Jay Kuten: Marijuana debate needs clear minds

Against: Harete Hipango's reply lacks fact-based reasoning. Photo/file

In elementary school we were required to memorise some poems, among them Rudyard Kipling's If. I can still recall a few lines ...

"If you can keep your head, when all about you are losing theirs and blaming it on you, if you can trust yourself when all men doubt you, yet make allowance for their doubting too ... "

Though modern PC critics might deplore Kipling for his jingoism, his overt imperialism and his racism — he gave us "the white man's burden" — his words are still relevant. The heads being lost are those conveying the henny-penny of the sky's collapse were we to pursue a rational science-based policy on medical cannabis.

The argument in favour of taking cannabis from under the penumbra of dangerous drugs — the Misuse of Drugs Act (1975) — and placing it within the safeguards of the medical pharmacopeia lies squarely within the conventional medical standard. That standard, one any physician must respect with each prescription, is the risk-to-benefit ratio — in other words, the weighing up of potential benefit as against possible harm, side-effects etc.

Of late, although my TV watching — except for the news — is only a few hours weekly, I have noticed an increasing frequency of one traffic advert. It's the crash of a car driven by a cannabis smoker depicted using a device that increases potency.

I am no fan of conspiracy theories and put it down to probable coincidence until I read on their website that the NZ Transport Agency acknowledges a purposive campaign against cannabis driving.

That this campaign comes at a time of a national dialogue about medical cannabis is deeply concerning. Particularly as even those charming "ghost chips" or "my balls are in your hand" adverts — ads against alcohol driving showing no consequential crashes — are currently seldom broadcast.

Direct effects and side-effects are important for understanding public health implications of these two — cannabis and alcohol.

According to Statistics NZ, 84 per cent of Kiwis use alcohol at least weekly, while 14.6 per cent use illicit cannabis, although frequency for the latter includes sporadic use.

In the United States, 49 per cent of traffic fatalities involve alcohol. The statistics for cannabis in traffic fatalities are not available but, even in a worst-case scenario, the proportions of 84 to 14.6 usage would suggest a much lower rate for cannabis, if any.

This raises the question of the political import of the NZTA campaign — particularly when Labour put forward its terminal illness cannabis bill up against the Greens' bill to medicalise but not decriminalise medical cannabis, supported by 78 per cent of New Zealanders.

Who then are these repeated images of crashes, out of proportion to fact of hazard, designed to persuade?

Perhaps it's politicians, like our local MP Harete Hipango. Ms Hipango, whom I commended for her opposition to seabed mining, replied to my inquiry as to her vote against medicalising cannabis in a manner I found wanting as to fact-based reasoning.

Her reply, a self-serving dish of politician-speech (including a dismaying gratuitous inquiry as to whether I voted for her) amounts to two things — (1) shooting the messenger by finding Green MP Chloe Swarbrick's presentation of her bill too "emotional"; and (2) the need for scientifically proven evidence of the proper use of medical cannabis.

Emotions run high on both sides of this subject. Ms Hipango uses purple prose to claim "destruction wreaked by addiction to cannabis" — the latter controversial, with scant evidence beyond anecdotal.

We might all endorse the need for clinical trials that would permit a better science for medical cannabis. The problem is that this is a Catch-22 offer — as long as cannabis is illegal, the necessary clinical work cannot go forward. I'm sure Ms Hipango knows this, as she wrote she had decades of experience as a lawyer.

I just wish we could have a reasoned conversation about medical cannabis, without the politicians putting doctrinaire thumbs on the scales.

Jay Kuten

Jay Kuten is an American-trained forensic psychiatrist who emigrated to New Zealand for the fly fishing. He spent 40 years comforting the afflicted and intends to spend the rest afflicting the comfortable.