Hard News by Russell Brown

28

The Scientology front operation behind the "No" campaign on cannabis

Last night, One News ran a follow-up story to its Colmar Brunton poll results on the cannabis referendum, headed here as Government accuses big American anti-cannabis group of interfering in NZ politics.

In truth it wasn't just the government: Justice minister Andrew Little, National's Shane Reti and the Greens' Chloe Swarbrick all appeared on camera to express unease about the entry to the referendum fray of the American lobby group Smart Approaches to Marijuana.

SAM is controversial in the US too, not least on account of its tireless efforts to avoid revealing who bankrolls its activities. Say Nope to Dope, which was founded by Family First's Bob McCoskrie, yesterday swiftly issued a press release on behalf of SAM-NZ denying that the local "No" lobby was being "bankrolled by or controlled by US organisations".

Further "SAM in the US are not telling our coalition how to run our campaign, and have not contributed one cent to it."

But Say Nope to Dope did, three weeks ago, issue the press release announcing the formation of SAM-NZ, to be fronted by Aaron Ironside, a Christian life coach, former radio DJ and longtime associate of McCroskie, who had also been announced only days before as Say Nope to Dope's new spokesperson.

Yesterday's press release included a list of other individuals and organisations who are part of the "No" coalition. It includes quite a number of well-known conservative voices, such as school principal Pat Walsh and Jess McVicar of Sensible Sentencing Trust. There are individuals with a commercial interest in talking up the drug war, such as Methcon's Dale Kirk and Drug Detection Agency owner Kirk Hardy.

There are various conservative Christian groups, along with a couple of senior members of the New Zealand Muslim Association (but not, it appears, the association itself). It's about what you'd expect: people with vested interests and people and organisations that routinely oppose liberal social change, along with a few who have entered the fray because they're genuinely concerned about cannabis legalisation.

But there are also four names from an organisation that will be less familiar: Drug Free World. That will be Drug Free World Aotearoa New Zealand, which set up a Facebook page earlier this year. It appears to have evolved from Drug Free Aotearoa, which was estabished by Taranaki woman Rose Denness in 2012. Denness's name will be familiar to people who have studied the Church of Scientology.

Yes, she is a Scientologist, and Drug Free World Aotearoa New Zealand is Scientology front, along with Narconon and various others listed by then-Green MP Kevin Hague in Parliament in 2009. Said Hague at the time:

I am not a person with a religious belief myself, but I do not object to churches providing social services, provided that the church connection is transparent and that the service is not a front for recruiting into the church. It seems to me that the Church of Scientology fails on both those fronts.

The "About" page of Drug Free World Aotearoa New Zealand's Facebook links directly to the website of the Foundation for a Drug Free World, a notorious Scientology front with a long history of wangling its way into official drug education programmes to peddle pseudoscience.

It even happened here: Drug Free Ambassadors, another Scientology front managed to get public money for 130,000 copies of a booklet distributed to New Zealand schools.

It's possible, probable even, that many of the people involved here in Drug Free World have no idea what it actually is. The old Drug Free Aotearoa used to wrap itself in tikanga so the links weren't obvious, and Drug Free Ambassadors claimed a "partnership" with Māori wardens. Some may have come to it via the "briefings" that can be booked via its Facebook page (the first one is free, of course).

If some elements of this anti-reform coalition are opaque and questionable, its embrace of a harmful Scientology front is actively alarming. And it says something about the nature of the active opposition to cannabis law reform in New Zealand that it's there.

6

Towards the referendum: this might actually be a trend

Back at the beginning of April, when we had much else on our minds, I wrote this post urging some caution in interpreting the results of the latest Horizon poll, conducted in February, on voting intentions in this year's cannabis referendum, which was paid for by Helius Therapeutics.

I wrote that the structure and style of the questions:

... sets up the proposition in quite an obvious way, with legalisation and regulation implicitly presented as the prudent and responsible course of action: “controls” versus “no controls".

It’s not dishonest: it’s literally the argument most of us make for reform. But it has very probably had a bearing on responses, and was crafted with that in mind.

Well, Horizon and Helius have published another poll, using the same questions and structure, and it really does seem to show a rising trend towards a "Yes" vote in September:

There's a difference in the way the reports are reported though: in Horizon's release on this latest poll, results for the question At this time, do you think you will vote for or against legalising cannabis for personal use in New Zealand? are listed before those on prohibition and its outcomes in New Zealand, not after. I suspect that doesn't actually mean a change in the order of the questions, but I'll check.

The actual overall increase in intending "Yes" voters is modest: from 54% to 56%. But that's up from 39% in August last year. And there are increases over February regardless of who respondents voted for in 2017. Striking increases in support among Act voters (from 45% to 70%) and New Zealand First voters (from 46% to 53%) may reflect a small numbers problem, but even among National voters, 31% would be prepared to overlook partisanship and vote "Yes", up from 27% in February.

In demographic terms, only the over-65s aren't showing majority support for reform.

What's happened between the two polls? A sharp tilt towards Labour in party voting intentions for one thing. But Horizon polled its panel between June 4 and 10 – days after the New Zealand Drug Foundation's 'On Our Terms' campaign launched on June 2.

The message of the campaign is very clearly emphasised on its home page. The page leadline is: It's time to take control of cannabis on our terms. The referendum is characterised as the Cannabis Control Referendum. It lists 8 key control measures of The Bill. And that's all above the fold. The word "control" is further emphasised with the use of colour.

This aligns with the way the Horizon poll questions talk about Controls over growing and selling personal use versus Continuing with no controls.

I don't think Helius and the Drug Foundation are really colluding over this – they're simply discovering what argument resonates with the public in their research.

So we're not only seeing a steady increase in support for reform – albeit in response to a poll structured to cultivate that support – we may also be seeing what the winning argument might be.

The challenge for reformers as September approaches will be to keep that the argument – and, ideally, to separate that argument as much as possible from political partisanship. In the run-up to an election, that might not be easy. But it's becoming clear that's the job.

16

Cannabis research: there's a lot of it about!

I try my best to know what I don't understand, and one of the things I know is that meta analyses and evidence reviews are difficult for lay people to assess. The merging of data from multiple sources is complex and understanding what's going on requires actual knowledge of the character of the studies incorporated in the review.

So when the people from Say Nope to Dope last week trumpeted a new meta analysis of findings about cannabis and violence, I was cautious. In the case of this new paper from the University of Montreal, I didn't have journal access anyway. But one of the headline findings struck me as extraordinary: the headline odds ratio for lifetime use was 1.94; meaning that anyone who has ever tried cannabis was nearly twice as likely to have committed a violent offence as as anyone who hadn't. In a country like New Zealand, where 80% of us use cannabis at some point, this seemed to have some remarkable implications.

So I asked Professor Joe Boden, director of the Christchurch Health and Development Study, whose research interests include both substance use and "the social and psychological determinants of maladaptive behaviour including aggression and violence."

He didn't take long to come back: the Canadian paper had misquoted an odds ratio from a paper by the Dunedin Multidisciplinary Health and Development Study (the companion longitudinal study to the Christchurch one) "as being 6.9, when the adjusted OR is in fact 3.15."

The adjustment of data to account for confounding factors – alcohol use, socioeconomic status, underlying conditions, etc – is crucial in this kind of work, so presenting unadjusted data as adjusted is quite a problem.

It has since turned out that there are sufficient questions about the Canadian paper to warrant a formal approach to the publishing journal, the American Journal of Psychiatry, which might take a long time to work through. But Professor Boden was happy enough to be quoted on what he and his team are seeing.

He says Figure 2, a table and plot of odds ratios from the 30 studies analysed, is "riddled with errors" – including with respect to Arsenault et al, the paper from the Dunedin study.

"Some of the ORs reported are unadjusted, whereas others are adjusted.  It is to some extent unclear which ones were used in the analyses. Given their comments, I believe it is possible that the authors used the wrong odds ratios in their analysis, as the higher ORs were the ORs that appeared in the error-riddled Figure 2."

Further, he says, the authors acknowledge that the dose-response relationship between cannabis and violence  "was observed primarily because of two studies that reported high odds ratios," one of which was the Arsenault paper. The adjusted odds ratio, the one that should have been used, was only moderate.

Professor Boden also noted "a high degree of heterogeneity" in the studies included, meaning "the studies included were sufficiently different in design, scope and analysis that the 'true' effect size is still unknown – effect sizes reported in the paper are indicative)." The effect itself – violent behaviour – is not measured in the same way across the source studies. But the authors observed that odds ratios were lowest (1.66) in the most reliable category of research – the longitudinal studies.

"If the number [in the Arsenault study] included the unadjusted figure rather than the adjusted one," says Professor Boden, "then the already weak OR (1.66) will cross into non-significance and will be no different from 1 (no effect)."

The authors also state that many of the included studies either haven't adjusted for potential confounding, or did not account for things such as other substance (particularly alcohol) use, conduct problems, psychopathic traits, and history of violence.

"Conduct problems is the big one here, as it is highly correlated/co-morbid with substance use and misuse."

One further cause for caution with this kind of work is that it's dealing with an association between two things that are quite rare: heavy and persistent cannabis use (the exposure) and violent behaviour (the outcome).

"What this means is that estimates of the OR will be highly inflated, and it is usually advised to calculate the risk ratio instead in these cases – that is, cumulative incidence in those exposed versus cumulative incidence in those not exposed."

 (There's a reasonably straightforward explanation of the difference between odds and risk ratios here.)

None of this is to reject the idea of an association between (particularly heavy and early) cannabis use and violence, but the association is complex and in some cases causation may run the other way: so conduct disorder involving violence may be a predictor of early cannabis use.

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Professor Boden is also the author of a Spinoff article published this week: What 40 years following thousands of NZ people tells us about cannabis harm, which briefly outlines the conclusions of research founded in New Zealand's two longitudinal studies. You're almost certainly familiar with these findings: principally, that early and heavy use of cannabis is associated with an increased risk of psychotic symptoms later in life.

Some of their findings have been challenged, but we can confidently say as a result of these two studies that heavy use of cannabis in adolescence is A Bad Thing.

Professor Boden concludes:

Given our research on the risks associated with cannabis use, why do the directors of both the Christchurch and Dunedin studies maintain that cannabis should be dealt with as a health issue, and not a justice issue? The reason again is related to our findings. 

First, despite being a banned substance, cannabis is commonly used across both cohorts, indicating that prohibition does not stop people using cannabis. Second, we found that those who were arrested or convicted of a cannabis offence did not reduce their use of cannabis (in fact some increased their use), suggesting that being subjected to the force of the law does not deter people from using cannabis. Third, the Christchurch study found that Māori were three times more likely than non-Māori to be arrested or convicted on a cannabis offence, showing that prohibition law is enforced by the police and courts in a racially biased way. 

Collectively, our findings suggest that cannabis prohibition laws are not fit for purpose, and that in the 21st century we must deal with the problems associated with cannabis in a way that promotes health, equity and justice for all New Zealanders. The way forward is through legalisation and strict regulation as provided by the Cannabis Legalisation and Control Bill.

If you find that interesting, you may want to read the long version: Patterns of recreational cannabis use in Aotearoa-New Zealand and their consequences: evidence to inform voters in the 2020 referendum, a new article for The Journal of the Royal Society of New Zealand, with Joe's colleague Richie Poulton as lead author. It concludes with much the same observations as the Spinoff article on the ineffective and counterproductive nature of cannabis prohibition and signs off with this:

Given that the referendum process does not allow for a more graduated, evidence-informed move towards legalisation, we urge the government to establish clear expectations for a careful, deliberative roll out of a new legislative framework if voters select this option. Systematic ongoing evaluation of the impacts of, and concerns about, harmful use will be important. The plan should be flexible in order to consider real-world commercial imperatives and profit-making activities. The parallels are obvious with the alcohol industry, such that identification of new markets (e.g. youth) resulted in the emergence of alco-pop products. In this regard, it is reassuring that the ‘rules of engagement’ published in 2019 (and summarised above) appear thorough and well-considered. One thing is very clear from the research – and thankfully it appears to be a message that has been widely understood and accepted – regulations that restrict access to use by children and adolescents must be prioritised and enforced.

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A more recent article from University of Otago researchers, Cannabis, the cannabis referendum and Māori youth: a review from a lifecourse perspective, for the New Zealand Journal of Social Sciences Online, focuses on the particular harms suffered by Māori, both through unhealthy use and the impact of criminalisation. It concludes:

It is clear that the combination of early and regular cannabis use negatively impacts on young people’s health and wellbeing. Rangatahi Māori are more likely to use cannabis in Aotearoa New Zealand compared to their non-Māori peers. Moreover, they are more likely to be criminalised for its use from a young age even when they have similar levels of use to non-Māori. The evidence to date shows deeply entrenched inequities beginning in youth for Māori in relation to cannabis use and convictions. Based on current research findings from Aotearoa New Zealand, we conclude that cannabis use should be treated as a health and not a criminal issue.

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The editorial in the May 22 issue of the New Zealand Medical Journal, by Chris Wilkins and Marta Rychert of Massey SHORE, also raises some interesting questions about the Cannabis Legalisation and Control Bill to be voted on at this year's referendum. In truth, most of them – including the detailed regulations for retail premises and the precise role of local authorities – seem like the kind of things on which a Parliament would seek to direct the proposed Cannabis Regulatory Authority, should there be a "Yes" vote, but they're worth discussing now. (I confess, I hadn't picked up that it's still unclear which government agency would direct the new authority.) I do think (the authors disagree) that there is enough explicit provision in the CLCB for non-profit retail outlets without pre-emptively fencing off a specified proportion of the market for them. And I still don't think liquor licensing trusts are a good model.

The authors conclude:

We recommend the inclusion of a formal minimum price for cannabis, the lowering of the cap on the THC potency of cannabis plant products, a set proportion of licenses for social benefit operators, and a framework to allow the emergence of cannabis social clubs.

It's not clear that in New Zealand conditions, particularly with a cap on licences, prices would collapse the way they have in some US jurisdictions, and there are perils, if you want to replace the black market, in setting prices too high. The authors also ask how potency limits for home-grown plants would be monitored – and frankly, they can't. It's not really viable to hold people accountable for the potency of plants they can't test.

Another paper by the same research team, Exploring medicinal use of cannabis in a time of policy change in New Zealand, is not available to non-subscribers, which is a shame, as it's useful and interesting.

It's based on a survey of people professing to use cannabis for medicinal reasons, which is separate to the MCANZ survey I've mentioned here before (that one is still being prepared for publication by its author Geoff Noller), and its results are variously quite similar and quite different to that one. One interesting – and encouraging – difference was the relatively high use of vaporisers (31.5%) compared to the draft MCANZ results. On the other hand, respondents don't seem to have been asked whether they sought higher-CBD ratios in their illicit cannabis, where Noller et al did (and found a relatively high level of awareness).

Also:

• Most people surveyed had used cannabis recreationally, and nearly half were doing so at the time they were surveyed.

• The condition groups for which cannabis was used most often were: pain (80.9% of respondents used cannabis for at least one pain condition), sleep (65.9%) and mental health conditions (64.0%), followed by gastro- intestinal (17.1%) and neurological (12.2%) conditions and cancers (6.7%)

• Participants overwhelmingly believed their symptoms had improved since starting to use cannabis for medicinal reasons. Seizures received the highest scores for perceived improvement (ie, 97.2% who suffered from seizures reported their symptoms had improved)

• Only 14% of patients had asked their doctor for a cannabis prescription, and only a third of those had actually received one. Unsurprisingly, nearly all of those were for CBD-only products, on which there are no official prescribing conditions, and only 18% were for Sativex, which contains THC (and was the only approved THC product at the time of the survey). The NZMA can insist all it likes that people can access cannabis products on prescription, but it still ain't true.

Perhaps the most interesting part is this graph:

It's a bit hard to read here, but the class of prescription medication most often stopped as a result of cannabis use was gabapentinoids. The class in which use was most often reduced was opioids – 95% of those who used opoids reported reducing their use as a consequence of using cannabis. (NB: The reported reduction in anti-psychotic medications might look alarming, but those are frequently used at low doses to treat conditions like anxiety.)

This is exactly what I've heard while talking to patients. There's a quality of life issue here, particularly in the case of the gabapentinoids. About half of the people surveyed reported side-effects from their cannabis use – "increased appetite" was easily the most common (29.5%), but small numbers did report psychological problems such as anxiety (6.4%) and "depressed mood" (3.8%). In general, however, these people seem to have been glad to substitute cannabis for the heavier prescription medications and their side-effects.

I think this is something prescribing doctors need to bear in mind while scorning cannabis as unproven. Patients' sense of wellbeing is not irrelevant.

5

Lately in cannabis

Anyone who keeps an eye on evidence around cannabis and public health will be familiar with the Christchurch Health and Development Study. It's one of two local longitudinal studies frequently cited with respect to cannabis and youth development. But in a new article in the New Zealand Medical Journal, it is used for something different: attitudinal research about cannabis reform ahead of this years referendum.

The sample size – 899 – is that of a respectable poll. But it differs from a conventional opinion poll in some key respects: the most obvious of these being that everyone "polled" is 40 years old and was born in Canterbury.

Timeliness is another one: the research was conducted between June 2017 and June 2019. So it was almost all done before the May 2019 Cabinet paper on this year's referendum was published and some of it well before the coalition agreement in which a referendum was first announced. So several questions relate to an anticipated legal age of use of 18, rather than the proposed 20.

But it does signal where reform campaigners need to try and win the argument with middle New Zealand, and how difficult that could be.

The study finds 49.8% of the cohort against legalisation, 26.8% in favour and the remainer "neutral" on the issue. But a near-majority (47.8%) is in favour of decriminalisation and a 42% plurality believes decriminalisation would not increase drug problems in New Zealand, versus only 32% who believe it would.

This is somewhat in line with conventional opinion polling in 2017-18 – people believing that decriminalisation is a lower-risk option than legalisation and regulation. And yet the evidence increasingly is that the reverse is true, that legalisation allows for important regulatory controls that simply removing criminal sanctions does not. In Canada and some US states, actual of de facto decriminalisation regimes saw increases in youth use that stopped or reversed under legalisation.

So legalisation campaigners are talking to an audience that's not necessarily wedded to prohibition, but will need to convince doubters that legalisation is the better, safer option.

But the study's legalisation question also warrants attention. Its proposition is that "Cannabis should be legalised and available for sale to people aged 18 or over, like alcohol and tobacco." Does the comparison with the two problematic legal drugs taint the question?

Legalisation campaigners will need to convince doubters that the regime proposed in the referendum bill is not "like alcohol and tobacco", but in fact considerably stricter. (Which is objectively true.)

The study also shows overwhelming support for medicinal cannabis. More than 83% agreed or strongly agreed that "Doctors should be able to prescribe cannabis based products for medicinal purposes (eg, to relieve chronic pain) without restriction" and nearly 88% agreed or strongly agreed that "Cannabis or cannabis-based products can be an effective form of relief for people experiencing chronic pain or physical health problems." Only 2% of the cohort firmly believed that doctors should not be able to prescribe cannabis products.

But now that we have regulations controlling the production and prescription of cannabis products by fitting them within the existing pharmaceutical regime, does it look like the kind of medicinal cannabis people were thinking of?

Legalisation campaigners will need to convince doubters that the kind of medicinal cannabis (perhaps "therapeutic" is a better word than "medicinal") access they support might not ever happen without a "Yes" vote for broader legalisation.

The two strongest predictors for support for legalisation were regular use of cannabis at some point and use of any other illicit drugs at some point. Māori, people with experience of depressive illness and people with higher educational attainment were also more likely than others to favour legalisation.

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Professor Joe Boden, who did the media duties on the study, is also one of the authors of another academic article on legalisation published this month.

Facing the option for the legalisation of cannabis use and supply in New Zealand: An overview of relevant evidence, options and considerations is primarily a review of the evidence of legalisation in other jurisdiction – of which the authors clearly believe there is not enough.

They do, however state that "[l]egalisation offers some distinct advantages" over decriminalisation, "for example regulated use, products and user education, yet outcomes depend on essential regulation parameters, including commercialisation, and policy ecologies."

The tone sometimes seems to be that of the lead author, Auckland University's Dr Benedikt Fischer, who is not a prohibitionist but has been vocally concerned about commercial creep in North American regimes. The discussion for the article says of any permission for commercial production or distribution of cannabis that:

Based on experiences from other psychoactive substance policy fields, it is most likely that, in both direct and indirect ways, this will contribute to a markedly increased cannabis‐related adverse health and social harm burden in New Zealand under legalisation.

But the only evidence cited relates to alcohol sales. One study cited essentially compares shop-bought booze to home brew, which is relevant in some territories but not in New Zealand, and another looked at ED attendances in the wake of the Sale and Supply of Liquor Act 2012 and found that while the number of visits to liquor outlets increased after the Act, characteristics of drinking sessions that led to ED visits, including the amount consumed, did not change.

I'm not at all convinced on this evidence that the mere presence of business would lead to "markedly increased" adverse health outcomes. Especially under the very tight regulations proposed on use and sale in New Zealand – which the authors note are so strict as to be "questionable" in comparison with the rules on alcohol and tobacco – and given the provisions in the referendum bill that aim to curb market dominance and provide for community enterprise. The authors do, after all, note an absence of "apparent major or ‘catastrophic’ consequences" in even the most commercialised cannabis regimes.

The "hybrid" system in Canada, from which Dr Fischer hails, perhaps had commercial creep baked in thanks to its medicinal regime, which allowed large cannabis companies to grow and push marketing boundaries well before the federal government introduced general legalisation. Indeed, legalisation in Canada can even be seen as a bid to belatedly tie down a burgeoning grey market as much as a liberalisation.

It also seems notable that Canada's model is very popular among Canadians, while Uruguay's wholly non-commercial state monopoly struggles with logistics issues and is unpopular there, even among cannabis users.

All that said, the paper is a thorough and challenging summary of not only the evidence but the arguments for cannabis reform. It's worth your time.

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Oddly, the "Big Cannabis" problem in the Canadian system is basically overlooked in a public discussion paper published recently by NZIER , which offers "some facts and recommendations" ahead of our referendum, but offers scant consideration to licensing. That may be because it was published before the market allocation and licensing provisions arrived in the final version of our referendum bill, but it feels like a big gap – the more so because is bears directly on one of the paper's big conclusions: that cannabis prices will fall under legalisation. That really depends.

Cannabis is cheap to produce at scale, but the collapse in US prices seems mostly related to a level of oversupply that's actually destabilising the young industry. In Washington State, growers are now not only keen on limiting the number of licences, but happy to see the quantity allowed at different licence tiers reduced. Last year in Oregon, where the oversupply is even more prodigious, the government passed legislation last year allowing it to limit the number of licences issued when supply exceeds demand.

And demand for cannabis is clearly not unlimited. In Canada, the very modest growth in demand has been among occasional users and older people, while youth use has declined. The heavy users who consume most of the weed are just doing what they've always done, but more legally. Even in places, like Colorado, where overall use increased a bit more steadily after legalisation, it seems to have hit a hard plateau.

It would be fair to say the designers of New Zealand's system do not anticipate a big increase in production. Indeed, one of the stated aims of our regime is to reduce not only cannabis harms but cannabis production over time. As the NZIER authors observe, this may be incompatible with even the small increase in overall use likely under legalisation.

The NZIER paper also largely ignores the so-called "social equity" features of some US jurisdictions, which are clearly reflected in our bill, which addresses the particular harm suffered by Māori under prohibition. But it offers some interesting insights – especially on the gulf in carbon emissions between indoor-grown cannabis and outdoor. Cannabis production in New Zealand has steadily moved indoors as a consequence of police activity since the 1980s. The difference is strong enough to say that legalisation would be good for the planet.

NZIER also puts a value on the tax windfall from cannabis legalisation: near enough to half a billion dollars.

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Finally, let me link you to something that's not an academic publication or  an economic analysis, but does deserve attention. It's a press release on behalf of Pearl Schomburg, the medicinal cannabis advocate I profiled recently in the Weekend Herald.

After the Herald story was published, Pearl had a lot of people contacting her for help. She was ready for this – we discussed it before I filed the story. As she says in the release:

"Since then my phone has not stopped ringing with patients needing help, most of them elderly. They feel like they have nowhere to turn and fear persecution. It really isn’t good enough. We need access to safe products now."

Yes, there is now a new medicinal cannabis regime: the regulations came into force halfway through the virus lockdown and they're pretty good. But the experience of other jurisdictions suggests that it will take at least three years to get up to speed, for locally-manufactured cannabis therapeutics to make their way through the process and for enough doctors to get comfortable with prescribing.

But some doctors are never going to prescribe, and most "green fairies" aren't going to be able to produce to GMP standard. Yet some of them are producing good, reliable cannabis products – I've seen the results of tests done on the quiet by ESR and I've seen enough patients, Pearl included, using those products as a substitute for bucketloads of pain medications that that were blighting their lives.

The problem is that there are also bad actors and bad – possibly even poisonous – products. And there's currently no way for patients to tell, or for producers to demonstrate their products are as advertised. Even if you believe that the therapeutic potential of cannabis is completely oversold, it's a harmful situation that needs fixing.

Pearl, a great-grandmother, doesn't see the need to draw a hard line between use for pleasure and use for relief, but this part of of the cannabis community really isn't about getting wasted. You're not going to get high off rubbing a balm on your sore bits – but as a cannabis preparation that balm comes with a harsher legal sanction than the $50 bag of buds you bought from your dealer. It doesn't make sense and I don't think it's line with what the public actually thinks.

But I think the right thing isn't going to happen here unless and until there is a "Yes" vote in the referendum. It's not just "vote yes so your grandmother doesn't get busted" – it's "vote yes so she doesn't get poisoned."

PS: If you want more like this, there's a Drug Foundation webinar on Thursday in which Pearl features. You can register here.

1

Speaking as equals: the rise of Know Your Stuff

Five years ago, Know Your Stuff didn't have a name. They were just a group of people from the festival community who began testing party drugs onsite because they'd seen the consequences of people taking substances they couldn't identify or didn't understand. They didn't want to see people in their own culture in distress, or needing medical attention, or dying.

Since then they've grown, taken on a name and a brand and become a key part of the frontline of harm reduction. Until this year, they've had to operate on a wink and a nod, because of the potential consequences for event organisers who allow them on site. This year, that changed: Splore's organisers decided they would talk to news media and be open about Know Your Stuff's presence and why they were there.

The result was this One News report, which features a quick bite of the Splore Listening Lounge conversation I had with Know Your Stuff's deputy manager, Dr Jez Weston. The edited transcript of that conversation is published below.

We don't know what next summer's festival scene looks like, or if there will be one. But if festivals go ahead, I think there's the potential for a return to dangerous substances being sold as MDMA in particular, given likely disruption to international supply chains. If that happens, you'll hear about it first from Know Your Stuff – and their role will be more important than ever. But maybe we'll get that law change ...

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Our first guest represents an organisation I've seen grow from a down-low testing service for mates to an organisation everyone else, including medics and journalists, relies on for accurate information on what's happening with party drugs. So please welcome Dr Jez Weston of Know Your Stuff. Jez, first, a quick explanation for people in the audience who who may not know: what is Know Your Stuff? What do you do?

Okay, we go to a lot of festivals, we set up a tent, people bring us their drugs. And then they can get them tested before they take them. They can find out what they've got and get good advice about what are the risks, what are the impacts, what's going to happen, how to stay safe, in a nonjudgemental, supportive environment. And one of the reasons that works is that we're all festival-goers, all of our volunteers, it's very much a peer-led grassroots organisation. This has grown out of the festival community. It's still very much part of the festival community.

And that applies to you too. You've got a 'doctor' in front of your name, but you came into this as a member of the community.

Yeah. This was set up by Wendy Allison. She was doing it, it must have been five years ago, pretty underground, and I was helping her with some shifts. And I realised, my background, I'm a scientist, and I actually really like doing the science. Someone comes to you with something, it's an experiment to find out what it actually is. And then it's also an experiment to go, here's some advice you can use, and really give people actionable advice.

So what's happened with Know Your Stuff over the past year? Because you've become increasingly prominent, especially for an organisation that does something that presents legal challanges.

We've got two big things at the moment. One is trying to get the legal position clarified, and I'll go into that in a bit more detail later. The other is just growing. Growing really fast – by 30-50% each year in terms of the number of tests, the number of events, the number of volunteers.

In my day job, I work on research commercialisation and investment, and I'm often helping start-up companies go, hey we've got a product, everyone wants it, how do we grow this company to something that can serve that?We're a social organisation but it's exactly the same pathway. How do you put in place management, how do you scale up, how do you deliver process? How you just cope when things are just growing rapidly?

And I guess it complicates it that you've also been part of the political conversation in the past year.

Yeah. I should explain. So nothing we do is illegal, okay? We're not handling the substances, we're not giving any of the substances back. The clients, whoever comes along, they have to do all the sample handling for themselves. Obviously, our clients are in possession, so that's illegal, but hey, they're trying to look after themselves.

The risk comes in a line in the Misuse of Drugs Act 1975:  Section 12 says it's a crime to provide a venue for people to take drugs. Now, does having testing on site mean that you're providing a venue? No one really knows. No one's been to court yet about this. But if someone was convicted for that, then, the festival owners, the people who put on all of this stuff for us, they potentially could get 10 years in jail. Which is crazy.

So that's where the risk is, it's for the people putting on the party. 

Yeah. It's a legal gray area and we've been working with a lot of festivals for quite a few years now. We still can't say what festivals we go to. We can't say up front that we'll be at particular festivals, we're always getting asked, will you be at X, and we kind of have to go, Well, kind of just come look for us, see if we're there. But thanks immensely to Splore, Splore's been a festival that's been the most open about having us on site and making sure that people can find us and know that this is a thing that they can do to keep themselves and their friends safe.

And if people do want to find you, you're up by Wellness.

We're in the Seaview camp site by the Wendy's Wellness Area and if you look for the Orchard Thieves bar, we're just to the right of that. Open from 10 until six o'clock. The quiet times are in the middle of the afternoon, when it's way too hot. If you come along at like five to six and go, "we're going out tonight, we've got shitloads of drugs, five different things we want to test", we'll be like, "it's 6pm, come on mate, seriously". Come before 6pm please.

And part of the reason it takes a little time is that there is counselling goes on here, isn't there? It's not just here's what you've got, off you go.

I wouldn't call it counselling. It's a discussion. Because we're very much speaking as equals. We're not going, well okay, we almost never say to someone, look, this is really dangerous, don't take it. That's not our role. We're going to find out the information about the substance itself, we're going to have a conversation with the people who've got that substance, get an understanding of their level of experience and familiarity and have a conversation about what's going to happen, how can you stay safe, how can you look after each other.

Now another conversation people might find themselves having is with the research team who are studying the impact of what you do, which is partly how you've been able, it was a nice compromise brokered by Chloe Swarbrick essentially, wasn't it? Because New Zealand First stood in the way of a law change.

If you see people walking around in pink hi-viz, that's the Victoria University team. They are doing some independent research into the attitudes to and effectiveness of drug testing. Know Your Stuff, we think it's a great thing, we think we're making a difference, we think we've got really solid evidence to show the impact of what we're doing, but we would say that, wouldn't we?  Having that independence adds weight to the political argument.

New Zealand First, they're an interesting organisation for a whole bunch of reasons. There are people within New Zealand First who are very supportive. There are people within New Zealand First who are taking a very moralistic, in honesty, okay, can anyone tell me the name of the law and order spokesperson for New Zealand First? [Silence from audience.]  Exactly. And yet this one particular guy is having a bit of an outsized impact. He turned up and said, taking drugs is bad, bad things should happen to people who take drugs, up to and including death. And I think that's pretty callous. If I had kids, it's not a situation I'd want them to be in.

But Young New Zealand First at their party conference raised up a request to reconsider their stance. I mean, I didn't even know there was a Young New Zealand First. But having met some of them, they're pretty good guys. And so New Zealand First is kind of going either way, and maybe in some sense is looking for a face-saving way of actually getting on with an effective piece of work that really does make a difference to people's lives. So hopefully that's where the independent research steps in.

We should get on to the News You Can Use. What have you been seeing this season that people should be wary of? What advice can you offer?

Okay, three things. First is, there's just a lot of MDMA in the world right now. But one pill is not necessarily one dose. We are seeing a hell of a lot of pills that are two, three, maybe even more doses than that. And our tech can give an indication of dosage, it's not great on the percentages but it can give an indication – certainly better than just chucking it down your neck. And so if people know, then they can take a half. Maybe not even that.

Other things: there have been a lot of cathinones around in previous years. Cathinones, your bath salts, eutylone,  methedrone, pentylone – we called that last summer's shitty drug, and we have seen some of that mixed in with MDMA. And the health risks from that, it will just make you very agitated, it will keep you awake, and you might want to take more. And if you do take more, then you might end up not sleeping for a very long time.

One of the theories we've got is that nobody wants to buy this stuff, okay, so what we're seeing, it's mixed in with MDMA and so if you do a reagent test – those are the little colour-changing chemicals you can buy from The Hemp Store or Cosmic – with MDMA those give a really black colour. And that indicates there's MDMA in there. That doesn't rule out anything else, and that black colour kind of covers up all of the cathinones, the bath salts. We've got a spectrometer, so we can actually detect those mixtures.

So if you have MDMA and it feels a bit odd, come to us. We can find out what it might actually be.

Third thing, caffeine. People are putting a lot of caffeine in some pills, which kind of surprises me, but then again it's cheap. And you've got these MDMA pills, they've got a lot of MDMA in them, people take them, and they're like, Oh, I don't want to dance, I just want to lie down. Cause you've taken way too much MDMA, okay? So people are putting caffeine in there so people will be able to get up and dance.

And the other mixture we keep seeing claimed, because of that, loads of people bring us pills that say, people have told them, it's MDMA and ketamine. It's not MDMA and ketamine, we've never seen that combination. It's just too much MDMA. You take it, you feel completely monged, you can't stand up. It's just too much. Take less.

Take less. Start low, go slow. You have been in the past year running testing sessions at the Drug Foundation offices in Wellington, outside the festival environment. I know that there are a lot of people in Auckland who would find that useful. Is there any prospect of that happening?

Most of the time we are not at festivals, much as we'd like to be. So we've been running monthly clinics in Wellington CBD, people can come along, test what they've got, what they're planning on taking. Part of Know Your Stuff growing is now we have Auckland teams, we have Christchurch, we have Dunedin.

We would like to have monthly testing at each of those venues, Auckland first. What we haven't got is a venue. And we would love to find somewhere that is relatively central, has a waiting area, and then a fairly private testing area, that's accessible evenings or maybe Saturday afternoons. So if you know of any venues, please come and find us and we'll have a conversation.

Hopes for the future. You want that law change, don't you?

We want the law change. Because then we can be entirely open, and if you come and find us and you look for our signs, they've got the happy-face-sad-face logo on them. It doesn't say, "Bring us your drugs." I would love to have a great big sign, a big flashing sign that says "Bring us your drugs," okay? We would like to be really open and be able to publicise in advance that we'll be at festivals.

The other thing we would like is funding. We run entirely off donations. And if you think about how much money we are saving the country and the health services, if we can avoid even just one helicopter trip, then that would pay for another spectrometer for us. But New Zealand's just pretty crap at funding preventative health care. And I think that's a broader problem than just Know Your Stuff.

Do you think the fact that you now seem to be a key part of the information environment is going to help? Because clearly the health services rely on you as an early warning. Newspapers treat you as a trusted source, and run stories off it, and increasingly seem to get them right. Which hasn't always been the case, has it?

We've had a lot of good coverage from the media. Some of it's been a bit sensationalised, but that's going to happen. At the end of each day, we will catch up with the [onsite] medics.  And we will say, Look, here's what's on site, here's what you might have to deal with at three o'clock in the morning. They're always super, super grateful to have that info.

We talk with our clients and say, Okay, how is this changing your behaviour? And a lot of people say, yeah, I'm going to take less, going to take it more sensibly, going to know what to expect if I'm taking this, won't be so worried if it's kind of weird. But then they say, outside of festivals, it's actually changed my behaviour. Because I grew up in New Zealand where you just kind of necked it and waited for whatever was going to happen. They've been saying that outside of festivals, they're taking a more cautious and respectful approach to drugs. And I think that's probably a bigger win.