Pubdate: Thu, 12 Jun 2014 Source: Independent (Malta) Copyright: 2014, Standard Publications Ltd Contact: http://www.independent.com.mt/ Details: http://www.mapinc.org/media/2884 Author: John Cordina 'IF A DRUG WORKS, LET US USE IT' Former health minister Godfrey Farrugia is adamant that he had every right to propose the medical use of non-smoked cannabis products or synthetic derivatives, despite Parliamentary Secretary Chris Fearne's insistence that such requests were not for politicians to make. In comments made to The Malta Independent, the Zebbug family doctor confirmed that the government's parliamentary group had been informed of his intentions before he went public with his proposal in Monday's parliamentary sittings. But Mr. Fearne's reaction, made in comments to the Times of Malta, was that the government would only consider such a proposal if a request was made by industry or a professional body, and insisted that it was not up to politicians to make such a request. Dr Farrugia's partner, fellow MP Marlene Farrugia, took to Facebook to hit back at the parliamentary secretary's suggestion, writing that "politicians can come up with any reasonable request on behalf of the people they represent." She also insisted that the parliamentary secretary's assertion that politicians should not come up with such suggestions was "outright stupid" and represented "arrogance par excellence." The former health minister concurred, stating that Mr Fearne's statement "is an unbecoming comment from a professional colleague." Months of research preceded proposal When contacted, Dr Farrugia emphasised that as a former minister, a family doctor with 28 years' experience and as an MP, he felt he had every right to make his proposal, which, he emphasised, was based on extensive research. He revealed that he first started to look into the matter when he was Health Minister, a post he vacated when a cabinet reshuffle was carried out last March. His interest in the medical use of cannabis products or synthetic derivatives was sparked by his official visit to Israel in late January, which served to discuss cooperation between the two countries on health. At his request, Dr Farrugia had received a presentation on the medical use of cannabis in the Middle Eastern country, which is arguably a world leader in the field: while recreational use of the drug remains illegal, it is utilised for various medical purposes. The MP then carried out his own research into the topic, continuing to do so even after the reshuffle took place. The therapeutic use of cannabis - or its active ingredients, which are known as cannabinoids - has been the subject of continued medical debate in the past few decades, although the topic has proven to be controversial. Dr Farrugia's own approach can easily be described as cautious: he is only advocating the use of cannabis products or synthetic derivatives where they are proven to be beneficial. He said that he was not ready to advocate their use for conditions such as Parkinson's disease, as research into the matter was not yet conclusive. Cannabinoids can serve as appetite stimulants, anti-emetics and anti-spasmodics, and can also have some analgesic effects, and one of their first approved medical uses - which Dr Farrugia is in favour of - - is the treatment of nausea and vomiting for patients undergoing chemotherapy. Dr Farrugia is also in favour of using cannabinoids to address appetite loss in HIV/AIDS patients. Of course, medications to address nausea and appetite loss already exist, but as is the case with every form of treatment, they may not prove to be effective with every patient. The medical use of cannabinoids, Dr Farrugia explained, could provide a second line of treatment which could help ease the suffering of patients undergoing treatment or palliative care. "If conventional treatments do not work, and there is a drug, which is available on the international market and which works much better, let us use it on these patients," he exclaimed. Preventing abuse Dr Farrugia stressed that he has sought to make sure that the medical use of cannabis would not pave the way for abuse. He rules out recommending smoked cannabis for medical use: his proposal covers synthetic derivatives or cannabis extracts. Synthetic derivatives have actually been used for decades: the US Food and Drug Administration had approved two synthetic cannabinoids in pill form - dronabinol and nabilone - for medical use back in 1985. A cannabinoid mouth spray also exists, but Dr Farrugia is not yet advocating its use because its approval for medical use is not as universal. According to Dr Farrugia, synthetic cannabinoids should be only prescribed by consultants. To further reduce the risk of abuse - an inherent risk with all prescribed medication - he recommends that prescriptions should be limited to as short a period as reasonably possible, such as a single cycle of chemotherapy. As things stand, the medical use of synthetic cannabinoids appears to be legal, subject to the approval of the Medicines Authority, although the law might need to be changed if cannabis extracts are to be utilised: the Dangerous Drugs Ordinance has no stated exception to its ban on cannabis and "any extract or tincture thereof." But the law presently makes an exemption for the medical use of cocaine and morphine, albeit in preparations compounded in such a way to prevent the feasible recovery of the controlled substance in question. Adding cannabis to the list, on the basis of scientific evidence, is perhaps hardly controversial, particularly in line of the government's plans to decriminalise drug possession. When asked, Dr Farrugia said that he was not planning to file a private member's motion on the issue, but reiterated that the issue should either be looked into by the Medicines Authority, or perhaps included in the upcoming white paper on decriminalisation, even though it was technically a separate matter. - --- MAP posted-by: Jay Bergstrom