With the Carr government recently announcing a trial of the medical use of cannabis to start before the end of the year, it was surprising to see so little resistance to the idea. Perhaps people actually realised that this is not the first step towards legalisation of the drug, but rather an act of compassion towards those people who have not been able to find assistance through traditional medicine.

The medical uses of cannabis have been recognized for thousands of years. Physicians in ancient China used it to relieve constipation, loss of appetite and pain during childbirth. With the development of synthetic drugs in the 20th century, herbal remedies in general fell into disuse.

In 1999, as part of the NSW Drug Summit recommendations, the NSW Working Party on the Medical Uses of Cannabis was asked to advise the NSW Premier on the possible medical uses of cannabis and cannabinoid drugs.

Cannabis is a term that refers to the plant or products of the cannabis sativa plant (such as hash). Cannabis may be smoked in a joint, or in a waterpipe (bong). It may also be eaten, but smoking is the more common method because it is the easiest way to achieve the desired effects. We use the term cannabinoids to refer to pharmaceutical quality drugs that act in the same way in the body as some substances in the cannabis plant, such as THC.

Two examples of cannabinoids are nabilone, which is THC in a capsule and is available in the UK for medical uses, and dronabinol, which is synthetic THC and is available in the US. At this time there are no cannabinoid drugs readily available in Australia.

Cannabis and cannabinoids are useful to relieve symptoms of illnesses, but do not cure the underlying disease. Many of the uses of cannabis for medical purposes revolve around its ability to reduce pain and nausea, stimulate appetite and perhaps reduce muscle spasms.

It has been agreed that cannabis or cannabinoids may be useful for some persons with the following conditions: HIV-related and cancer-related wasting; pain unrelieved by the usual pain-relief treatments; neurological diseases such as multiple sclerosis; spinal cord injuries; and nausea and vomiting in cancer patients undergoing chemotherapy.

Although there is a large amount of anecdotal evidence, and some good research evidence, about the usefulness of cannabis for these conditions, there is a lack of good controlled evidence. Further research is needed to examine the benefits that cannabis and cannabinoids appear to have for these illnesses.

There are a number of barriers that face this trial. One of the most difficult will be around the smoking of the drug. Smoked cannabis is unlikely ever to be prescribed in Australia because a smoked plant product will not satisfy the requirements for registration as a therapeutic good. Registration is required if cannabis is to be medically prescribed. How this and other problems will be solved will make for interesting reading in the daily newspapers over the coming months.

Remember: if you do not want any negative consequences, do not use the drug, and no matter how many times you have used a substance, never be blas?

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