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The use of cannabis for medicinal purposes in Ireland is edging closer to reality, completing a 177-year 360-degree pivot that, thanks to one man, changed western medicine.
In 1839, Irish physician William Brooke O’Shaughnessy brought cannabis into Europe from India. Seeing beneficial effects the drug seemed to have on relieving pain while in the subcontinent, O’Shaughnessy, having written numerous papers on the drug, thought it well suited for western medicine.
The drug took off and, for around 100 years, its widespread use (crossing the Atlantic, too) was notable throughout the streets of major cities, largely thanks to its pungent smell.
However in the 1930s, US lawmakers decided against it, instigating a ban that spread throughout much of the western world up until recent years.
Pioneered by certain US states voting the drug back into medical practice, it now looks like Ireland will follow suit, returning O’Shaughnessy’s find into the general public.
Coming back
Initiated by Gino Kenny, TD today (1 December), the Dáil will vote on a Bill entitled: ‘The Cannabis for Medicinal Use Regulations Bill 2016’. This proposes to allow patients to buy oils, sprays and tablets made from the drug to alleviate their pain.
Kenny said his reason for bringing the Bill forward was due to a request by a constituent family with a child suffering from Dravet Syndrome. Cannabis oil was an option they wished to pursue, but in Ireland it was not possible.
Since proposing the Bill during the summer, “the response has been overwhelmingly positive”, according to Kenny. It is expected that the sitting Government will allow the bill to pass, a landmark decision.
But what are the medical benefits of the drug? The answer is complicated.
Fruit salad
“Well, the plant itself is really a fruit salad,” said Laurie Mather, emeritus professor of anaesthesia at the University of Sydney, when discussing the drug on the Science Vs podcast last year.
Tetrahydrocannabinol (THC), for example, is the component in the plant that gets people ‘high’. Cannabidiol (CBD) is often used for oils, like the ones Kenny’s constituents are seeking out. However there are many, many more components that make up the popular plant.
“There are hundreds of substances in the plant,” said Mather, but what each substance does is still being uncovered.
For example, there is evidence of pain relief qualities, as well as appetite stimulation qualities. There is also evidence that marijuana can reduce muscle spasms and control vomiting. These are beneficial tools that medical professionals could harness when dealing with, say, cancer patients.
However, these benefits have been questioned, or at least dampened, in particular research papers.
Less clear
For example, UK scientists looked at 79 randomised trials of medical cannabis and its effects across a wide range of ailments.
While most studies showed improvements among the participants, it was hard to tell if this was just chance, given the marginal gains and relatively small pool of tests.
Pain relief was the area where the drug showed the best signs of success, though this lack of tests is largely down to the drug’s classification – it’s hard to test illegal drugs on patients.
“Further large, robust, randomised clinical trials are needed to confirm the effects of cannabinoids, particularly on weight gain in patients with HIV-AIDS, depression, sleep disorders, anxiety disorders, psychosis, glaucoma, and Tourette syndrome,” reads the paper.
Prof Brendan Kelly, professor of psychiatry at Trinity College Dublin, told The Journal that the scientific evidence shows cannabis is bad for mental health, noting “the overwhelming majority” of studies demonstrating this.
Better options
Kelly points to other, better painkillers that would be more suitable to patients.
“Cannabis will never be an ideal medicine for pain relief, not least because there are other non-dependence producing medications which can and should remain first-line agents in the management of pain,” he said.
Though the Irish government seems to agree with Kenny’s idea at the moment, to a degree. Simon Harris, Minister for Health, TD last night said he did not agree with all aspects of the Bill.
“However, on the central objective of the bill (access to medicinal cannabis products), I accept the deputies’ bona fides, share their desire to make progress on this matter and it is clear there is much common ground on this across the Oireachtas,” he said.
“Therefore, while there are elements of the Bill I do not and will not support, I don’t wish to divide the Dáil on this issue and will not oppose the Bill at second stage.”
Kenny, for his part, said despite the risks of cannabis availability on the streets of Ireland, “the pros far outweigh the cons”.
That is something that only time will tell.
“Obviously, under our bill, the person that is ascribed any cannabis-based medicines, they are the only user of it,” said Kenny.
