Legislative Council
The Hon. DIANA LAIDLAW (Minister for Transport and Urban Planning): In responding to the Hon. Michael Elliott's motion, I acknowledge his longstanding interest in the issues of drug law reform and promoting a range of approaches to the drug problem. As the Hon. Mr Elliott contends, there is no single solution.
In speaking to the motion today, I want to thank and acknowledge the work undertaken on my behalf by officers in the Human Services area, particularly the Minister's office, as much of the research and background has come from that source. With regard to cannabis, the Hon. Mike Elliott has proposed the separation of the cannabis market from the market for other illicit drugs. I consider that it would be useful to canvass a little of the background of the work that has been done in Australia to look at such issues. In 1994, the National Task Force on Cannabis released its reports, which included an analysis of the various legislative options for cannabis, such as total prohibition, prohibition with civil penalties, and regulated availability. It was pointed out that the regulated availability model does not have a working example in practice anywhere in the world. The approach of the Netherlands is similar to the regulated availability model in that personal cannabis use is not prosecuted by police and cannabis is available from approved outlets such as `coffee shops'. However, the Netherlands approach is unique in that the policy of not prosecuting cannabis users is not written into the law; rather, it is due to a directive to operational police not to pursue personal cannabis offences. It is argued by proponents of this approach that this system has been successful in achieving separation of the cannabis market from the other illicit drug markets with the benefit of reducing opportunities for cannabis users to come into contact with other drugs as well as eliminating the negative impacts on cannabis users that result from their coming into contact with the criminal justice system. The expiation approach in South Australia (the CEN scheme)—which, incidentally, I supported when legislation was introduced into this place—was, in fact, introduced with similar goals to the Netherlands approach, that is, to reduce the negative social impacts of `criminalisation' on cannabis users and to lessen the likelihood of association with other drugs. In 1987, South Australia was the first jurisdiction in Australia to change its approach to minor cannabis offending through the introduction of the Cannabis Expiation Notice scheme. This scheme is an example of a `prohibition with civil penalties' approach to dealing with minor cannabis offences.As members would be aware, this scheme involves the issuing of on-the-spot fines to individuals detected for minor cannabis offences by police. Similar expiation schemes have now been adopted by the ACT and the Northern Territory. In 1994, the National Task Force on Cannabis recommended that the expiation approach to minor cannabis offences be further evaluated. This led to further research being commissioned to examine in detail the social impacts of the CEN scheme in South Australia.
The findings of this research were presented to the Ministerial Council on Drug Strategy in May 1998. In essence, the research showed that the CEN scheme had been well accepted in the law enforcement and criminal justice sectors and the community at large and had had no untoward impacts on the level of cannabis use in the community. Whilst the evaluation has shown that a high proportion of expiation offenders are still receiving criminal convictions due to non-payment of expiation fees, the CEN scheme has the potential to realise greater social benefits, given some enhancement of the operational parameters of the scheme. Some recommendations have been made, including the provision of public education to improve awareness of the health impacts of cannabis use and the financial and legal consequences of failing to pay expatiation fees. The South Australian Controlled Substances Advisory Council has considered the findings of the study and a submission is under consideration by the Government.A further issue which is often raised is that the availability of cannabis for recognised medical conditions should be through prescription by medical practitioners. In May 1998 researchers from the Drug and Alcohol Services Council and the University of Adelaide presented a discussion paper to the Ministerial Council on Drug Strategy, which reviewed the evidence on therapeutic uses of cannabis and synthetic forms of the active agents of cannabis. This paper concluded that there remains insufficient published controlled data to form a view one way or the other as to the therapeutic value of cannabis and synthetic cannabinoids but that there are indications of potential therapeutic value.
The paper gives some attention to suggestions that cannabis is more effective therapeutically than the pure preparations of synthetic forms of the active agents (cannabinoids). One of these synthetic preparations, Dronabinol or Marinol, has been used in the USA and was until recently available in Australia on a trial basis for the treatment of an AIDS related wasting condition. However, its use has been associated with lethargy, sedation, psychoactive effects and variable absorption. Clearly, further research is needed to confirm whether there is a difference between cannabis and the synthetic preparations and, if so, the reason for that difference.
Of course, if cannabis itself were to be used for medical purposes attention would first need to be given to the safe and efficient delivery of therapeutic doses and associated practical issues to do with classification, production, etc. Much has happened internationally with regard to the medical use of cannabis in the past year. In the USA, during November 1998 six states (Alaska, Arizona, Colorado, Nevada, Oregon and Washington State) plus the District of Columbia passed initiatives to enable the use of cannabis for medical purposes.
In the UK, a 1998 report by the House of Lords Science and Technology Committee recommended allowing doctors to prescribe cannabis for medical use whilst maintaining the ban on recreational use. Major clinical trials of medical uses of cannabis are now under way in the UK and the USA looking at its use in the management of post-operative pain, the muscular rigidity of multiple sclerosis, and as an appetite stimulate for AIDS patients. The UK trials are supported by the company, GW Pharmaceuticals, which is producing the cannabis and examining mechanisms for efficient and effective delivery for therapeutic purposes.
Therapeutic use of cannabis should be distinguished from the more general social use of cannabis rather than being caught up in the same debate. Decisions on the therapeutic use of cannabis must be based on scientific and clinical evidence of efficacy.518 Advice to the Government is that at this point of time insufficient evidence is available to make an informed decision on regulatory mechanisms to support the prescription of cannabis. Rather, we should await the outcomes of trials overseas and any complementary work that might be done in Australia.
Turning now to the second part of the Hon. Mr Elliott's motion, which seeks to call on the Federal Government to allow the proposed heroin prescription trial to proceed. I am sure all members would have noted in recent days that the Prime Minister has reaffirmed his stance against heroin trials proceeding. Members will also be aware that on 10 December 1988 the House of Assembly appointed the Select Committee on a Heroin Rehabilitation Trial with the following terms of reference: To investigate and report on whether the Government should conduct a scientific medical trial to determine if the provision of injectable heroin as part of a program of rehabilitation improves the community's ability to attract and retain into abstinence treatment drug misusers who are committing crimes, at risk of transmitting HIV or at risk of death or serious injury as a consequence of their abuse. The committee's terms of reference will require an examination of the impact of the current prohibition regime, the effect of current programs of drug education and rehabilitation measures, trial models (for example, the ACT proposal and overseas experience, such as the Hon. Mike Elliott has referred to), legislative aspects and Australia's international obligations. The findings of the select committee will inform further debate in this area. We cannot forecast what the select committee's findings will be. It may be that they will support a renewed approach to the Federal Government. However, it has been suggested to me that at this stage, taking into account recent pronouncements by the Prime Minister, it seems that a further approach to the Federal Government would not be particularly productive. In the meantime, we will continue in this State with trials into alternative pharmacotherapies—buprenorphine, tincture of opium, LAAM, and rapid opiate detoxification and naltrexone maintenance—in an attempt to find a range of therapies to assist people with drug problems. In summary, while noting the drug policies of the Netherlands and Switzerland, neither the Minister for Human Services nor I support the motion moved by the Hon. Mr Elliott for the reasons that I have outlined. We support the further exploration of these issues through the select committee of the House of Assembly.The Hon. CAROLYN PICKLES secured the adjournment of the debate.