Vera Twomey’s walk to the Dáil was a landmark moment for patients all over Ireland, and the latest moment in a wide history of people having to fight for access to medicinal cannabis, writes David Linnane.
The real drive for legal medicinal cannabis started in the 1980s in San Francisco, coming out of the counter-culture and gay rights movements. When the HIV/AIDS epidemic struck, a group led by Dennis Peron who has previously focused on getting legalisation for recreational cannabis, pushed for access and flouted the laws to provide it.
While cannabis was illegal and little medical research had been carried out on it, that community in San Francisco saw the anecdotal evidence of what it could do for people suffering from HIV or AIDS. While it was not a cure, it did assist with pain, sleep patterns, nausea, and appetite. It was also being used by people with cancer as a compliment to treatments like chemotherapy.
Rather than accepting that the drug was illegal, Peron and others fought for a change in the law and access to what they saw as an essential drug. The San Francisco Cannabis Buyers Club was eventually founded and flouted the state and national laws and began directly providing the drug to people who needed it, while campaigning for legalisation.
The group involved doctors in the process and gave employment directly to people suffering from illnesses like HIV and AIDS as it expanded to care for thousands of people. Within a few years, against significant political resistance, medicinal cannabis was legalised in California by referendum.
Their case showed that when society has a real debate about the impact of the war on drugs on medicine, people are compassionate and take the side of the patients, not the state.
Ireland proved this week that it has reached the same conclusion, as shown by the outpouring of support for the Twomey family.
Whether it was online or in person, people have been overwhelmingly supportive of Vera Twomey as she walked from Cork to Dublin. Hundreds walked with her when she made the final leg of her trip to Leinster House. The queue of TDs waiting for a photo opportunity with her proved that people of all parties realise that the public cares about this issue and wants a change.
There isn’t any significant evidence that wider drug legalisation, as seen in The Netherlands or Colorado, is a priority for the public, but medicinal cannabis is treated differently because it fits the same criteria as many other treatments, like Orkambi for cystic fibrosis.
It’s a medicine that could have major benefits for people with debilitating conditions, and one that they are denied access to at present. The public is able to separate an attitude to an illegal drug and an essential medicine in the same way that heroin is banned but morphine is used in hospitals.
While people are using it illegally anyway, legalisation would allow them access to the right medical advice and the specific type and quantity of medicine that they need.
The public demand is clear, but the solution is tougher and more complicated.
Minister for Health Simon Harris and his colleagues in Fine Gael have been resolute about their belief that doctors prescribe medicine, not politicians.
However, politicians set the rules under which doctors operate, and the current rules for prescribing cannabis are incredibly restrictive compared to any other medicine.
Citing a lack of scientific evidence for the benefits, the government set out rules that allow access on a ‘compassionate’ basis, but which favour other treatments. The number of applicable conditions for which it can be prescribed is also tightly limited.
Where this all failed is in supporting doctors to prescribe the medicine. As the government says, doctors are the experts, not them, but experts still need training.
While cannabis use is widespread, cannabis prescription is absolutely new to the Irish medical system, and doctors who have never dealt with it before cannot be expected to be experts on it. Ava Twomey’s neurologists are refusing to sign off on the prescriptions until they have the training to do it properly.
That’s where Mr Harris comes back into it. He can’t be expected to prescribe the drug, or even force a doctor to prescribe it, but he is the one in control of the chequebook and he is the one who sets the rules.
It now up to him to bring Irish doctors up to the standards that they themselves are demanding so that children like Ava can get the medicine that they need.
Just like San Francisco has its hero in Dennis Peron, people all over Ireland have a hero in Vera Twomey. If the government does act on this, and it is likely to given the public pressure, Ms Twomey’s walk from Cork to Dublin may go down as one of the most significant individual acts of protest in Irish history.
She might have walked as a mother who wanted the best for her child, but people with conditions like Ava’s will thank her for walking for all of them in the years to come.
This story first appeared on the Evening Echo.