The Experts - Undisclosed Agendas

When they got invited to provide their views on Medical Innovation Bill to the parliamentary portfolio committee on health, the medical and legal experts drew virtual lines on the sand. There was consensus on the need for consideration of medical cannabis, but little effort was made to hide self-serving agendas.

Experts or no experts!

The experts who met Committee members on May 28, 2015 presented legal and medical viewpoints that included graphic images and professional experiences. Most said research into medical cannabis is needed. At the end of the session there was total confusion and anger, with the politicians more subjectively wiser than when the Bill was first tabled in Parliament by the late MP Mario Oriani-Ambrosini.

Verifiable information that we have received indicates that one of the experts, Willie Pienaar, a psychiatrist and associate professor at Stellenbosch University, confessed that morning not to have known exactly what he had been summoned to talk on. But when he got to it, he talked of his days managing psychiatric patients. After his convoluted presentation, the professor concluded by posing ten questions that he needed answered before consideration of the Bill. The questions included:

• Do we need more effective treatments for the named disorders and thus allow progress and treatment outcomes?
• Do we truly know what should be researched? What are the focus disorders?
• What specific products work for each named disorder?
• Can our current system police and regulate manufacturers to produce for medical purposes only?
• Can medical use of cannabis produce foreseen and unforeseen results?
• The definition of cannabinoids in the Bill doesn’t include synthetic drugs – should we amend this?
• Can commercialization and industrialization terms be clearly defined?

He then immediately proceeded to inform the MPs that he was giving the Bill his seal of approval. This confused the politicians with one honourable member loudly wondering; “You say overall yes to the Bill, yet you raise a lot of questions that we should go find answers. How do you then arrive at an overall ‘yes’?

These experts were supposed to provide answers, but not bombard the Committee members with questions and challenges.

While Prof. Piennar displayed ignorance on what was expected in his presentation, his colleagues from the South African Medical Research Council (SAMRC) came choreographed to communicate their case seeking cash injection into their coffers. Presentations and their responses to questions were concluded with indirect or direct pleas for more money for research into medical cannabis.

Two of these experts then pointed the obvious, that most painkillers in the market are highly addictive and abused. Similarly worrying, although appearing to have escaped the politicians, was a revelation by Prof. Solomon (Solly) Rataemane that some of the cases before the Health Professions Council of South Africa involve physicians themselves getting addicted to pain-medication that they prescribed to patients.

In a matter-of-fact-tone, another SAMRC expert stated that it is common knowledge opiate drugs are addictive, hence the fear that allowing the use of cannabis for medical purposes would compound the addiction and overdose problems that the doctors are already struggling with. However, an international anti-narcotic chief, Dr. Lochandra Naidoo, was quick to ‘clarify’ to the Committee members that opiate drugs are not “addictive when used to alleviate authentic pain".

The politicians did not ask the doctor to explain what he meant by ‘authentic pain’, so we did. In response to our email, Dr. Naidoo wrote; “Medical practitioners need to screen high risk patients and closely supervise them. Most other patients do not get addicted when used for the right indication.”

That response did not even come close enough to an explanation on what authentic pain would be according to the learned doctor. Dr. Naidoo must have missed a study that found that the most commonly abused controlled pharmaceutical in the US were painkillers – all of which were opioids. Topping the list were hydrocodone, Methadone, Xanax and OxyContin. The study further found that there were 785 reported deaths in 2007 in Florida (one State alone) that were directly attributed to Methadone addictions and overdoses.

So why did Dr. Naidoo cunningly withhold vital information from the politicians? The answer could lie in the good doctor’s other day job - being the founder of Jullo Foundation, an addiction treatment centre in Durban and having been a member of the Opiate Advisory Board of South Africa between 2006 and 2008. So could Dr. Naidoo have been out to protect his interests?

Methadone for instance is more than a pain medication. It is also used as “a maintenance anti-addictive and reductive preparation for use by patients with opioid dependence.”

In his presentation, Dr. Naidoo introduced what he called an authoritative image of the damage to the brain caused by cannabis. The ‘holes’ in the brain imagery were taken using Single Proton Emission Computed Tomography (SPECT), a system that has made Dr. Daniel Gregory Amen the wealthiest psychiatrists in the world.

SPECT: The images the MPs were never meant to see...

What he however failed to disclose to the committee members were the other brain images taken by the same technology. He also did not disclose that Dr. Amen’s techniques have been declared ‘unscientific’ by numerous experts including Dr. Robert Burton, a former chief of neurology at Mount Zion – UCSF Hospital. Amen’s technique was also discredited by several other studies that we came across. Simply stated, the holes Dr. Naidoo displayed to the politicians could have been caused by other factors and not necessarily smoking cannabis. Some experts have gone as far as comparing Amen’s techniques to a 19^th Century phrenology that was declared bogus.

Just three years ago, in a thoroughly sourced report, The Washington Post lined a battery of experts in the field who all seemed to agree that Dr. Amen was simply selling hope and belief to the venerable with no scientific value. Dr. Naidoo selectively passed the same to politicians who he literally impressed with his various previous positions.

With Dr. Naidoo’s subjective view and without providing complete information, it was therefore easy to find Patrick Maesela, MP, declaring; “we need to make sure there are no holes in anybody’s brain…”

Other than Dr. Naidoo, an act that could not have been covered by various audio recorders in the room was that of the Deputy Director General of the department of health. As he concluded his PowerPoint presentation that discouraged the legalisation of raw cannabis - big pharmaceuticals must be allowed to process the weed and determine the dosage and cost – he displayed the drug Sativex.

Sativex, a drug manufactured by the UK’s GW Pharmaceuticals, is claimed to contain all the ingredients (compounds) found in raw cannabis. So technically, using the Sativex oral spray is the same as smoking cannabis, but the DDG quietly implanted its image on the heads of Committee members. Is the department of health planning to introduce the drug while at the same time barring cheap natural products?

We raised the question in an email to the department’s spokesperson, Joe Maila. We asked if he could confirm if it were the official department’s policy to licence Sativex for distribution and sale in the country while prohibiting every other possible avenues. Weeks after our email was confirmed received on his iPhone and desktop, no response ever came to us.

When we reached him on his cellphone on the morning of Youth Day (June 16), he curtly told us, “Mister, if you have nothing to do, don’t disturb my peace. Let me enjoy my Youth Day.”

Would it be surprising to soon see this wholly-cannabis drug, Sativex in the drug stores? One thing that the department may not be considering is the ultimate cost to patients. In New Zealand, one of the countries that has licensed its sale, an average annual prescription cost about US$16,000 (R.195,000). That is an expense normal patients would not afford. What shall be next? Would GW Pharmaceuticals then demand ownership of all cannabis products in the country? It would be interesting to obtain a copy of Sativex’s patent.

Some sobriety is indeed needed in consideration for this proposed legislation. Emotions and corporate greed should be set aside.

Other than the Committee chairperson, Mary-Anne Lindelwa Dunjwa, who appeared to remain composed and unmoved by the pseudoscience presented by the addiction doctor, the parting words surely came from the IFP member of parliament Narend Singh.

Singh signed off; “I wonder if the good doctors can say let’s ban cough syrup in SA because it’s addictive, let’s ban benzene because people smoke it, let’s ban petrol because people sniff glue. Also, I wouldn’t want us to leave this meeting with the misconception that the prime mover of this bill, the (late) Hon Ambrosini, was under any influence by anybody when he put this bill on the table. He suffered from cancer, and it’s because of his own research that gave rise to this bill.”

• For those interested in listening to the entire presentations by the experts to Parliamentary Portfolio Committee on Health:

                           Part 1

                           Part 2