{'fraction_non_alphanumeric': 0.022054556006964595, 'fraction_numerical': 0.014799767846778875, 'mean_word_length': 5.1996402877697845, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Should doctors be allowed to prescribe cannabinoids for pain in Australia and New Zealand?

Clarification is needed around the use of cannabis in chronic pain. In Australia and New Zealand, general practitioners are routinely faced with patients who smoke cannabis for ‘so called’ medicinal reasons. Criminal drug laws in all Australian States continue to prohibit the possession, cultivation and supply of cannabis – even for medical purposes. In Australia, a parliamentary committee is recommending that the New South Wales Government amend legislation to allow the medical use of cannabis by patients with a terminal illness and those who have moved from HIV infection to AIDS (Legislative Council, 2013). The recommendation, if adopted by the Government, will allow patients with specific medical conditions certified by their specialist treating medical practitioner to possess and use up to 15 grams of dry cannabis or the equivalent amount of other cannabis products and equipment (Legislative Council, 2013). The inquiry by the Legislative Council’s General Purpose Standing Committee No. 4 was established in November 2012 to examine the efficacy and safety of cannabis for medical purposes. The Committee believed that people who are at the end of their life and take measures to either relieve their severe pain or stimulate their appetite should not be criminalised (Legislative Council, 2013). The medicinal use of cannabis has been much debated in New Zealand. It has been estimated that 13.4% of those between the ages of 16 and 64 years in New Zealand use cannabis (United Nations Office on Drugs and Crime, 2006). In New Zealand, the use of cannabis is governed by the Misuse of Drugs Act 1975. Unauthorised possession of any amount of cannabis is illegal. In 2006, Metiria Turei from the New Zealand Green Party proposed the ‘Misuse of Drugs (Medicinal Cannabis) Amendment Bill’, whereby cannabis would be allowed for medicinal use (New Zealand Parliament, 2009). The bill was defeated. Calls are being made for the legalisation of cannabis, citing its compassionate use for alleviation of a number of ailments. The Law Commission’s Issues Paper on ‘Controlling and Regulating Drugs’ recommends those suffering from chronic or debilitating illnesses be able to use cannabis under medical supervision, particularly where conventional treatment options have proven ineffective (Law Commission, 2010). Pressure is being placed on the judicial system to condone its medicinal use. In March 2012, Victoria Davis was discharged without conviction by Judge Tony Zohrab on charges of cultivating cannabis. She grew the plants to help her husband cope with phantom pain. The New Zealand Medical Association does not oppose partial decriminalisation of the use of small amounts for medical purposes, provided it can be shown that no harm would result. In New Zealand, all injured patients are covered by accident compensation insurance. The Accident Compensation Corporation in New Zealand has been requested to fund synthetic cannabis (nabiximols or Sativex®) for chronic pain, where conventional treatments have failed or are not tolerated. At present, Sativex® is approved for use as an add-on treatment for symptom improvement in unresponsive patients with spasticity due to multiple sclerosis under strict medical supervision after ministerial approval has been granted. The types of synthetic cannabinoids used are shown in Table 1.