THW Require the Provision of Cannabis in Any State Funded Medical Program

The focus of this debate is quite specific. In many countries in the world the recreational use of Cannabis is so widespread as to be beyond debate. In other countries it’s use in any form is so vigorously pursued by the authorities that there seems little chance of anything resembling decriminalization, let alone legalization, happening within the foreseeable future.

However, there is one issue that is not in dispute; that marijuana has a palliative effect in the treatment of several diseases, many of them severe and some terminal. However it is rare in any nation (there are a few, such as Canada[i]) where governments are required to offer it as a drug in government funded medical programs and pharmacies.

Some context is useful here. There are many - possibly most – drugs in pharmacies around the world that, if taken inappropriately, can function as narcotics and can be perilous. Morphine is the most obvious example of such a substance – its illegal counterpart, heroine, is an extremely lucrative street drug. It is almost definitional about drugs that they can be helpful or harmful, depending on how they are taken and by whom. Even relatively benign painkillers such as codeine and vicodin have the capacity to be addictive and dangerous if taken in the wrong way and yet are freely available in pharmacies around the world.

This is why the word “require” is so important in the motion. This is not a debate on the legalization of cannabis for recreational use, rather it’s primary focus is the refusal of governments to make use of a freely available drug with a proven medical benefit. Government might well point out that since the production of the drug is illegal in much of the world and its importation is illegal in many of the countries where such a regulation would be imposed.

There would, of course, be issues such as the control of circulation should such a measure to be introduced. There are other practical concerns, but these have been addressed in those jurisdictions where the medical use of marijuana has been legalized. That said they are all jurisdictions in which the recreational use of the drug is widespread and either decriminalized or so commonplace as to not even be a matter for comment, let alone prosecution.

There are many commodities in which there is both a legal and illegal trade so from the point of view of the proposition, there is precedent. However, it may not be a comfortable one as the analogies are mostly trades such as guns and similar controlled products.

[i] Health Canada, ‘Frequently Asked Questions – Medical Use of Marihuana’, hc-sc.gc.ca, 13 June 2005, http://www.hc-sc.gc.ca/dhp-mps/marihuana/about-apropos/faq-eng.php

 

Title 
Cannabis has many medical properties, notably the alleviation of suffering in chronic diseases. It should therefore be freely available
Point 

Cannabis has been used for medicinal purposes for at least 5,000 years most frequently as an analgesic, that is to say it reduces pain. It also stimulates hunger and can be used as an anti-emetic to control nausea and vomiting. As the DEA Administrative Law Judge Francis L. Young noted in a 1988 ruling[i], there is no evidence of a fatality resulting from the misuse of cannabis. Indeed the Dutch government currently permits doctors regulated by its Ministry of Health and Welfare to prescribe cannabis to their patients. Further, the Dutch state has licensed a pharmaceutical firm to provide cannabis of a guaranteed level of purity to pharmacies and medical professionals.[ii]

There are accounts and studies of its successful application to treat the effects of chemotherapy as well as its palliative[iii] use in MS and AIDS[iv]. For governments to turn their backs on a perfectly useful drug simply to prove a point is confusing at best and petulant at worst.

[i] Docket No. 86-22. “OPINION AND RECOMMENDED RULING, FINDINGS OF FACT, CONCLUSIONS OF LAW AND DECISION OF Administrative LAW JUDGE.” FRANCIS L. YOUNG, Administrative Law Judge. 6 September 1988.

[ii] Bedrocan BV home page, 15 November 2011. http://www.bedrocan.nl/

[iii] “Cannabinoids as antioxidants and neuroprotectants.” Espacenet patent search. 07 October 2003. http://worldwide.espacenet.com/publicationDetails/biblio?CC=US&NR=6630507&KC=&FT=E&locale=en_EP

[iv] “Cannabinoids as antioxidants and neuroprotectants.” Patentstorm. 07 October 2003. http://www.patentstorm.us/patents/6630507/fulltext.html

Counterpoint 

Government has a role in establishing what is an acceptable level of behaviour within society. Full in the knowledge that some people will use any substance responsibly and others less so, governments make decisions to protect their citizens and to show a lead. It is the settled will of most people in most countries that cannabis is not a drug they consider acceptable for use in a modern society. Furthermore, there are plenty of other drugs that can be used for all of the uses Proposition has identified. Legalizing cannabis for medical use would send out the message that it is safe to use when all practical evidence suggests that the social, if not the medical, ramifications are anything but safe. Proposition need to demonstrate a medical use for cannabis that cannot be met by existing pharmaceuticals.

Title 
All drugs can be used for a variety of purposes some appropriate some inappropriate that’s a matter of choice, treatment should be based on medical reality
Point 

Any drug, legal or illegal, can be used sensibly or it can be abused. If society bases its decisions on the medical provision of drugs on the presumption of abuse the shelves of most drugstores would be empty. The idea that the burden of proof should be set at demonstrating that nothing else can achieve the same results is absurd – let’s ban Codeine because Aspirin works just fine. Drugs that have similar effects are distinguished according to the speed, duration and efficacy of those effects, in addition to the drug’s side-effects. Different individuals experience the pain-relieving effects of aspirin in different ways. A wider range of individuals may experience a longer lasting reduction in pain if taking codeine. Similarly, an even larger number of individuals respond positively to cannabis.

The reality is that we trust doctors to make judgments on what is a sensible course of treatment, not politicians and certainly not a hysterical media.

As the law currently stands, politicians are stopping medical professionals from making decisions in the best interest of their patients because nobody wants to be seen to blink first. California and Nebraska already blinked, as have Austria, Canada, Spain and Germany as well as other nations. A failure to recognize this fact is simple political cowardice[i].

[i] http://en.wikipedia.org/wiki/Medical_cannabis#National_and_international_regulations

Counterpoint 

Of course all drugs can be abused but introducing one into the system full in the knowledge that it will be abused is an entirely different matter. On the basis of the balance of probabilities, the moment any government says that cannabis is safe to use and, more than that, beneficial to health then every pothead in that jurisdiction has an excuse.

The only way the War on Drugs can work is if prohibition is applied universally. We expect doctors to work within the law and the government, along with medical governing bodies, has a role in determining what it is appropriate to prescribe and what is not[i].

There are no situations where society simply stands back and leaves it to individual clinicians to act without guidance. They act within a framework that gives primacy to clinical need but does not ignore the wider social implications. Society regulates when a doctor can rules that someone is incapable of work or needs surgery at the expense of the state. In this particular regard, governments feel that society is best served by not adding cannabis to the pharmaceutical melting pot.

[i] Comment. “Kent Doctor Richard Scott Warned Over Faith Discussion”. BBC. 23 May 2011.

Title 
For governments to refuse treatment on the basis of an unreasonable assertion is cruel and blindly ideological
Point 

The current legislation on drug use in most countries was delivered without canvassing medical opinion and under the influence of public hysteria and moral panic. Seemingly logical but flawed theories linking the use of “soft” drugs to later use of “harder” varieties (cocain, amphetamins) have often been used both to justify and to promote drugs legislation. The apparent sense of these arguments belies the fact that they have been repeatedly disproven[i].

Lurid, prurient portrayals of the catastrophic consequences of narcotics use in the mass media are frequently used to back up arguments that drugs- even cannabis- are so dangerous that even carefully controlled medical applications are unacceptably risky.

It is clearly the case that when any substance has a proven medical benefit it should be available for prescription. Legislation already exists in most countries to contain the possibility of misuse of prescribed drugs.

However, it is clearly the case that politicians are avoiding this issue not because there is medical doubt on the matter but because they are incapable of reaching a logical conclusion for fear of hysterical – and easy – headlines. To withhold treatment  from patients who need it on the basis that a tabloid will run a ‘Soft on Drugs’ story the following morning is the height of irresponsibility.

[i] Degenhardt, L, et al. “Whoare the new amphetamine users? A ten year prospective study of young Australians. Adiction, volume 102, 8, p1269-1279. August 2007. http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2007.01906.x/abstract;jsessionid=90232042DE3BB4456F9DE6F41F29BFBF.d03t03

Counterpoint 

Ultimately, in most countries where this is even under discussion, politicians run away from this issue because there are no votes in it. The people don’t want it and that view must be respected.

Drugs policy is, ultimately driven by a standard of what the people in a democratic nation consider appropriate; a couple of drinks after work on a Friday is okay, getting stoned on a regular basis isn’t.

Governments have a responsibility to set out a moral code that is acceptable to the broadest possible spectrum of the society they represent. If they accept that cannabis can be used to alleviate suffering in patients then why not accept that it is okay to drink at work. Both substances have a similar pain relieving effect, both have similar negative effects. It is easy to envisage, on the basis of the proposition side argument given above, that an individual may claim that alcohol does more to address his various aches and pains than aspirin or codeine. Society works because there are limits.

Title 
In most countries where there is an acceptance of the medical value of cannabis it is fairly easily available, this would simply condone its recreational use
Point 

At a time when governments, along with health professionals, are trying to restrict the use of legal drugs such as alcohol and nicotine, giving the use of cannabis the sanction of government approval would take health policy in a direction that most people do not wish to contemplate.

Effectively, such a change in policy would announce, ‘We’d rather you didn’t drink or smoke but it’s okay to get high’.

In most nations where this discussion is even happening the personal use of mild narcotics is ignored by law enforcement. However, legalizing the use of drugs in any way says to the world at large, ‘this isn’t a problem, do what you like’.

The production of drugs ruins lives and communities. Any attempt to fully legalise marijuana for medical use would only be effective in western liberal democracies. There is a high probability that it would incentivise increased production of the drug in states where it remains illegal. For the reasons given above, legitimatizing cannabis’ use as a medicine would increase or entrench its use as a recreational drug Restrictions on cannabis production would place the market under the control of criminal gangs. As a result, cannabis growing would continue to be defined by organized violence, corruption, smuggling and adulteration of the drug itself.

Legitimatising cannabis use via state legislation ignores and conceals the human suffering caused by the production of drugs in both developed and developing states. .

Moreover, many organized crime networks prefer to grow and sell cannabis over other, more strictly regulated drugs. It remains highly likely that the legal market for cannabis that the state proposes to create would become a target for organisations attempting to launder the proceeds of crime, or pass off tainted marijuana as medical grade forms of the drug.

Counterpoint 

There is compelling evidence that people are more than capable of making the distinction between the use of a drug for recreational and medical use[i]. The long term effects of using alcohol or nicotine recreationally have been demonstrated to be fatal; the same cannot be said for cannabis. Further this is about using the drug in a medical setting under the supervision of medical professionals.

As Opposition has conceded, this is something that already happens. As societies, we condone the use of far more powerful drugs on a daily basis. This is a clear example of a situation where politics is ignoring reality out of expediency. This is not a proposal for vending machines to sell crack but for the medicinal use of a drug with a proven track record.

[i] Gary Langer. “High Support for Medical Marijuana”. ABC News. 18 January 2010.

Title 
By expanding the legal use of the drug, it simply makes the illegal, recreational use easier as there’s a greater supply
Point 

If the drug were made available, it would need to be grown somewhere, stored somewhere and sold somewhere. Increased supervision of pharmacies and users would be required, in order to guard against the possibility that medical cannabis might be sold on for recreational purposes. Although other pharmaceuticals have narcotics effects, none has the marketability, or market share of cannabis. Many legal types of pharmaceuticals already form the basis of criminal empires and this move would exacerbate that.

Moreover, the increased visibility and mobility of cannabis within the economy will make it easier for determined criminals to hide or obscure the origins of cannabis produced illegally. Individual citizens will be less likely to consider cannabis use that they are victim to as being illegal. It will become harder and more expensive for the police to enforce restrictions on the use and production of cannabis for recreational purposes.

It has been well argued that “drugs are not a threat to society because they are illegal; they are illegal because they are a threat to society”[i]. Legalization in any form will be misconstrued and the health effects will be damaging[ii]. Even if side proposition can demonstrate that the health effects of cannabis are negligible, the risk of incentivizing increased production of cannabis in foreign territories and increased trade and transfer of cannabis at home is simply too high for the state to accept.

[i] Charles D. Mabry, MD, FACS, Pine Bluff, AR. “Physicians and the War on Drugs: The Case Against Legalization”. Bulletin of the American College of Surgeons. October 2001.

[ii] Hillary Rodham Clinton, JD, US Secretary of State and US Senator (D-NY) at the time of the quote, stated the following during an Oct. 11, 2007 town hall meeting at Plymouth State College

Counterpoint 

Ultimately there is a clear difference between the medical use of a drug, the banning of which is both harming patients and is against the wishes of many societies and allowing a free-for-all. As a society we regulate the use of other products to ensure that they are not available to minors or open to abuse.

Clearly there would need to be regulations and, equally clearly, sometime those regulations would fail. However, that is true of all regulated product and the blanket ban isn’t producing terribly impressive results at the moment.

There is compelling evidence of the palliative effects of cannabis as well as popular support for its medicinal use; good policy should not be bound by a reactionary response to the simple mention of the word. There are side-effects to the use of almost any drug but they are relatively benign in this instance compared to many alternatives.

Title 
By promoting the use of soft drugs in any context, encourages young people down a slippery slope toward harder drugs
Point 

Part of the attraction of cannabis, especially among younger users is its appeal as a ‘forbidden fruit’. Removing that would mean that other, harder drugs would be sought out to fulfill the same need to rebel.

A government sanction on a drug with a proven tendency to effect memory and other neurological functions would still hold open the door to other, more dangerous, drugs as a form of rebellion. In this regard the continued ban on cannabis – and the relative tolerance of the breach of that ban – sends out a clear message of ‘this far and no further’.

Any signal that this narcotic is acceptable simply increases the stakes.

Counterpoint 

Government policy on this issue has long been confused. When it is perfectly acceptable for politicians, celebrities and other public figures to admit that they have broken the law and face no sanction, it is time for the law to change. Virtually all of the societal problems caused by its usage are directly as a result of its illegality. None of those problems speak to its role in a medical setting.

When not under the threat of tabloid headlines, opinion leaders from across the political spectrum accept that this makes sense[i]. The difficulty is that policy makers only accept the fact after they’re in office, not while they’re facing election. The use of the word ‘Former’ in pronouncements on this subject is noticeable

[i] Lyn Nofziger, former Press Secretary to Ronald Reagan, wrote the following in the foreword to the 1999 book Marijuana RX: The Patients' Fight for Medicinal Pot, by Robert C. Randall and Alice M. O'Leary

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