Pubdate: Thu, 12 Jun 2014
Source: Independent (Malta)
Copyright: 2014, Standard Publications Ltd
Author: John Cordina


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 

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.
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