ACC is being called on to change its approach to the funding of medical cannabis products, with advocates saying the current process is cruel and outdated.
That process is forcing some people into the black market to illegally purchase cannabis to help relieve pain.
One man spoken to by the Herald, who did not want to be named, said that after ACC refused his request to fund pain-relieving cannabis products, he was forced to enlist the services of "green fairies".
These are people who provide cannabis products to people who use them to relieve pain.
Green Party Drug Law reform spokeswoman Chlöe Swarbrick said ACC's approach to cannabis is a symptom of a system that is "so obviously broken – this is just icing on the cruel cake".
ACC Minister Carmel Sepuloni told the Herald the Government was in the process of returning ACC to its "original purpose".
That purpose is: "Assisting all New Zealanders who have an injury".
She did not explicitly reference reforms around cannabis funding.
But she said changes at ACC would consider a range of conditions the agency covers and taking an "evidence-based approach to updating the list of chronic illnesses caused through workplace exposure to harmful environments".
In the meantime, however, ACC chief clinical officer John Robson has admitted "we do not have a cannabis strategy" and each request is considered on a "case-by-case" basis.
"All applications to fund cannabis-based medicines are considered by an ACC clinical advisor with a relevant pharmaceutical or medical background."
But Swarbrick said that bar is "extremely high".
"No New Zealand products have passed the extremely high, pharmaceutical-grade quality standards framework."
In fact, she said just eight people received ACC funding for cannabis products last year.
"Meanwhile, patients continue to suffer. Not only because they cannot get affordable, legal access to their medicine, but because tens of thousands of New Zealanders are still likely to be turning to the black market and risking jail time."
The Herald has spoken to one man who is in this position.
He did not want to be named, as his employment contract means he can be the subject of random drug testing.
He has chronic pain as a result of a motorcycle accident five years ago.
Standard pain medication has not been effective, he said, so he turned to cannabis products to ease the pain.
Although products such as CBD oil and Sativex have been effective, they were expensive.
The man told the Herald that Sativex alone cost close to $950 a month.
He turned to ACC for help late last year but he was denied.
"We're unable to approve your application because there is no current evidence that it is effective for chronic pain management and chronic pain is not an approved use for Sativex in New Zealand," ACC told him in a letter.
"It is not the generally accepted standard of treatment for pain in New Zealand nor is it a cost-effective treatment."
The letter went on to say that there were safety concerns with the adverse-effect profile of cannabidiol products and the provider had "not provided any quality scientific evidence-based literature to support the unapproved use".
In lieu of the Sativex, the man has been forced to get CBD and THC oil from the black market.
This, he said, has been effective as his use of Tramadol as a pain relief drug has dropped from 400 milligrams a day to zero.
He said ACC should be more liberal in its approach to funding cannabis for treating pain.
But an ACC decision-making document, obtained under the Official Information Act, reveals its approach to funding cannabis is narrow.
"We do not normally pay for products available for use in the community that contain controlled drugs, such as cannabis and ketamine," the document said.
"This is because of the:
- lack of high-quality clinical evidence that supports their use
• wide availability of other pharmacological and non-pharmacological interventions to achieve rehabilitation outcomes
• unapproved/non-regulated therapeutic use (ie Medsafe has not registered and/or approved the product or indication for use)".
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