Pauline Hanson (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I rise to speak to One Nation's Improving Access to Medicinal Cannabis Bill 2023. Medicinal cannabis has only been legally available since 2016. Since it was down-scheduled through measures like the Authorised Prescriber Scheme, the number of Australians prescribed medicinal cannabis products has increased from a few hundred in 2018 to more than half a million in 2022. This growth clearly shows there is a prominent place for medicinal cannabis products in Australian health care. However, a system which worked quite well for only a few thousand scripts a year is under strain from hundreds of thousands of scripts. Patients have more recently encountered increasing problems with accessing these products, along with other issues like product quality, availability and pricing. These difficulties have resulted in a small drop in prescriptions. We consider this legislation to be a timely response.

Our bill cleans up the poisons schedule listings for medicinal products derived from cannabis and makes them available under schedule 4, meaning they can be prescribed by any doctor or veterinarian. In addition, the bill provides for low-strength preparations to be made available over the counter at a pharmacy or veterinary practice for purchase by adults. The strength of these products is determined by the level of tetrahydrocannabinol¸ or THC, in them. This is the intoxicating compound. All states in Australia now have a one per cent limit on THC in these products, which is still well below the level that could produce intoxication. Such products are commonly called hemp.

Our bill harmonises Commonwealth law with state laws, increasing the level at which products are considered hemp from 0.1 per cent to one per cent. Previously, a hemp classification was based on the species of the plant from which the product was derived: sativa or indica. However, growers overseas have bred new varieties of these plants which are much lower in THC but have higher levels of other beneficial healing compounds. Our bill reflects that a hemp product can only be determined by its THC level.

Perhaps the most important benefit of this bill is that it will help to significantly reduce the cost of medicinal cannabis. By moving it to schedule 4, more doctors and vets can prescribe it, so economies of scale will work in the patient's favour. More crucially, moving it to schedule 4 opens the pathway for listing medicinal cannabis products on the Pharmaceutical Benefits Scheme. A successful PBS listing application usually requires a sponsor with deep pockets who can later recover costs from its patent on the listed product. However, you can't patent a natural plant. There is a solution to this, and One Nation will soon introduce proposed legislation which will enable the listing of medicinal cannabis products on the PBS.

Another important element to increasing access is to ensure doctors, pharmacists and vets are educated about medicinal cannabis so that they are prescribing or selling the appropriate product for a given condition. It would be wise for the Therapeutic Goods Administration to maintain the requirement that medical professionals complete an appropriate medicinal cannabis course before they are able to start prescribing it. This isn't a criticism of doctors, who can only prescribe what's available, but one of the reasons for the recent reduction in medicinal cannabis scripts is that patients feel the product did not work for them. However, this is usually because the wrong product was prescribed for the health profile of the patient.

Our legislation supports Australians who are seeking more natural medicines and medical treatments. The cannabinoids in cannabis are as natural as any other product available. They're found in other plant species and in spices like black pepper and turmeric. They are manufactured by our own bodies and play an important role in the human body's capacity to heal itself. They are also manufactured in the bodies of the pet animals we keep. The full range of these cannabinoids are available in cannabis plants, but that's not all that's in these remarkable plants—there are around 500 other health-promoting compounds, antioxidants, dietary fibre, minerals and trace elements.

As more Australians access medicinal cannabis to treat a wide variety of conditions, state and territory governments will need to have another look at the way they test motorists for intoxication. The purpose is to ensure that motorists are not impaired or present a danger to themselves and others on the road. This should be based not on a chemistry test but on whether a driver is actually impaired, as it is evident that medicinal cannabis products can result in a positive drug test while not actually impairing the person being treated with them.

A final point: our legislation very strictly does not allow children under 18 to access any of these products. With clear evidence that medicinal cannabis is effective in treating a wide range of conditions and with clear evidence that it is in high demand in Australia, it is time to elevate it as the primary healthcare option it should be. One Nation has always put Australians first, and in this spirit I commend this legislation to the Senate.

Anne Urquhart (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

In Australia we have a national classification system that controls how medicines and chemicals are made available to the public. Medicines and chemicals are classified into schedules in the Poisons Standard according to the risk of harm and the level of access control required to protect public health and safety. This bill, the Improving Access to Medicinal Cannabis Bill 2023, is an attempt to down-schedule substances contained in medicinal cannabis products. Furthermore, the bill attempts to remove any requirement for medicinal cannabis products to be accessed via the Special Access Scheme or Authorised Prescriber Scheme.

The Therapeutic Goods Administration are the Australian government authority responsible for evaluating, assessing and monitoring products that are defined as therapeutic goods. The TGA have advised they have serious concerns with both proposals put forward in the bill. It seems that the impacts of the proposed bill have not been carefully considered. It leads me to question how much research and consultation went into the drafting of this bill. The government considers this proposal to be inappropriate, as the current scheduling of these substances is the result of a long and well-considered process based on clinical evidence and expert advice. I am a supporter of the well-considered use of prescribed medicinal cannabis in appropriate circumstances and have been involved in Senate committee hearings inquiring into this matter. I've met and spoken with people who use medicinal cannabis on prescription to treat medical conditions, with positive results.

In late 2019 through to the tabling of the committee's report in March 2020, I was an active participant in the Senate Standing Committee on Community Affairs inquiry into current barriers to patient access to medicinal cannabis in Australia. Subsequent to that inquiry, I worked hard in my home state of Tasmania, along with my colleague Senator Bilyk, to encourage the state government to adopt the recommendations of that inquiry and improve access to medicinal cannabis products for Tasmanians who are suffering and to bring the state into line with other states and territories.

This bill has the potential to undo much of the good work that is being done to give those who suffer from medical conditions access, where the use of medicinal cannabis products is deemed appropriate, to those products by medical prescription. The scheduling of substances contained in medicinal cannabis products is the result of a very careful and considered assessment of the most appropriate pathways to access medicinal cannabis products, based on available scientific knowledge, input from scheduling committees and expert clinical advice. I'm a great believer in science, and we should always look at the science closely.

The impacts of this bill have not been carefully considered and do not reflect expert clinical views. Cannabis, the plant, and THC, a psychoactive component of cannabis, were historically included in schedule 9, prohibited substances, of the Poisons Standard, which severely restricted patient access to medicinal cannabis for many years. A decision to amend the scheduling of CBD to a schedule 4 prescription-only medicine in March 2015 and to amend the scheduling of cannabis and THC to a schedule 8 controlled drug in August 2016 enabled prescriptions of both CBD- and THC-containing products for therapeutic purposes, subject to state and territory requirements.

But this bill proposes to down-schedule medicinal cannabis products from schedule 8 to schedule 4, which would conflict with the scheduling policy framework for psychoactive drugs that has been agreed by all states and territories through the then Australian Health Ministers' Advisory Council. The proposed down-scheduling would not in and of itself have the claimed effect of permitting access to medicinal cannabis products through any medical practitioner. This is because Authorised Prescriber Scheme and Special Access Scheme approvals are required for most medicinal cannabis products, as they are not included in the Australian Register of Therapeutic Goods.

To lawfully supply a therapeutic good that is not included in the register, one of the pathways for accessing unapproved goods, such as through the Special Access Scheme, Authorised Prescriber Scheme or Personal Importation Scheme, must be used. The rescheduling of the products would not change this in any way. So, even if this bill were to pass the chamber, it would not have the effect its proponents seem to believe it would. It's important to understand that the Special Access Scheme and authorised prescriber pathways were specifically designed to ensure both medical expertise and TGA oversight over the use of unapproved therapeutic goods for patients.

These safeguards and this level of medical oversight over the use of unapproved therapeutic goods allow safety concerns to be quickly identified while balancing the importance of ensuring patient access to new treatments. Therapeutics goods that are not on the register can be lawfully supplied only under an exemption authority or approval. This is to strike an appropriate balance between ensuring that therapeutic goods available to Australians are safe and of acceptable quality and making therapeutic goods available to Australians who need them.

The current scheduling of substances contained in medicinal cannabis products was the result of a very extensive process to ensure that the scheduling of substances is appropriate. The proposals in this bill have not undergone such extensive consideration. Another matter to consider is that, because we are a federation, the states and territories play a major role. Each state and territory has its own laws that determine where consumers can access a particular drug and how it is to be packaged and labelled. The standard is given effect through state and territory legislation, and it remains with the state and territory governments as to how they give effect to any decision to down-schedule a substance in their own jurisdiction. This bill includes a down-scheduling proposal to allow cannabis products with THC below one per cent and CBD below 10 per cent to be sold over the counter in a pharmacy or veterinarian practice to a person aged over 18. This is much greater than international practice.

Article 30 of the Single Convention on Narcotic Drugs, 1961, as amended by the 1972 protocol, which is a treaty that Australia is a party to, requires drugs, including cannabis and extracts regardless of THC concentration, to be under medical prescription. So the proposal in this bill would not be consistent with Australian's obligations under the single convention.

Medicinal cannabis is a very fast-developing therapeutic product, not just here in Australia but across the world. There remains much to be done in this emerging area to improve access to safe, affordable and effective medicinal cannabis products, but this bill does not provide for a coherent way forward. It is not the solution to improve access to safe, affordable and effective medicinal cannabis products. It fails to take into account the processes our country uses, the nature of the Federation, the treaties we are signatories to as well as the safety mechanisms we have in place when it comes to the prescription of medicinal cannabis products that are unapproved by the TGA.

It is possible that this bill is the result of frustration as to what some may see as the slowness of the processes that allow the approval of products and their scheduling on the Australian Register of Therapeutic Goods. Therapeutic goods are assessed according to their level of risk against acceptable standards of quality, safety and efficacy or performance. The scheduling of substances contained in medicinal cannabis products is the result of a carefully and considered assessment of the most appropriate pathways to access medicinal cannabis products based on available scientific knowledge and input from scheduling committees and expert clinical advice. Those processes and assessments are there to ensure medicinal cannabis products are safe, effective and meet specific manufacturing and product quality requirements. These processes and assessments take time.

Progress is being made however. At this time two medicinal cannabis products have been evaluated and approved by the TGA and are included on the Australian Register of Therapeutic Goods—Sativex, which is used to treat certain patients with multiple sclerosis, and Epidiolex, which is used for patients with certain epileptic conditions. I have heard firsthand of the great benefits that these have brought to some sufferers of epilepsy and certain multiple sclerosis, and I'm excited by the science and the discoveries that are being made.

As our medical practitioners are increasingly finding, access to medicinal cannabis products in Australia is straightforward and almost 300,000 prescriptions for medicinal cannabis have been written in recent years. Most of these medicinal cannabis products are unapproved therapeutic goods. Through the special access scheme the TGA can approve any medical practitioner to supply an unapproved medicinal cannabis product for an individual patient, typically within just a few days. In addition, under the Authorised Prescriber Scheme, a suitably authorised doctor can prescribe products without obtaining patient-by-patient approvals from the TGA, and, as the evidence base is increasing, more prescribers are accessing unapproved medicinal cannabis products for their patients through these access pathways.

As we learn more and as the science and research is done, more products will become available both as unapproved medicinal products and as medicines on the Australian Register of Therapeutic Goods. I have no doubt there is a lot yet to learn about the possibilities and benefits of these products, but this bill will do nothing to advance them, make them safer or more available.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

It gives me great pleasure to be able to stand and make a brief contribution to the Therapeutic Goods (Poisons Standard—February 2023) Instrument 2023. This particular bill seeks to reschedule medicinal cannabis to schedule 4, allowing prescription by any medical practitioner. Adopting a definition of cannabis that allows higher levels of THC—up from 0.1 per cent to one per cent, which is below the recognised level for any hallucinogenic response and harmonises common law with state law—allows whole-plant cannabis product with a limit of one per cent THC and 10 per cent cannabinoid to be sold over the counter at a chemist or by a veterinarian to persons over the age of 18 and retains soliciting for hemp as a product with existing limits unchanged.

As I said, this bill provides for medical practitioners to be allowed to prescribe medicinal cannabis for human and animal applications, with supply made through any chemist for humans and through veterinarians for animals. The bill offers three categories. If the product is hempseed and hempseed oil containing 75 milligrams per kilogram or less of cannabinoid oil and 10 milligrams per kilogram or less of THC, it is a food product and excluded from the schedule. If the product is above the allowable levels for food and below one per cent THC and 10 per cent CBD, it is a chemist- and vet-only product. If the product is above one per cent THC or 10 per cent CBD, the product is a prescription product only.

In government, the coalition delivered the biggest reforms to medicinal cannabis, which have changed the lives of so many Australians, through the Narcotic Drugs Amendment (Medicinal Cannabis) Bill in 2021. The bill amended the Narcotic Drugs Act to support an innovative Australian medicinal cannabis industry for the benefit of Australian patients. It did so by reducing the burden of regulation in the licence assessment process by providing for a single medicinal cannabis licence to replace the previous suite of licences required for cultivation, production, manufacture and research. It also provided greater certainty to businesses and reduced duplicative processes by providing for the majority of licences to be permanent. It also reaffirmed our commitment to patient availability for safe, legal and sustainable supply of cannabis-derivative medicines.

The coalition's medicinal cannabis bill replaced the obligation for separate licences for any cultivation, production, manufacture and research activity with a single licence. Significantly, the majority of these single licences are perpetual, thus reducing the regulatory burden. The coalition's bill maintained the current specific supply pathways for medicinal cannabis, including for clinical trials under the Therapeutic Goods Act and approvals or authorities under the act. They were supplemented by additional powers for medical and scientific research and additional clinical trials, provided that they did not involve administration to humans, and the development of a reference standard.

The coalition also introduced a separate regulation-making power to prescribe additional supply pathways anticipated to ensure compliance with the goods manufacturing requirements under the Therapeutic Goods Act. Reminding us all of the reasons for the medicinal cannabis regulatory scheme, our bill also included a clear statement of its purpose and an assurance that medical cannabis products would be available to patients for therapeutic purposes. These changes maintained the careful balance that the act strikes between facilitating cultivation, production and manufacture of a cannabis drug and implementing Australia's obligations under the Single Convention on Narcotic Drugs to safeguard against illegal practices to provide for safe and sustainable pathways for patient access to medicinal cannabis therapies.

Whilst the coalition appreciates the work that One Nation has done with this bill and the intent of this bill, there remain some serious concerns around the details that would allow the scheduling of a medicinal cannabis product to a schedule 4 item. The coalition has some further concerns about how this rescheduling would allow access through a medical practitioner, so at this time the coalition is not in a position to support this bill.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

The Greens have a long history of campaigning for medicinal cannabis to be accessible and affordable to the Australian community and we welcome reforms that assist in achieving that goal. We're very proud to be here in the Senate as a party and as a political movement that has worked alongside advocates for the greater access to medicinal cannabis for decades, as well as campaigners who are working right now to bring us to where we need to be in relation to the broader based legalisation of cannabis more broadly as part of proper drug law reform. The Greens were part of the push in this place to start treating medical cannabis as a therapeutic drug, and I want to pay a really heartfelt tribute in my contribution today to our former leader Richard Di Natale, who championed medical cannabis and drug law reform more broadly.

We know that medical cannabis is an important drug. It is an important drug that is used to treat or alleviate mental health conditions. Let's say this really clearly: medical cannabis is a medicine, and it should be accessible in an affordable way for people who need it. It is not good enough to say, 'This is theoretically available, if you can jump through the many hoops that exist and if you can afford the many additional charges that come with it.' That does not, in fact, constitute an actual framework that is accessible to the people who actually need it. We also clearly know from the evidence that has been given by so many in our community that this medicine is used to relieve serious health conditions, such as epilepsy in children and adults; to treat the symptoms of multiple sclerosis, chronic pain and chemotherapy, particularly chemotherapy-induced nausea; and, of course, to ease the various symptoms and experiences of those during palliative care.

We in the Greens knew that Australia needed to make this drug available as a therapeutic drug, but most Australians who need medical cannabis still have no real way to access it. It was very clear, from the work that Richard did and that advocates have done for a very long time, that we needed to make this available as a therapeutic drug. Yet we sit here in 2023 in a reality where most Australians who need medical cannabis still have no real way to access it. As I said, if there is a theoretical legal pathway, that is fine, but, if that legal pathway to access a medicine is full of institutional and administrative barriers and is, critically, very expensive, then it is not practically available to the broad swathe of the community that actually need it. This is resulting in a reality where there is still a black market in Australia for medical cannabis because the government has not taken the necessary steps to make it fully available and to treat it as a legitimate therapeutic drug. I'm very happy to be joined in the chamber by Senator David Shoebridge, who is doing fantastic work on the broader question of the legalisation of cannabis in Australia and the ways in which the federal government must engage itself in that work.

The Senate enquiry that examined access to medicinal cannabis in Australia, which reported in 2020, made a series of landmark recommendations to significantly improve the lives of Australian patients. The Community Affairs References Committee, which was led by Dr Di Natale in his former role as our health spokesperson, heard many of the failings of the current arrangements for accessing legal medicinal cannabis products in this country. The committee recommended that, if current arrangements were not sufficiently improved in the next 12 months, the government should consider establishing an independent regulator for medical cannabis. It has now been 36 months since that recommendation was handed down. The arrangements have been improved in that period of time, but they do not go far enough. People are still relying on a black market to access medical cannabis simply because they cannot afford it—not because they don't need it, not because they don't qualify for it, but because they simply cannot afford it, this critical medicine that they may need in the management of their epilepsy, in the management of their multiple sclerosis, in the management of the terrible nausea that comes with chemotherapy and to ease them in that palliative phase of health care. They can't access it, because they can't afford it. The government must provide a pathway for medicinal cannabis to be supplied under the Pharmaceutical Benefits Scheme. We in the Greens know this, and the community knows this. The current pathway through which people are required to travel is too expensive and too complicated.

In the previous sitting week, I moved a second reading amendment to the Therapeutic Goods Amendment (2022 Measures No. 1) Bill 2022, which we considered. This amendment called on the government to ensure that affordable medicinal cannabis products are made available to all patients who require them for therapeutic use and to consider and implement the outstanding recommendations of the Community Affairs References Committee's 2022 inquiry. I put that amendment to the Senate at the previous sitting, and what was the result? Both parties voted it down. This is really not good enough, folks. We've got a situation where people need access to medicine, and those people have taken the time to give evidence to a Senate committee. That evidence is often given in the context of really serious health conditions. They shared with this place what needs to change, and that committee said these changes need to come into place in the next 12 months or the government needs to act. Thirty-six months on, we have had a little bit of action but not enough, and we have seen no leadership from the government in this place on that issue, when there are recommendations sitting before them which they could so easily enact.

It is far past time for the Labor government to ensure that medicinal cannabis is affordable for the Australian public. The lived experience and the research support it. So do all the families who actually need to access it and who have cried out during so many of these investigations and reports. The Greens will continue to fight for access to and affordability of medical cannabis, alongside our broader work to legalise cannabis for all Australians, which Senator Shoebridge will shortly outline for the chamber.

Lastly I will say this for everybody who may be watching this debate feeling a bit frustrated by the inaction of this government: I think there is deep, deep cause for hope here. We saw many community campaigners across the country push for years to see the rescheduling of MDMA and psilocybin for the treatment of PTSD and depression. The TGA and the government of the day dug their bloody heels in on that one, year after year. The Greens worked with the community—and I particularly want to give a shout-out to the wonderful campaigners, scientists, advocates and mental health professionals at Mind Medicine Australia for their continued advocacy on this issue—and we won. In February, we won. The TGA was forced to do a 180 degree turn on this and to reschedule psilocybin and MDMA for the treatment of PTSD and depression, opening up an incredible field of practice for the treatment of those really, really debilitating conditions. So this can be done. Continued pressure will see change. By continuing to work together with the community, the Greens are committed to seeing an accessible and affordable pathway for medicinal cannabis for everyone.

David Shoebridge (NSW, Australian Greens) Share this | Link to this | Hansard source

I rise to commend the words of my colleague Senator Steele-John and the work that he's done in this space over a number of years. The Greens firmly believe that recreational and medicinal cannabis should be legalised. I note that this Improving Access to Medicinal Cannabis Bill 2023 is seeking to provide greater access to medicinal cannabis. The Greens are on record as repeatedly pushing for greater access to medicinal cannabis, and I commend the senator for bringing the bill to the house. The truth of the matter is that this parliament and different state and territory parliaments have legalised access to medicinal cannabis, but done so in a way that only people with wealth can access legalised cannabis through the current rules. So, yes, if you have chronic pain, if you have untreatable nausea, if you have untreatable depression, if you have a variety of extraordinarily debilitating illnesses where medicinal cannabis has been proven to be of enormous benefit and you have money then you can access legalised cannabis in Australia. That's the combination. But if you have untreatable chronic pain; untreatable, ongoing nausea; terrible effects, potentially, from an array of traditional medicines to deal with pain and nausea, you go to your doctor and your doctor says, 'I think you could be best served by cannabis. Here's a prescription for cannabis.' You then go to the pharmacy and you realise it is $500 a month. You are on Centrelink. You're not getting legalised cannabis. You are not getting the medicine you need to help you. That's the state of the law in Australia at the moment. It's the state of the law and it's a reality, and that's the reality we need to fix.

In my work as the drug law reform spokesperson for the Greens, the issues with medicinal cannabis have kept coming back and back to my office as we have been moving to legalise recreational cannabis in this country. Indeed, I was at a public rally, only in the last few weeks, in regional New South Wales and a woman came and saw me and said that she had had a cannabis prescription from her doctor for the better part of two years. She had had one round of cannabis prescription. She'd gone to the pharmacist and paid the $300 to $400 to get the cannabis prescription. It was amazingly beneficial. It was everything she wanted. It took her off a variety of prescription painkillers. It was amazingly effective but she could only afford it once. Since then she had had to go back on the drip of the highly addictive, deeply troubling traditional painkillers under a traditional prescription, which she felt dumbed her down, gave her nausea, affected her appetite, affected her life, because she couldn't afford the legalised cannabis. Then she said that, in fact, on occasion she had just been getting black market, recreational cannabis and that had been really helpful and had been having the same effect. She lived in regional New South Wales. She had a choice then. She could get the black market, recreational cannabis, which was having the same health benefits as the legalised cannabis at a fraction of the cost, but then she couldn't drive. And if she couldn't drive she couldn't go see her doctor, she couldn't go shopping, she couldn't catch up with her family. So, again, because of the ways the laws operate, she then stopped taking the recreational cannabis and went back onto the prescription medicines again.

There's this toxic mix of broken laws in relation to cannabis that are all founded on this damaging political consensus amongst the Labor Party and the coalition—

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Big pharma.

David Shoebridge (NSW, Australian Greens) Share this | Link to this | Hansard source

and big pharmaceutical; I accept that interjection—that say we need to continue to criminalise cannabis in order to drive the profits of the pharmaceutical industries and in order to drive the moral agenda of the ALP and the coalition. And who's paying the cost of that? People who desperately need access to medicine, that's who's paying the cost of that.

So, yes, let's get on and radically reduce the cost of legalised cannabis. Let's come to this position that no matter what's in your wallet, no matter who your mum and your dad are, no matter what property you own, if you go to a doctor and a doctor says you need legalised cannabis then you should be able to get it, afford it and treat your chronic pain, treat your health conditions. That's the way the world should operate in a country like Australia.

Then when we do that, let's also legalise cannabis. Let's get the police, the courts and the criminal justice system out of something like 80,000 Australian's lives a year, who are being prosecuted, criminalised, dragged through the criminal justice system, because they are caught possessing one or two joints. Let's do that. Let's take what is perhaps a $25 billion-a-year market out of the hands of criminals and organised crime and bikie gangs. According to the National Criminal Intelligence Commission and the data they have about the prevalence of cannabis use in the country, that's the size of the annual market for recreational cannabis at the moment: $25 billion a year. Let's take that out of the hands of the wrong people, who use it to corrupt our political system, to corrupt our police and to corrupt our courts. Let's take it out of their hands; let's legalise it; let's put safety controls on it; let's put truth-in-advertising controls on it; let's put advertising controls on it; let's deal with it like we're rational human beings. Then we could also reap some $28 billion in tax revenue in the first decade of doing that. Let's maybe deal with this like grown-ups.

I note Senator Steele-John's comments on how we've finally got the TGA to permit MDMA and psilocybin to be used from 1 July to deal with otherwise untreatable depression and PTSD, and that's a major step forward. But it's almost as though we haven't learnt from the legalise cannabis debate. We're seeing reports today that getting access to MDMA or psilocybin under the system that has been set up by the TGA is going to cost patients something like $25,000 a year because of all the restrictions that apply to those drugs. Because they remain class 1 drugs, patients have to set up all of these additional checks and balances and further reporting protocols every time they seek to get access to a medicine that could save their lives. Again we're going to see that, yes, this medicine is available, but only for those with the wealth to access it.

Think about the veterans with chronic PTSD who don't have that money and who will be going to their psychiatrists with the hope that they can get one of these prescriptions come 1 July. Psychiatrists will write out the prescription and give it to them, and then they'll say: 'By the way, have you got $25,000? Because that's what it's going to cost you,' with them on a veteran's pension, surviving with all their troubles. By legalising this in such a narrow way for medicinal purposes and then putting all of these constraints on it and making it unaffordable, you're offering false promise. So let's get on and legalise medicinal cannabis seriously. Let's make it available to everyone who needs it, regardless of what's in their wallet. Let's try and come together as a chamber and as a parliament and actually legislate for good.

Peter Whish-Wilson (Tasmania, Australian Greens) Share this | Link to this | Hansard source

I also rise to make some comments and add my support to the excellent contributions from Senator Steele-John and Senator Shoebridge. I'd also like to start by acknowledging the work of many advocates over many years to get medicinal cannabis to where it is today—particularly Senator Richard Di Natale, who was a drugs and alcohol doctor before he went into politics. He's continuing his work in that area, post politics. I remember him speaking about it relentlessly in this chamber and having meetings for all parliamentarians in the committee rooms with people who were suffering terrible illnesses and calling for the legalisation of medicinal cannabis. I would like to acknowledge the LNP for taking their first steps in this regard, especially in relation to the limited access to medicinal cannabis we have today.

I remember, as the agriculture spokesperson for the Greens at the time, the irony of seeing former minister Hunt removing restrictions for the growing of medicinal cannabis in Australia solely for the export market. We were able to grow cannabis to create CBD products and THC products, and to sell into this massively burgeoning export market. But we weren't able to sell those Australian-grown products to Australian patients, which was obviously a ludicrous position to be in. I remember his media release specifically saying that this is one of the biggest growth markets in the world in terms of high-value agricultural products. At a very similar time we were seeing Canada and other countries remove restrictions and legalise cannabis, and it seemed so ironic that Australian patients couldn't access it at all, legally. But that has changed. There is limited access.

For those Australians who don't understand how it works—it's still remarkable how many don't know that you can access cannabis legally—you need to go to your GP, and your GP needs to then, essentially, recommend you to a specialist group of doctors, who often do their consults online. An example company would be Tetra Health. A number of specialist doctors around the country have done what's required by the TGA to be able to prescribe cannabis, but many GPs just don't know about it. I've had discussions with a lot of really good GPs, a couple of whom are close friends, and they say: 'Peter, we don't have time. We are under the pump every day, with waiting lists of up to six weeks just for common colds, COVID and a whole range of things. We don't have time to go and do the course to be able to prescribe this.'

If you get a GP that is even onside, they will recommend you to a series of specialists. The GP has to provide a very specific medical reason as to why you should have access to medicinal cannabis. If you get that referral, you then go through a process where you're assessed, usually by a nurse, and you have to fill in a number of forms. Then that assessment gets passed on to a doctor who is a specialist in the area. Then what happens is the doctor will work with you over a period of time in an assisted therapy. They'll prescribe cannabis to you based on their consults with you, which can be quite extensive, and they will then have regular catch-ups with you to make sure that the medicine that they're prescribing is working for you. That's the feedback loop.

But it is really expensive. These doctors will charge a one-off fee just to start the process. I think it's at least $300, and that's without even paying for your cannabis. As Senator Shoebridge so eloquently put it, it's not accessible. It's not accessible to ordinary, everyday Australians. Senator Steele-John or Senator Shoebridge—it may have been either one; they're both doing fantastic work in this area—asked the TGA at the last estimates how many Australians are currently legally on medicinal cannabis. Over 300,000 Australians have accessed the scheme, but we know that it's estimated at least 800,000 Australians are using cannabis products. There's a massive gap there of half a million Australians who are using black-market products that aren't regulated, and the sole reason for that is they don't have the money to afford the medicinal cannabis scheme. We've seen good first steps, and I do thank the previous government for the work that they've done on getting it to this stage.

I would also like to throw my support behind the comments made by both my colleagues in relation to MDMA and psilocybin. This has been a long road. I would also very much like to thank Mind Medicine and a number of other advocates for their leadership on this issue. Australians shouldn't be denied the treatments and therapies that they need. The thing about this is that it's very similar to medical cannabis in that, if you're lucky enough to be eligible for this treatment now, it's very specialist and very expensive. There are a number of bottlenecks that we need to get through. I was recently on a conference call with Mind Medicine, with 300 or 400 other Australians who are interested in this trial—many of them doctors, by the way. They did recognise there would be bottlenecks, for example, around who could prescribe these products, how much they would cost and what that would look like. It's very early days, and I would urge the government and the TGA to get through these as quickly as possible, because we know there are people who desperately need this treatment.

What Australians don't understand around MDMA and psilocybin is that the results have been so stunning in trials overseas in showing how quickly this treatment can work. It's also an assisted therapy. You don't get given an MDMA medicine script from your doctor. You go and work with a psychotherapist, usually a highly trained psychiatrist, who, at the moment, under the current TGA rules, which were announced in February, needs to register with the TGA, which is another process in itself, and we're not quite sure what it looks like. These trials have been so stunning in their success that often it takes only two assisted therapy sessions for people like veterans with severe PTSD or for people with end-of-life illnesses who are suffering significant anxiety. Thankfully, many of us are not in that cohort of Australians who have been diagnosed with a terminal illness and are suffering pain, but the mental pain and stress, not just for them but for their families who are dealing with this, can be extraordinary and significant and debilitating. A couple of assisted therapy sessions for people with these illnesses can make a significant difference.

We are not quite sure how it works, but there is a lot of evidence that psilocybin, for example, and MDMA can essentially rewire the synapses in your brain that are failing. This is also for another cohort of people who are classified as terminally suicidal people, people who have got to the point in their life where they are literally going to take their own lives—all existing therapies have failed. These drugs have an incredible ability to rewire your brain. It involves the plasticity of how your brain works. For some people, parts of their brain have literally switched off. They do not work. These drugs can connect those synapses. I have seen videos of it, using medical technology and looking at scans of brains. It literally lights up parts of the brain that have died in many people. Working with a trained psychiatrist, they are able to literally bring people's brains to life.

There has been a lot of stigma around the use of these drugs for many years. The whole war on drugs—crikey, we could talk for many, many hours about what a waste of money, time, energy and human life that has been. I want to make this really clear. If you look at the Greens policy on drugs and you go to our website—I invite all Australians to do that—where we talk about decriminalising and legalising drugs, the very first sentence says, 'We recognise drugs can do harm.' That is why we need to take a harm-minimisation approach to the use of drugs. We also recognise they can do a lot of good, such as in the correct application of things like psilocybin—magic mushrooms—and MDMA, but this whole stigma around the war on drugs has essentially cut off the head of the medical application of these drugs for so many years. It is great that we are at least taking the first baby steps to explore the potential of these drugs. It is a whole new frontier of medical science and a very exciting one. I know my medicine—many of their followers are budding graduates in psychology, psychiatry or medical who want to get into this field because it offers so much promise.

We are talking about people with very severe illnesses for whom nothing else has worked, and that is essentially why the TGA approved this. If you read the announcement on their media release, they said, 'We accept that other therapies have not worked, and by definition, we need to give this a go.' Of course, that raises the problem that, because there haven't been phase 1 to phase 3 trials of some of these drugs in Australia, we do not have the information. We can learn from the trials that are happening overseas, which are very promising, but because of the inertia and inaction in this country for so many years, we do not have that data. These trials will be a live social experiment to provide that data for us. I think this is going to be extremely valuable. The same applies to medicinal cannabis. The 300,000 Australians out there on this medicine and working with doctors who are trained in this area will provide us with valuable information that, I hope, will propel us to the next stage.

The other thing that we very rarely talk about is the potential for our agricultural communities. I am sure there are senators in this room who know producers currently of medicinal cannabis or hemp. Hemp is generally used for industrial applications and productions and has been used for thousands of years, as has cannabis, but hemp can be used for CBD products. Basically, your brain has cannabinoid receptors. I don't know whether senators know that, but it's actually the most common receptor in the human brain. Why do our brains have cannabinoid receptors? Obviously we've evolved that way. We know these drugs can actually light up parts of our brain, and we can use the CBD from hemp. However, the higher-value applications are in the growing of cannabis for either CBD oil, which has no THC in it—you can take it and you're not going to get high, but it has very valuable properties for people with a number of illnesses—or THC products.

These are high-value products for our agricultural communities. We have a number of growers in Tasmania. I think Tasmania is currently the biggest producer of cannabis. Much of it is still exported overseas. Senator Urquhart knows some of the producers in her area in the north-west of Tasmania. I've been down and visited the compound of Tasmanian Botanics, outside Hobart. When I sat down with them they had a number of complaints about how the process works, which I don't have time to go into today. Clearly we're still getting this right, and there are things we can learn from overseas about the legalisation of drugs. Tasmanian Botanics produces products that are now available through the Australian scheme, but the company admits that these products are really expensive and hard to access. And of course if we do legalise these drugs completely they obviously will be able to grow these as well. But we do see overseas that there are a number of growers in northern California who were growing illegally for many years and the government essentially sat down and worked with them to feed them into the legal scheme, and they became regulated. I think it's been a big success.

It's very encouraging that we're having a discussion today about how we can continue to advance this very exciting frontier of medicine that I think's going to open up huge possibilities. I hope also, for human development, that we can start seeing our world differently, that we can start seeing each other differently and that we can start exploring this frontier, but it's got to be done the right way. I think the bigger debate is about legalising cannabis and finally walking away from this terrible war on drugs that has literally achieved nothing. It's available on every street corner. We have people going and buying cannabis and other products in car parks or in dodgy circumstances. We have people who are on highly addictive drugs and have addiction issues, which is a health problem, and they are dying because we're not assisting them in the way we should. These people need our help. They don't need to be put into a criminal system where essentially they're condemned for the rest of their life—not being able to get a loan, not being able to get a job. We're creating a subclass of people in our society. So the Greens are very pleased to be debating this bill today.

Debate adjourned.