Emeritus Professor Laurence Mather

The University of Sydney

Emeritus Professor Laurence Mather

"Not many generations ago, most medicines were prepared as mixtures, tinctures and elixirs from natural sources, typically as extracts from plants or animal parts. As pharmaceutical sciences advanced, it was recognized that particular chemicals in those extracts could provide the effects being sought medically.
 
At the same time, laboratory and clinical researchers set about determining how these various chemicals worked to achieve those effects.  Pharmaceutical companies went about providing those chemicals in purer and ready-to-use dosage forms.
 
A prime example is how traditional tinctures and extracts made from opium had to be swallowed by the patient to relieve pain. By the early 20th C, a product called papaveretum, a selective extract of some of the more important chemicals from opium, allowed rapid pain relief by means of injection.
 
By the later 20th C, papaveretum was being replaced by individual pure components, especially morphine and codeine, and provided in a variety of dosage forms, that can achieve equivalent results with less likelihood of side effects, and with the regulation of purity required by contemporary society.
 
During the same period, scientists found that the body has its own set of chemical substances and mechanisms that work to produce the pain-relieving effects which the opium chemicals were being used to augment. However, some people use these chemicals for other than pain-relieving purposes – and this is often referred to as “recreational use” or “drug abuse”.

In attempts to prevent harms from such use, legal mechanisms have been placed to regulate and control the supply and use of such chemicals. By-and-large, these are successful and are accepted by society. Such regulations and controls are part of the body of ‘concepts and tools’ used by a compassionate society for permitting medicines to be used by patients in need.
 
Like opium, Cannabis is the basis of many traditional medicines. However, Cannabis was made an illegal substance in Australia in the mid-20th C, at a time of meagre scientific knowledge about its chemical composition, and certainly no knowledge of how it worked medically. Despite research on its medical use being thwarted, largely as a result of legal sanctions, it has become clear that Cannabis has genuine uses for certain medical conditions.
 
Again like opium, it has been found to work by augmenting a system of natural body chemicals. Unfortunately, the failure to distinguish between recreational and medicinal uses of Cannabis has continued to skew political and societal attention towards the hazards, rather than the benefits, of medicinal Cannabis ‑ and its use is largely still illegal. Part of the problem for changing political attitudes comes from the fact that Cannabis is a veritable chemical ‘fruit salad’, and that the chemical composition is neither easy to provide to patients in a standardised manner, nor certain as to which combinations of chemicals are to be preferred for treating particular conditions.
 
Nevertheless, the evidence from legally-conducted research with various chemical combinations, and from individual patients with a multitude of Cannabis preparations, largely point to the same conclusions ‑ that there is compelling evidence for the reasonable use of Cannabis in many distressing conditions for which conventional remedies are not providing sufficient patient comfort.
 
Surely a compassionate society should be willing to create the legal and moral concepts and tools for adding Cannabis to the list of medicines available to patients in need, and to support medical and scientific research to enable its best use."