traumatic brain injury, PTSD, other medical conditions, growing up in a dysfunctional family, and/or environmental factors. One study cited to support the bogus claim found a reduction in IQ of 8 points in long-time users. This has not been replicated. Several studies including a twin study done by University of California, Los Angeles (UCLA) and University of Minnesota showed this adverse IQ was not true. In fact, Cannabis has helped many with ADD and ADHD pay better attention and raise their academic scores from C’s and D’s to A’s and B’s. One of the most egregious allegations is that Cannabis can change brain structure. Those trying to make the case point to effects in the hippocampus, amygdala and prefrontal cortex. Of course, there are effects on this part of the brain, because it is where many CBl receptors are located. This is why Cannabis has such beneficial effects on treating anxiety, depression and impulse control.

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Psychosis

Another canard (unfounded rumour or story) is that regular use is linked to an increased risk of psychotic symptoms. This too is untrue. If it were true, epidemiology would show an increased incidence of psychotic behaviour in the 1970’s or 1980’s because of the pervasive use of Cannabis. There has been no such increase. Over the past 60 years the incidence of psychosis has stayed flat or slightly declined. Instead, Cannabis has been shown to be beneficial in the treatment of bipolar disorder and schizophrenia.

Educational Attainment

Then there are those who insist Cannabis is linked to lower educational attainment. This too is untrue. The work of Dr Melanie Dreher with children exposed to Cannabis in utero and in breast milk demonstrated that these children did better in school and reached their developmental landmarks sooner than those children whose mothers did not use cannabis in pregnancy.


 

David Bearman, M.D. is one of the most clinically knowledgeable physicians in the US in the field of medicinal Cannabis. He has spent 40 years working in substance and drug abuse treatment and prevention programs. Dr Bearman was a pioneer in the free and community clinic movement. His career includes public health, administrative medicine, provision of primary care, pain management and Cannabinology.

Adapted from Illegally Healed

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Decriminalisation versus Legalisation, of Cannabis

 

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Decriminalisation refers to a reduction of legal penalties imposed for personal Cannabis use, either by changing them to civil penalties such as fines, or by diverting Cannabis users away from a criminal conviction and into education or treatment options (known as ‘diversion’). Cannabis possession for personal use and use itself would still be legally prohibited, but violations of those prohibitions would be deemed to be exclusively administrative violations, removed completely from the criminal realm. Decriminalisation largely applies to use and possession offences, not to sale or supply. The idea is to provide users with a more humane and sensible response to their use. Decriminalisation has the potential to reduce the burden on police and the criminal justice system. Essentially, under decriminalisation, law enforcement is instructed to ‘look the other way’ when it comes to possession of small amounts of Cannabis for personal use only. Under decriminalisation, both production and sale of Cannabis remains unregulated by the State. Decriminalisation does not address the black market nor criminal networks and relies on the ‘discretion’ of law enforcement. 

Image result for cannabis decriminalisationAs an example in Jamaica, according to The Economist:

“Decriminalisation is only half the answer. As long as supplying ‘drugs’ remains illegal, the business will remain a criminal monopoly. Jamaica’s gangsters will continue to enjoy total control over the ganja market. They will go on corrupting police, murdering their rivals and pushing their products to children. People who buy cocaine in Portugal face no criminal consequences, but their euros still end up paying the wages of the thugs who saw off heads in Latin America. For the producer countries, going easy on ‘drug’-users while insisting that the product remain illegal is the worst of all worlds”.

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Legalisation, on the other hand, is the lifting or abolishing of laws banning possession  and personal use of Cannabis. Legalisation would eliminate, or significantly reduce, the illegal black market and criminal networks as criminals do not profit in a legal market.  Legalisation allows government to regulate and tax Cannabis use and sales, accruing taxation revenue as they currently do from gambling, alcohol and tobacco. Moving the issue away from police and the criminal justice system and concentrating responses within health would save big taxpayer dollars and remove the negative consequences (including stigma) associated with criminal convictions for Cannabis use. Finally, use figures post legalisation in most jurisdictions show either no change or a drop in use numbers, along with a reduction in crime and overdose deaths from all other drugs.

Currently legal drugs, such as alcohol and tobacco, are widely consumed and associated with an extensive economic burden to society – including hospital admissions, alcoholism treatment programs and public nuisance.

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We should all be concerned about laws on substances deemed drugs (as Cannabis, for example, is a herb) because they affect all of us: people who use; who have family members using; health professionals seeing people for related problems; ambulance and police officers; and all who pay high insurance premiums because drug-related crime is extensive. Drug-related offences also take up the lion’s share of the work of police, courts and prisons. The moral argument against legalisation suggests the use of illegal drugs is somehow amoral, anti-social and otherwise unacceptable in today’s society. The concern is legalisation would ‘send the wrong message’. The moral argument also applies to decriminalisation, as lesser penalties may suggest society approves of drug use. Many countries, including Australia, have decriminalised Cannabis use to some degree: measures include providing diversion programs (all Australian states and territories) and moving from criminal penalties to civil penalties (such as fines in South Australia, Australian Capital Territory and the Northern Territory). 

Portugal2018

Research on Portugal suggests previously illegal drug use rates didn’t rise under decriminalisation, with measurable savings to the criminal justice system. The Portuguese government had been waging the ‘war on drugs since the 1980’s, but it wasn’t working (and hasn’t worked anywhere). Around 1% of the population was addicted to heroin in 1999 with the highest number of drug-related AIDS deaths in the European Union. In 2001 they took the unprecedented step of decriminalising all illicit substances deemed as ‘drugs’, from Cannabis to crystal methamphetamine to heroin. The Portuguese drug policy has been lauded by ultra-conservative and quasi-judicial, International Narcotics Control Board (INCB), which deemed it exemplary in December 2015. A decreasing trend in the total number of notifications of human immuno-deficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cases has continued to be registered since the early 2000’s. In 2016, a total of 1,030 new HIV-positive individuals and 261 new AIDS cases were reported for all risk groups; 14.3% of drug users who had ever injected and tested at outpatient treatment services were HIV positive, indicating an overall downward trend since 2013; and, Portugal’s drug-induced death rate sat at three per million residents, five times lower than the European average.

CannabisUsePortugal2017

A person caught using or possessing a small quantity of drugs in Portugal for personal use (by law, should not exceed quantity required or average individual consumption over a period of 10 days), where there is no suspicion of involvement in trafficking, will be evaluated by a local Commission for the Dissuasion of Drug Addiction (CDT), composed of a lawyer, a doctor and a social worker. Punitive sanctions can be applied, but the objective is to explore the need for treatment and to promote healthy recovery. Trafficking may incur a sentence of 1-5 or 4-12 years’ imprisonment, depending on specific criteria, such as the nature of the substance supplied. The penalty is reduced for users who sell to finance their own consumption. Decriminalisation seems to have taken some pressure off the Portuguese criminal justice system. In 2000, approximately 14,000 people were arrested for drug-related crimes. This number dropped to an average of 5,000-5,500 people per year after decriminalisation. However, the number of people the police have cited for administrative drug use offences has also remained constant at about 6,000 per year. 

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Uruguay legalised Cannabis use in December 2013 under President Jose Mujica, known for donating 90% of his wages to the needy. The goal was to stamp out the black market, controlled mainly by Paraguayan smugglers, without encouraging consumption. Other considerations were to assist health problems, battle ‘drug’ related crime by controlling growing, importing and distribution of Cannabis and lowering the profit organised crime rings would gain by trafficking etc. Three separate surveys were conducted early 2014, late 2015 and mid‐2017 with national representative samples of adults. 60.7% of respondents in 2014 were against legalisation; in 2017, 54.1% remained opposed. In 2015, half those interviewed (49.9%) supported access through self‐cultivation, while 38.6% favoured Cannabis clubs and 33.1% agreed with retail sales in pharmacies. Support for medical Cannabis was high in 2015, with 74.5% favouring it. The surveys evidenced a change in public opinion toward legalisation. 

Registered Uruguayan citizens (not visitors) are able to get Cannabis in one of three ways: grow up to six plants at home; join a club (45 members can cultivate up to 99 plants); or buy in pharmacies. Consumers are restricted to 40 grams (1.4 ounces) a month. About 10% of adult Uruguayans smoke at least once a year and more than 6,600 people initially registered to grow at home, with 51 clubs opened. Cannabis Clubs can grow a wide variety of plants, more than pharmacies are allowed to sell, with no limits on THC. “It’s the equivalent of comparing a bottle of wine with a box of wine” says Marco Algorta, grower at the 420 Cannabis Club in Montevideo. His worry is 99 plants are not enough to supply members with their full entitlement and he wants permission to grow more. 

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Even then, clubs and home growers will only cater to a niche market and pharmacies’ business will build, slowly (it’s only been five years since legalisation, this coming December). Thirty pharmacies initially signed up to cover much of the country, but their corporate suppliers are allowed to grow only four tonnes a year, 15% of what Uruguayans smoke. In June 2017, Uruguay’s envoy to Ottawa, Canada, Ambassador Martin Vidal, said his country’s goal had not been to change the minds of other countries about Cannabis, but to get them to accept that there are other ways to approach ‘drug’ control. “Some other countries have joined us in this discussion and others in the future, maybe Canada will be one of them, will find it’s not that the path is already clear, but we have facilitated a lot because we worked very hard in the last years to introduce this perspective” said Vidal, whose country is home to about 3.4 million people, about one-tenth Canada’s population.

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There hasn’t been a rise in Cannabis use rates in Australia, despite states and territories introducing civil penalties for users. Research has noted a negative side effect to the way in which decriminalisation operates in Australia; ‘net widening’, whereby more people are swept into the criminal justice system than would have been otherwise under full prohibition because discretion by police is less likely and/or they do not meet their obligations. Despite the largely supportive evidence base, politicians appear reluctant to proceed along the decriminalisation path, let alone legalisation, due somewhat to vested interests (mostly pharmaceutical interests). But public opinion is largely in support of decriminalisation and even legalisation where it concerns Cannabis. In a national survey in 2015, more than nine out of 10 Australians (91%) believed the use of Cannabis for medicinal purposes should be made legal, according to a special survey conducted 20-22 October. Only 7% were against legalisation and 2% couldn’t say.

“Prohibition has failed. As a drug and alcohol doctor, I’ve seen that the ‘tough on drugs’ approach causes enormous harm. It drives people away from getting help when they need it and exposes them to a dangerous black market”, Richard Di Natale

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In April 2018, Richard Di Natale, Leader of The Australian Greens said: “The Greens see ‘drug’ use as a health issue, not a criminal issue. Our plan to create a legal market for Cannabis production and sale will reduce the risks, bust the business model of criminal dealers and syndicates and protect young people from unfair criminal prosecutions”. He said in a poll in 2017, 55% of Australians believed Cannabis should be taxed and regulated like alcohol and tobacco. The plan would be expected to raise “hundreds of millions” of dollars for the budget. In May 2018, Senator David Leyonhjelm, Liberal Democrat from New South Wales, put forward a private member’s bill, ‘Criminal Code and Other Legislation Amendment (Removing Commonwealth Restrictions on Cannabis) Bill 2018’, which would amend five Acts and the Criminal Code Regulations 2002 to remove barriers in Commonwealth legislation to the legalisation and regulation of Cannabis for recreational, medicinal, industrial and other purposes.

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“Adults should be free to make their own choices, as long as they do not harm others”, he told Parliament House in Canberra. The NSW minor-party Senator has been a long-time supporter of recreational Cannabis as a libertarian who champions free speech, lower taxes and unwinding gun control. Senator Leyonhjelm previously supported the Greens’ plan to make the herb legal in the face of bans in every state and territory. In March, a Victorian parliamentary Inquiry Into Drug Law Reform called for recreational use to be legalised, after MP’s visited Colorado and California, where it is legal to use Cannabis, recreationally. They argued a sales tax could be levied on Cannabis if it was legalised and explored how Cannabis could be regulated with child-proof packaging, only available for sale to adults. 

reefermadnessOpponents of legalisation are concerned it will increase use, increase crime, increase risk of car accidents and reduce public health, including mental health. None of which has happened in any jurisdiction under legalisation (in fact mostly the opposite has been shown to be true). The current incarnation of the Australian Federal Health Minister, the misogynistic Greg Hunt, actually said in April 2018, “marijuana is a gateway drug”. Hunt graduated in Law from Melbourne University and won a full scholarship for his Masters in International Relations via Yale University. Great qualifications for a health portfolio; a lawyer who spruiks ‘reefer madness’ rubbish, as the ‘gateway drug’ hypothesis was well and truly discounted decades ago. The majority of people who use Cannabis do not go on to use other drugs. In addition, alcohol, tobacco and pharmaceuticals usually precede Cannabis use, which if the theory were correct would make those drugs the ‘gateway’. There is also no evidence legalisation increases use

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Australia’s official drug strategy is purportedly based on a platform of harm minimisation, including supply reduction, demand reduction (prevention and treatment) and harm reduction. Arguably, policies should therefore have a net reduction in harm.  But some of the major harms from using illicit drugs are precisely because they are illegal. A significant harm is having a criminal record for possessing drugs for personal use. This can negatively impact a person’s future, including careers and travel. A large proportion of the work of the justice system (police, courts and prisons) is spent on drug-related offences. Yet, as Mick Palmer, former AFP Commissioner, noted “drug law enforcement has had little impact on the Australian drug market”. Decriminalisation may reduce the burden on the justice system, but not as much as full legalisation because police and court resources would still be used for cautioning, issuing fines, or diversion to education or treatment. 

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Legalising for recreational use would boost the budget by up to $1.8 billion a year, the Parliamentary Budget Office revealed. The independent costing of the policy submitted by the Greens shows a tobacco-style 25% per cent excise on each sale with a 10% Goods and Services Tax and a reduction in law enforcement would net $3.5 billion by 2020-21. Tourists travelling to Australia would add up to “10% of total sales”, earning $130 million in revenue by 2020. The boost would be used to fund drug education and treatment programs. The PBO said the policy would allow the Australian Federal Police to “re-allocate a proportion of the resources currently directed at Cannabis to strengthen the law enforcement of other illicit substances”, such as ice, methamphetamines and heroin.  There would also be minimal costs for the Australian Taxation Office and the Department of Home Affairs to administer the taxes, the PBO found, as that could be done through established systems and processes. 

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Many see Cannabis prohibition as an infringement on civil rights, citing the limited to non-existent harms associated with Cannabis use. This includes the exceptionally low rate of so-called ‘dependence’ (it can certainly be habit-forming) and impossibility of overdosing on Cannabis, as well as incredibly low to non-existent risk of harms to people using, or others. Many activities that are legal are potentially harmful: driving a car, drinking alcohol, bungee jumping. Rather than making them illegal, there are guidelines, laws and education to make them safer that creates a balance between civil liberties and safety. Legalisation of Cannabis is relatively recent in most jurisdictions so longer-term benefits of legalisation are not yet known. But one study found little effect of legalisation on ‘drug’ use or other outcomes and other studies have shown no increase in use, even among teens

Related imageIn Australia there is a lack of clarity about the issues with poor understanding of the different models of decriminalisation and some basic confusion existing between what decriminalisation and legalisation actually constitute. Many people equate decriminalisation with legalisation, but as detailed, they are very different in policy, intent, action and outcome. Decriminalisation is also sometimes incorrectly confused with harm reduction services, such as safe injecting centres. In order for the debate to progress, we need clarity of terms and dispassionate presentation of what evidence we have, not more ‘reefer madness’ from unqualified and ignorant, in their lack of education regarding actual Cannabis, elected officials, politicians, senior so-called ‘medical professionals’ and self-serving academics. Three words leap to mind, ‘Cranial Rectal Inversion’.
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Adapted from Decriminalisation or legalisation: injecting evidence in the drug law reform debate with Portugal’s Experience of Drug DecriminalisationThe status of support for cannabis regulation in Uruguay 4 years after reform: Evidence from public opinion surveysUruguayan pharmacies will start selling cannabisGreens want cannabis to be made legalDrug War Facts – Region – PortugalCriminal Offences in Portugal 2012, by Type of ‘Drug’Drug harms in Portugal 2018, Uruguay sets path for Canada on marijuana legalization within international treatiesLegal highs: arguments for and against legalising cannabis in Australia$3.5 billion budget boost from legalising marijuana, costing shows and Australia: Senator introduces bill to allow the use of recreational cannabis 

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Is the Government Removing ‘Medical Cannabis’ Competition?

This man was arrested for giving patients Cannabis medicine for free. Despite purported legalisation, it remains extremely difficult to access ‘medical Cannabis’ in Australia. 

Prominent Cannabis Grower Tony Bower Is Arrested For Gifting Cannabis Oil To Patients
Tony Bower – If You Can, Please Support His Legal Fund

Mullaways-Medical-Cannabis

On 28th March 2018, police arrested prolific Australian Cannabis grower and founder of Mullaways Medical Cannabis (company registered 21 October, 2008), Tony Bower. His company develops Cannabis-based medicines to treat a variety of illnesses and conditions, including chronic pain, epilepsy (particularly intractable paediatric forms), cancer/s and the likes of multiple sclerosis. As a result of his arrest, over 150 individuals who rely on his Cannabis-based treatments will need to look elsewhere, at least in the short term. Tony’s wife, Julie, said the couple had only a relatively small amount of Cannabis oil left in stock at the time of Tony’s arrest. 

“A 62-year-old Crescent Head man remains in custody following his latest appearance in court on three drug-related charges. Police executed a raid on a property near Kempsey. Anthony Bower was charged by police from the Mid North Coast Police District after they executed a search warrant with assistance of the Dog Unit. Police facts allege they located a large amount of cash, Cannabis leaf and 280 plants. Bower was arrested and charged with cultivating prohibited plant, deal in proceeds of crime, possess prohibited drug and supply prohibited drug. He was refused bail and remains in custody. His next court appearance is on 20 June”.

Tony waits in the Mid North Coast Correctional Centre for a June bail hearing after bail was refused in Local Court as he was deemed a high risk of ‘re-offending’. Anyone who knows, or has heard of, Tony, ‘Mullaway’, knows he is anything but criminal. To even suggest such seems, in effect, criminal, as laws based on lies are ‘pretend laws’ after all! However, the authorities have been trying to stop him and his important, life-saving work for years. Tony’s first time in court for growing and supplying Cannabis was in 1998, charged for cultivation. In 2013, he was charged with possession. Sentenced to one year’s incarceration, he appealed and was released after only six weeks. The following year, caught with more Cannabis plants, he was charged once again.

“A pretend law, made in excess of power, is not and never has been a law at all. Anyone in the country is entitled to disregard it”, Chief Justice Sir John Latham, 1942, South Australia v Commonwealth.

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Tony has long experimented with plant breeding to cultivate safe cannabinoid medicines. From Mullaways’ website;

“The Research by Mullaways Medical Cannabis has made it possible for the first time to; Design, Cultivate, Trial and Evaluate Cannabinoid Treatments using SAFE Doses of Cannabinoids / THCA / THC. While the rest of the Medical Cannabis Research world tries to genetically engineer Cannabis without any THC or tries to produce a rich Blend of Cannabinoids / THC from low THC Cannabis Mullaway’s Research has already produced the Jewel in the Crown of Medical Cannabis Research”.

However, Tony’s plans have been put on hold as he once again sits behind bars. In February 2016, Australia officially legalised ‘medical Cannabis’. Since then, government has signalled its intention to expand its ‘medical Cannabis’ operations, stating it would approve exports, becoming the fourth country in the world to do so. The country’s health minister said his government aims “to give farmers and producers the best shot at being the world’s number one exporter of medicinal Cannabis”.

Mullaways

Without legal permits, Tony was an easy target for law enforcement. But many in the community see Mullaways’ independent operation as a necessary alternative to the government-run, overly bureaucratic program. Many patients report accessing ‘medical Cannabis’ in Australia remains difficult. According to some estimates, only roughly one in ten users has been granted permission to access Cannabis legally, regardless of the government streamlining the current convoluted process.


Support Tony Bower with Legal Fees

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Adapted from Prominent Cannabis Grower Tony Bower is Arrested For Gifting Cannabis Oil to Patients with Man remains in custody on cannabis charges, Patient Access to Medicinal Cannabis Products in Australia

Azadirachtin, Hyperemesis and Herxing?

 

Image result for neemPeople have used Cannabis sativa L., (Cannabis) for thousands of years (2900 BCE in China) without a single sign of the purported ‘Cannabis Hyperemesis Syndrome’ (CHS) symptoms. Modern day organic insecticides have a lot to answer for, but nobody seems to be blaming them, when they should! At the beginning of the century, the evergreen Neem tree was highly esteemed by Indian migrants who took it to where they settled, introduced to Australia, Africa, south-east Asia and South America. Today, the Neem tree is well established in at least 30 countries across Asia, Africa, Central and South America with small scale plantations in Europe and the United States. 

Azadirachtin (C35H44O16) is the key insecticidal ingredient found in the Neem tree (Azadirachta indica), commonly called Indian (or Persian) Lilac or White Cedar. Neem trees were first introduced to Australia between 1940 and 1944 in the Northern Territory and Queensland. In the 1960’s, Neem trees were planted at Darwin Airport as part of a government–RAAF initiative. In Western Australia, governments promoted Neem as an amenity tree in the 1970’s (trees introduced into local landscapes with a deemed value to the community, i.e., for shade and mosquito deterrence) and in the late 1980’s, Comalco began trials of a new variety. The first Australian Neem workshop at the University of Queensland (1988) triggered a surge in interest. Landholders, scientists and companies started enthusiastically planting Neem trees and while heavily promoted, a viable industry did not develop and many plantations were abandoned. Neem has been sold as a nursery plant and at weekend markets for at least 20 years in Queensland.

Image result for neem oil on fruit and vegNeem has a range of uses but most interest lies in it’s pest control properties for which it is grown commercially. Azadirachtin is extracted from the seeds and leaves of the Neem tree and is promoted as an insecticide more ‘environmentally friendly’ than synthetics. However, in Australia in 1988, an economic assessment concluded, “Neem has little current demand with no local production and only small volumes of imports”. More than a decade later, in 2002, a report, ‘Pesticide use in Australia’, by the Australian Academy of Technological Sciences and Engineering, noted; The growth of the organic farming industry has created increasing interest in the possible use of naturally occurring products such as Neem … increasingly sought by growers for use in both agriculture and animal husbandry. Neem-based products are not currently registered as pesticides in the marketplace. Registration requires rigorous scientific assessment in terms of safety. Since such products are not currently registered, they cannot legally be used as pesticides”.

Image result for neem oil australiaIn May 2002, the Complementary Medicines Evaluation Committee (CMEC) noted an application to the National Drugs and Poisons Schedule Committee (NDPSC) had been made regarding Neem oil. The application had been evaluated by the Chemical Product Assessment Section (CPAS) of the TGA. The NDPSC discussed the toxicological profile of some types of Neem extracts which resulted in significant toxic effects in animals after oral administration, including testicular atrophy, impaired fertility and causing abortion (abortifacient) effects. There were case reports of lethal ingestion in children of doses as low as 5 ml and the NDPSC considered including Neem in Schedule 7 (Dangerous Poison) of the Standard for the Uniform Scheduling of Drugs and Poisons (SUSDP) with a Schedule 5 (Caution) entry for agricultural products. CMEC were advised the NDPSC foreshadowed inclusion in Appendix C of the SUSDP of Azadirachta indica (Neem) in preparations for human use. CMEC Members noted Appendix C lists substances, other than those included in Schedule 9, of such danger to health as to warrant prohibition of sale, supply and use. Members noted the foreshadowed action would directly affect the CMEC recommendation to permit listing of Neem seed oil and would prevent use of all Neem products in therapeutic goods, cosmetics or toiletries.

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Therapeutic Goods (Listing) Notice 2003 (No. 2)

Published in the Commonwealth of Australia Gazette No. GN 32, 13 August 2003
Therapeutic Goods Act 1989
I, TERRY SLATER, National Manager, Therapeutic Goods Administration, delegate of the Parliamentary Secretary to the Minister for Health and Ageing, under subsection 17 (5) of the Therapeutic Goods Act 1989, require the following therapeutic goods to be included in the part of the Australian Register of Therapeutic Goods for listed goods:

  1. preparations, referred to in item 3 of Schedule 4, Part 1 of the Therapeutic Goods Regulations (the Regulations) that contain, as an ingredient, cold-pressed Neem (Azadirachta indica) seed oil for topical application at concentrations up to 1%, and at concentrations greater than 1% when in a container fitted with a child resistant closure and labelled with the statements:
    • Not to be taken;
    • Keep out of reach of children; and
    • Do not use if pregnant or likely to become pregnant

Dated 4 August 2003. National Manager, Therapeutic Goods AdministrationDelegate of the Parliamentary Secretary


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Australian Federal Poisons Standard (2017) entry for Neem, Schedule 5;

AZADIRACHTA INDICA EXTRACTS (Neem extracts), extracted from Neem seed kernels using water, methanol or ethanol, in preparations containing 5% or less of total limonoids, for agricultural use. 

The Poisons Standard June 2017 consists of the Standard for the Uniform Scheduling of Medicines and Poisons No. 17 (the SUSMP 17). Schedule 10 (Appendix C) lists AZADIRACHTA INDICA (Neem) including its extracts and derivatives, in preparations for human internal use except ‘debitterised Neem seed oil’.


Image result for neem anthelminticNeem seeds comprise 40% oil. Azadirachtin, the major active ingredient’s content in the oil varies depending on extraction technology and quality of the crushed seeds. Neem seed oil as a traditional medical remedyin widespread use across the Indian subcontinent, Malaysia, Sri Lanka and Singapore, is anti-bacterial, anti-fungal, insect repellent, treats skin diseases and acts as an anti-fertility agent. The bark, leaves and purified biochemicals are anti-cancer and anti-microbial and Neem leaf extract possesses anti-inflammatory properties. Neem seed oil comprises many triterpenoids, of which Azadirachtin is the most well-known, however, there is no antidote available for Neem seed oil poisoning. Azadirachtin is implicated in causing Neem seed oil poisoning, causing diarrhoea, nausea and general discomfort when the oil is given orally as an anti-helmintic (kills worm-like parasites – flukes, roundworms and tapeworms). 

Image result for no specific antidote available for Neem seed oil poisoning.In adults, it presents as vomiting, seizures, metabolic acidosis (excessively acid body fluids or tissues) and toxic encephalopathy (malfunction of the brain), sometimes accompanied by anoxia (deficiency of oxygen reaching tissues). Recovery is complete with symptomatic treatment (therapy that affects symptoms, not cause). Fatal poisoning cases due to Neem seed oil in India and Malaysia have been reported. Five to ten millilitres of oil given orally to children against minor ailments caused vomiting, drowsiness, tachypnea (abnormally rapid breathing) with acidotic respiration (lungs can’t remove enough carbon dioxide [CO2]), polymorphonuclear leukocytosis (increased white blood cells) and encephalopathy developed within hours of ingestion followed by seizures, associated with coma (in some cases). Autopsy demonstrated pronounced fatty acid infiltration of the liver and kidneys, with mitochondrial damage and cerebral oedema, changes consistent with Reye syndrome (a rarely diagnosed disorder).

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The original purported CHS was a serious misdiagnosis by two South Australian General Practitioners, initially featured by the Australian Broadcasting Commission (ABC) as, Pot heads can’t stop puking, in October 2004. The article quoted a study that stated chronic Cannabis use could lead to regular bouts of non-stop vomiting and an obsession with hot showers. Dr James Hugh Allen, then a GP in Mt Barker, South Australia, needed a study to complete his specialty (anaesthesiology) so he reported this ‘rare, new syndrome’ in the November 2004 issue of the journal, Gut. Allen said the first case presented in the late 1990’s. The patient had a severe bout of vomiting. “He would vomit continuously for two or three days. It was so bad he had to go to hospital and be put on a drip”. The patient was a heavy Cannabis user who started smoking at age 19, with the vomiting starting three years later. Whilst in hospital the patient would sit in a hot shower, which he said relieved his nausea and vomiting. “It became an obsession. He would have 10 to 15 showers a day”.

Image result for south australia cannabis lawsAllen set out to test the theory that chronic Cannabis use could be behind otherwise ‘unexplained’ cases of vomiting. He identified 19 chronic Cannabis users (South Australia had fairly liberal laws regarding possession of small quantities for personal use). Of the initial 19, nine cases, plus one from Sydney, demonstrated Allen’s purported link between chronic Cannabis use and vomiting. “They all had exactly the same ‘syndrome’Out of the 10 cases, seven abstained and all got better. Three took up smoking again and got sick again. Of these three, two gave up again and got better and one continued smoking and remained ill”. Allen said the illness was reasonably rare, affecting perhaps 1% of chronic users. “But some people are very sensitive to Cannabis”. He said further research was needed to test this. In January 2013, Dr Allen presented a Submission to the New South Wales’ Government ‘Inquiry Into Use of Cannabis for Medical Purposes’, on behalf of the Mt Barker South Surgery. Drs Allen and Heddle wrote to remind government of their purported syndrome (having presented no further research on the subject).

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INQUIRY INTO USE OF CANNABIS FOR MEDICAL PURPOSES
Organisation: MT BARKER SOUTH SURGERY
Date received: 28/01/2013
We felt it was appropriate to inform the Committee about our original description of the entity of cannabinoid hyperemesis, which is a form of cyclical vomiting often needing hospitalisation that occurs in regular consumers of Cannabis, typically patients self-medicating with relatively high doses. If the medical use of Cannabis or synthetic cannabinoids is legalised, our fear is that use might increase the frequency of this syndrome, which is a distressing illness. This syndrome appears to be unique to Cannabis and our observations have over the last eight years been confirmed by reputable groups internationally … culminated in publication … of 98 cases from the Mayo Clinic … Dr Hugh Allen, MB,BCh, BAO, FRACGP, Dr Richard Heddle MB,BS, MD, FRACP


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Dr Kennon Heard, Colorado

Azadirachtin was first synthesised in the United States (US) over a decade ago (2007) and was given US Organic Materials Review Institute (OMRI) certification for sale. In 2000, use of Cannabis for medicinal purposes commenced in Colorado, US. The number of licensed patients initially grew at a modest rate, but in 2009, Colorado’s Board of Health abandoned the caregiver-to-patient ratio rule and the medical Cannabis industry took off. Increasing numbers of users started coming down with purported CHS. Coincidence? Not according to Dr Kennon Heard, Emergency Room physician at the University of Colorado Hospital in Aurora, Colorado. He published a study in 2015, ‘Cyclic Vomiting Presentations Following Marijuana Liberalization in Colorado’, and in 2016 told CBS News“They’ll often present to the emergency department three, four, five different times before we can sort this out”. The study shows since 2009, when medical Cannabis became more widely available, emergency room visit diagnoses for purported CHS in two Colorado hospitals nearly doubled. However, the study lacks scientific proof and according to experts, the symptoms are so rare it could simply be an allergy to certain terpenes, or an issue with unregulated flower. 

Image result for cannabis business allianceMark Malone, then Executive Director of the Cannabis Business Alliance, suggested the link between purported CHS symptoms and Cannabis use is far-reaching and unsupported. He called it an ‘alleged disease’ because real numbers are not presented and the study relies on information that patients “were more likely to endorse marijuana use” which proves nothing. While a few studies have generated interest in this topic, there have been no epidemiologic studies associating Cannabis use with the ‘alleged disease’. According to the same study, “this deficit is likely multifactorial due to the lack of formal diagnostic criteria for CHS, the relatively low prevalence of this syndrome and the social stigma regarding marijuana use that discourages self-reporting”. Malone is one of the many Cannabis experts who remain sceptical about the ‘alleged disease’. He said the study is unfounded and not well-researched.

Image result for cannabis industry coloradoThe study reveals no definitive link: “Patients presenting with cyclic vomiting after marijuana liberalization were more likely to have marijuana use documented in the ED record, although it is unclear whether this effect was secondary to increased use, more accurate self-reporting, or both”. Added Malone, “The industry in Colorado had not heard of this issue until this news story”. A third study from 2012 at the Mayo Clinic, used a relatively small sample of 98 patients, ten of which followed up with the researchers. Seven of the ten in the study stopped using Cannabis. Six of the seven went into remission. In the 2009 study the researchers note, “despite a high rate of marijuana use in our community, the absolute prevalence of cyclic vomiting remained low, underscoring that CHS is a relatively uncommon condition”

Image result for Azadirachtin is used to controlAzadirachtin is used to control white flies, aphids, thrips, fungus gnats, caterpillars, beetles, mushroom flies, mealy bugs, leaf miners, gypsy moths and other ‘bugs’ on food, greenhouse crops, ornamentals and turf. The labelling for food (fruits and vegetables) says you can use it up to the day of harvest and Cannabis growers have been doing just that. There’s a long history of safe use of organic Neem and Azadirachtin products with fruits and vegetables (<30 ml, one fluid ounce, of Neem seed oil has 200-2,500 ppm of Azadirachtin). This history says root drenches do not work, because the plants do not uptake the compound through their roots. Well, Cannabis does, which means the studies of them being safe products are wrong, when it comes to Cannabis. Many producers of Azadirachtin contaminated Cannabis are otherwise exceptionally clean, ‘organic’ growers and the only thing missing is their education on Cannabis being hyper-accumulatory with phyto-remediation capabilities and not the same as a fruit nor vegetable (Cannabis is a herb). Cannabis sativa L., grown for food, housing, oil etc., is known as ‘Industrial Hemp’ because it has the capability of hyper-accumulation of industrial waste. 

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Industrial Hemp (Cannabis sativa L.)


Hyper-accumulatory nature of Cannabis sativa L. is shown by accumulation of various metals (mg/kg) in industrial areas (Heavy metal contamination and accumulation in soil and wild plant species from industrial area of Islamabad, Pakistan’ 2010)

Concentration of metal (mg/kg) Root Shoot
Lead 29 mg/kg 30 mg/kg
Copper 29 mg/kg 18.2 mg/kg
Zinc 27 mg/kg 43.9 kg/kg
Nickel 13.6 kg/mg 11.3 mg/kg
Cobalt 24.7 mg/kg 14.8 mg/kg
Chromium 29.7 mg/kg 14.5 mg/kg

Azadirachtin is implicated in causing Neem seed oil poisoning and anecdotally, symptoms of Azadirachtin poisoning from contaminated Cannabis include:

  • Persistent early morning nausea
  • Inability to eat (not eating doesn’t help, however)
  • Recurrent episodes of severe nausea and intractable vomiting, hyperemesis (severe or prolonged vomiting)
  • Intense abdominal pain
  • Intense pain around the kidneys and lower back muscles along the spine
  • Severely increased muscle tension over entire body

Processed food only exacerbates the symptoms of nausea and pain. Temporary relief of symptoms including the back, gut and muscle tension pain can be had by taking a hot bath or shower and cessation of symptoms will follow when the Azadirachtin toxicity reduces and eventually ceases. ‘Clean’ Cannabis (without Azadirachtin) helps alleviate the symptoms. Benadryl (Diphenhydramine), an antihistamine mainly used to treat allergies can be used for nausea and provides some relief (anecdotally). Following the antihistamine with activated charcoal can help remove the Azadirachtin more swiftly. Further suggestions for remediation include anti-nausea medication (Maxalon used in hospitals) or ginger and cayenne pepper in food along with probiotics, yoghurt and even Kombucha.


The acute inhalation toxicity study in rats exposed to technical Azadirachtin showed the LD50 (Lethal Dose) is >2.41 mg/L per animal, the highest dose tested. Although this figure is below the 5.0 mg/L limit test dose for an acute inhalation study, the reported concentration was the maximum dose possible under test conditions. 

Image result for neem fruits vegetablesCurrent and historical misinformation across mainstream western medicine says the ‘alleged disease’ happens with mass use or ‘abuse’ of Cannabis. Reality shows this syndrome happens with even low use of heavily contaminated Cannabis. When plants are treated in vegetative or early flower stages, low concentration applications can produce lightly contaminated Cannabis. Anecdotally it takes a week or so of constant use for the Azadirachtin to build up to toxic levels. Gastroenterologist’s in the US were under the impression it took significant amounts of Cannabis use to cause the ‘alleged disease’ and were quite surprised to find it can be caused by even small amounts, heavily contaminated with Azadirachtin. They were even more surprised to find use of large amounts of Cannabis was not an issue, as long as the Cannabis was not treated with Azadirachtin.

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Timeline of synthetic cannabinoids and Spice products.

In October 2012 a case was presented at the American College of Gastroenterology, entitled ‘Spicing up the Differential for Cyclical Vomiting: A Case of Synthetic-cannabinoid Induced Hyperemesis Syndrome’. This described the severe illness of a 22 year old man with aggressive disease induced by JWH-018 and JWH-073 synthetic cannabinoidsThere is an escalating number of compounds with cannabinoid receptor activity being referred to as Spice or K2 (Cannabicyclohexanol), so-called synthetic ‘Cannabis’, of which almost nothing is known in terms of pharmacology, toxicology and safety and which were never meant to be combined, combusted and inhaled! Many ingredients are listed on Spice packets, with combinations greatly varying in number and concentration, often depending on country of distribution. A packet of Spice called ‘Banana Cream Nuke’ bought in the US had the following ingredients listed: alfalfa, blue violet, nettle leaf, comfrey leaf, Gymnema sylvestre, passion flower leaf, horehound and Neem leaf.

Two other cases of the ‘alleged disease’ associated with ‘synthetic cannabinoids’ have been reported, both in 2013. Synthetic cannabinoids are created in a laboratory and despite purported similarities in action, differ enough from Cannabis metabolites that standard drug screens do not identify them as they are entirely unrelated to the actual plant. However, even reporting of the ‘alleged disease’ not being exclusive to propagated Cannabis, but occurring with ‘synthetic Cannabis’, does not add any weight to Dr Allen’s ‘alleged disease’, in fact, the opposite is true. The symptoms are those of Azadirachtin poisoning, which is what it is. In jurisdictions where Cannabis is legal, check the source and you’ll find an Azadirachtin product is being used. Nothing to do with the Cannabis, nor it’s use, as sporadic or even one-off use can replicate the symptoms. Cannabis is merely a carrier! It is everything to do with Neem, however.

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Cessation of Cannabis treated with Azadirachtin or increasing use of untreated Cannabis are both effective treatments for the toxic effects of the otherwise seemingly harmless Neem. Thus, the ‘alleged disease’, the purported Cannabis Hyperemesis Syndrome is a complete misdiagnosis and a total misnomer as it has nothing to do with Cannabis!


Dr Allen stated in his original study; “The triad of chronic Cannabis, cyclical vomiting and compulsive bathing is indicative of a new syndrome with Cannabis ‘toxicity’ as a cause”. Cannabis is entirely non-toxic. Hence, Cannabis ‘toxicity’, like the Unicorn, does not exist.


Finally, further to having nothing to do with Cannabis, the ‘alleged disease’ exhibits such similar symptoms to ‘herxing’, the nth degree of getting worse before you get better, it’s not funny nor is it a coincidence! You might never have heard the term ‘Jarisch-Herxheimer Effect’ but generally speaking, most people have experienced it. The term was coined from the names of two doctors, Adolf Jarisch (1860-1902) and Karl Herxheimer (1861-1942) both of whom noticed that in response to treatment, many patients developed not only fever, perspiration, night sweats, nausea and vomiting, but their ailments became worse before settling down and healing. The more commonly known Herxheimer Reaction is a short-term (from a few days to a few weeks) detoxification reaction in the body. As the body detoxifies, it is not uncommon to experience flu-like symptoms including headache, joint and muscle pain, body aches, sore throat, general malaise, sweating, chills, nausea and a variety of other symptoms. Herxing is an over-reaction of receptors which basically do not know how to assimilate the tsunami of toxins, and produces a toxic response.

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Expanded from Cannabis Hyperemesis Syndrome (CHS) is Azadirachtin Poisoning, Marijuana Legalization in Colorado: Early FindingsTherapeutic Goods Listing Notice 2003 No. 2, Progress on Azadirachta indica based biopesticides in replacing synthetic toxic pesticidesPesticide Use In AustraliaComplementary Medicines Evaluation Committee – Minutes 34th Meeting 2002Azadirachtin, CHS (Cannabis Hyperemesis Syndrome) and BenadrylFinally, the Article on Cannabis Hyperemesis Syndrome that Readers DeserveComparative assessment for hyperaccumulatory and phytoremediation capability of three wild weedsRecognition and Management of Pesticide Poisonings, Neem oil poisoning: Case report of an adult with toxic encephalopathyAzadirachtinHandbook of Pesticide ToxicologyAzadirachtin, Cannabinoid Hyperemesis: A Case Series of 98 PatientsCannabinoid hyperemesis: cyclical hyperemesis in association with chronic cannabis abuseNeem Tree Risk AssessmentThe Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for ResearchBeyond THC: The New Generation of Cannabinoid Designer DrugsSynthetic Cannabinoid Leading to Cannabinoid Hyperemesis SyndromeCannabinoid Hyperemesis Syndrome: A clinical discussion and A Gut Gone to Pot: A Case of Cannabinoid Hyperemesis Syndrome due to K2, a Synthetic Cannabinoid

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