A leading pain management specialist says patients with chronic pain are refusing to use medicinal cannabis, even when it provides relief, because they want to continue driving without penalty.
Key points:
- Chronic pain patients avoid medicinal cannabis due to driving penalties
- Calls are increasing for law reforms and evidence-based exemptions for medical cannabis users
- There is an increase of medicinal cannabis use in Australia
Professor Richard Chye is a palliative care and pain management specialist at St Vincent’s Hospital in Sydney. He was also an inaugural member of the Australian Advisory Council on medicinal cannabis.
He believes current driving laws in every state except Tasmania are unfair because they do not test for impairment, but rather the presence of the psychoactive compound THC in a driver’s system.
“I have some patients who say yes, cannabis has worked for them, but they will prefer to put up with the pain than give up driving,” Professor Chye said.
“I think the current laws are unfair because the laws allow patients to drive with opioids. They are allowed to drive with morphine, but not allowed to drive with THC.
“They’re allowed to drive with benzos [benzodiazepines], with Valium in their blood, but not allowed to drive with THC. So, yes, the law is unfair and the law needs to change.”
Inequity in cannabis driving laws
Legalise Cannabis Party MP Jeremy Buckingham introduced a bill into the New South Wales Parliament this month to provide exemptions to the driving laws for registered medical cannabis patients.
He said the current laws which carry fines and driving disqualifications for the detection of THC in a driver’s saliva, blood, or urine only created a perception of safety not based on the reality.
“The data shows that people can drive with medicinal cannabis, not be impaired, and there’s not an explosion in the road toll and traffic accidents associated with the use of cannabis,” Mr Buckingham said.
“We’ve seen that in the United States. We’ve seen that in Canada. We’ve got these social laboratories that have been operating in other countries for nearly a decade.
“They have not seen an explosion in accidents associated with cannabis.
“People can take it responsibly, safely, and we can make sure that the roads remain safe.”
Advocating evidence-based reforms
In Victoria the major parties are supporting a closed trial for medical cannabis patients as part of a push to reform driving laws, and in Western Australia a parliamentary committee has also recommended exemptions for prescribed patients.
Australia is the only country in the world with random roadside THC testing.
At Sydney University’s Brain and Mind Centre, the Lambert Initiative is adding its academic heft to the push for reform of driving laws.
Psycho-pharmacologist Professor Iain McGregor said the research and advocacy centre had conducted about 60 studies since it was established in 2015 with a $33.7 million donation from the Lambert family.
It currently has 12 clinical trials underway, but he said getting volunteers had been a struggle because participants were told they could not drive, even when no longer impaired by cannabis.
“We’ve been drawing attention to that problem to the politicians and the regulators, but also conducting some research on the extent to which cannabis does impair driving,” Professor McGregor said.
This included a driving trial in the Netherlands with healthy patients tested after vaporising cannabis.
“We stuck them in a Volkswagen and they drove 100 kilometres on normal Dutch roads. It was a specially instrumented Volkswagen where we could measure all the fine details of their driving performance,” Professor McGregor said.
“Basically they showed very modest impairment for about three or four hours.
“The impairment would be on a par with something like a blood alcohol concentration of 0.04.
“So they weren’t weaving all over the road and speeding and driving dangerously.”
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Increase in medical cannabis use
Professor McGregor said researchers had also reviewed every study undertaken on cannabis impairment while driving.
“If you’re inhaling cannabis the impairment is mostly passed by about three or four hours after use,” he said.
“If you’re using oral THC in an oil then it tends to be a little bit longer, maybe up to eight hours.
“But a really important point is that if you’re a very regular user of cannabis, as most patients are who are using medicinal cannabis, the impairment tends to be a lot less.”
Despite current driving laws, Professor McGregor said there had been “an explosion” in the use of medicinal cannabis in Australia with more than one million prescriptions written and 300,000 registered patients.
It was mostly prescribed for three conditions — chronic pain, anxiety, and insomnia.
In the last one to two years, he said there had been a huge uptake from 18 to 30-year-olds, suggesting many were moving from the black market to a so-called green market with pharmaceutical-grade cannabis prescribed under medical supervision.
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