After nine months of bureaucratic processes, in 2009, I became and remain the first patient in Australia with my particular Parkinson’s disease (PD) symptoms to legally obtain and use a revolutionary cannabis-based medicine in a three-month clinical trial.
Sativex is not legal in Australia and its importation from Britain cost me $1000. But it did little to ease my symptoms, which was unfortunate not only for me but for the other 80,000 PD sufferers who could potentially benefit from the drug.
There are two glaring problems with this pharmaceutical. First, the psychoactive effects of its 55% THC content are claimed to be balanced by its other active ingredient, cannabinol, which is not psychoactive but has other medicinal properties. However, that was not my experience for I became stoned every time I took it.
This leads to the second problem — that the method of administration is inherently flawed.
Although it is supposed to be squirted onto the inner cheeks from a pump action sprayer, this is difficult to achieve. For one thing it is hard to spray accurately because there is no marker on the on the top of the sprayer to indicate the direction of the spray; the position of the ampoule blocks vision of the open mouth. Unlike aerosol sprayers, pump action sprayers such as Sativex require the user to use some force to ingest the correct dose.
Because the pump often sticks, the amount of spray generated is not an accurate or consistent dose. This is a particularly problematic for PD patients whose symptoms often include atrophy of fine motor skills, making it awkward for them to manipulate the sprayer.
Even if all these obstacles are overcome, there remains the problem that most of the medicine sprayed onto the cheeks runs down into the floor of the mouth and is swallowed into the stomach where it takes some four hours before its effects kick in, then producing a “high” lasting several hours, rendering the patient incapable of any sustained cognitive activity. So, instead of acting when the need is greatest, the drug’s efficacy is highest when it is least needed.
As I thought that my information about Sativex was important news for thousands of PD patients, I sent a letter to the British Medical Journal, the Australian Medical Journal and the Parkinson’s Disease newsletter. None of them ran the piece.
*Graham Irvine is a law lecturer and broadcaster and has recently completed a PhD on the legalisation of medicinal cannabis in New South Wales. Because university theses do not usually attract the attention of the media he has written this piece for Crikey to stimulate debate on this issue.