The year we are about to depart has been a frustrating one for the New Zealand medicinal cannabis community.
A cluster of companies established to produce and distrubute legal cannabis products ran up against a regulatory scheme that sometimes seemed unworkable and informal growers and green fairies struggled to see a place for themselves after the narrow failure of last year's cannabis legalisation referendum. Patients faced products disappearing from the shelves or seized at the border. A strengthened sense of common cause was probably the best thing to come out of the year.
Happily, a series of recent developments – most of them just this month – means it looks like 2022 will be a better story.
A week before Christmas, Rua Bioscience got the first New Zealand-produced medicinal cannabis product, a 100mg/ml CBD oil, past the extremely onerous "minimum quality standards" administered by Medsafe – nearly two years after the Medicinal Cannabis Scheme came into effect.
Three weeks before that, NUBU Pharmaceuticals cracked another barrier in the regs – the unrealistically low microbial count required for dried flower products – by gaining approval to import and distribute an Australian whole cannabis product to be used as a tea.
Notes on preparation of such a tea and a warning that the flower, "does not meet the minimum quality standard for product intended for use by inhalation" have since been added to the page listing products that meet the minimum quality standards. The product, ANTG Eve, grown by Australian Natural Therapeutics Group, meets Australian standards for use with a vapouriser , so patients will presumably make their own decisions there.
ANTG Eve itself is an interesting strain. It's 17% CBD with negligible THC content, but unlike most other high-CBD flower, it's an indica, rather than a sativa, strain (hemp is sativa). The terpenes in indica strains theoretically produce a more calming, sedative effect, especially in the absence of THC, and patient reviews here (free registration required) suggest success with anxiety, inflammation and chronic pain. It may turn out to be most useful for child epilepsy patients – if you recall the battle that Katy Thomas had this year to import a British CBD oil that seemed to work best for her epileptic son, that was an indica product.
ANTG is also talking up work by Australian cancer researcher Dr Matt Dun with the Eve strain. Dun tested Eve – in what form it isn't clear – in vitro on leukaemia and glioma cells and says he found the high-CBD strain more effective in killing cancer cells than high-THC strains. The cytotoxic potential of various combinations of THC and CBD has previously been demonstrated in vitro and in mouse models, especially for glioma, where treatment options are scarce and clinical evidence is limited. (That may change with a new Phase II trial at the University of Birmingham, funded by GW Pharma, which owns Sativex.)
I gather NUBU plans to keep on working on the microbial count limits – presumably aiming to demonstrate that limits intended for products like pharmaceutical powder inhalers shouldn't apply to use in vapourisers, whose tiny ovens typically run at 200º C or more.
There have been some other local developments: Rua shareholders vote on January 22 on a proposal to acquire New Zealand-based Zalm Therapeutics. The deal looks to primarily be a means to establish a relationship with current Zalm shareholder Cann Group of Australia. Rua would be able to take over Zalm's existing supply contracts with Cann Group and send its own genetics across the Tasman to be grown in Cann's indoor facility.
Does it seem ridiculous that it's still difficult for Rua to grow in New Zealand – and outdoors? Yeah, it basically is. But they've just brought on board E3C – East Coast Cannabis Company – to manage an outdoor growing trial. E3C, a grassroots grower collective, have been operating on the wrong side of the line and they've been brave being so visible and so vocal thus far, so this is a really big deal for them.
Had last year's cannabis referendum gone the way, groups like E3C would have lined up to go legit – not many people in the cannabis community actually want to be criminals – and it's great that Rua continues to offer this kind of opportunity to skilled growers.
For now, while the politicians either take fright or try and co-opt cannabis into their culture war, New Zealand Police seem to be showing herculean levels of discretion. They shouldn't have to but it's a very good thing they do.
Another of the larger ventures, Cannasouth, had a particularly difficult year, but this month finally did the $10m deal to acquire all of its cultivation subsidiary.
Finally, Helius CEO Carmen Doran published this pretty upbeat column about the year ahead, which notes "a long and hard haul" to this point, but argues that "thankfully the industry has now moved into the most important phase – delivery." It also mentions Rua – one effect of the difficulty with regulations has been to make the local cannabis industry even more collegial – and points to Helius subsidiary Hale Therapeutics completion of a pilot study aimed at developing a CBD treatment for dogs.
The second Helius-sponsored MedCann summit is set – virus willing – to go ahead in February. It looks like there'll be a fair bit to talk about.
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Amid all this talk about industry, I think it's important to acknowledge the work of patient advocate Gareth Duff in getting his prescribed medications – from Tilray and Medleaf – fully funded for a year. Not by Pharmac, or even ACC (who seem to accept applications from clients, but never approve them) – but the Ministry of Social Development.
This isn't a particular beef with Pharmac: it's not constituted to fund unapproved medicines and it's possibly not worth trying to change that. But people like Gareth and Pearl Schomburg, who have found themselves far more able to manage their lives and severe, chronic conditions with a handful of cannabis products than with the punishing loads of pharmaceutical medicines they previously required, are actually saving the system a lot of money. There needs to be a much better way of supporting them.
Gareth has written about it in a long post here on Facebook.
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Meanwhile, hanging over all of this is the maddeningly opaque process of amending international drug control treaties in line with 2019 World Health Organisation recommendations on reclassifying cannabis to acknowledge its medical use.
I've written an explainer about what's happening for the New Zealand Drug Foundation. Done well, this could establish a global set of rules and practices for cannabis cultivation and production. Done poorly – and some of the signs are not promising – it will be a missed opportunity to treat cannabis in a more rational fashion and will be simply ignored by more progressive countries.
Parts of the process have been relatively transparent, but since it moved on at the beginning of the year to the International Narcotics Control Board, a UN-aligned agency that doesn't even publish minutes of its meetings, it has fallen into a black hole. NGOs, who do most of of the thinking about drug regulation, have been entirely shut out.
Researching and writing the Drug Foundation piece reminded me, not for the first time, that the international system of drug control is a strange and self-sustaining business, in which the worst actors frequently have the most control. Change comes hard.
Happy New Year!