As Vera Twomey’s highly publicised fight for medical cannabis continues, Hannah Lemass explains the differences between cannabis medications
Vera Twomey and supporters blocked the entrance to Leinster House on 4 May in a demonstration for the right to cannabis for medicinal use.
Ms Twomey was removed by Gardai as the sit-in protest at the gates of Leinster House blocked traffic access to and from the building.
She spent the night before the sit-in camped outside the Dáil asking for Minister Simon Harris to speak with her.
In a Facebook video, she said that she had emailed the Minister the day before the protest to ask for a meeting but he did not respond.
Ms Twomey says that medicinal cannabis will help her daughter Ava who suffers from debilitating, life-threatening seizures due to a rare form of epilepsy called Dravet’s syndrome.
The Cork mother drew national attention last month when she completed a walk from her home county to the Dáil to raise awareness about her case.
People Before Profit TDs Richard Boyd Barrett and Gino Kenny voiced their support for Ms Twomey’s campaign on Twitter.
It was Gino Kenny who brought up the issue of medical cannabis in the Dáil last year.
His medicinal cannabis bill passed a Dáil vote in December 2016 but it has some distance to go before it will be passed into law.
A drug by many names
Marijuana, Pot, Weed, Dope, Reefer even Broccoli – Cannabis has been given many nicknames over the years.
Some of these tags are used interchangeably but there are some important distinctions to make when discussing medical cannabis.
Cannabis refers to the whole plant which belongs to the Cannabaceae plant family.
Many products can be made from the cannabis plant including the drug marijuana.
The dried crushed leaves have a psychoactive effect that gives a high due to the presence of certain cannabinoids.
There are more than 113 known cannabinoids but the discussion of medical cannabis in Ireland focuses two primary types, cannabidiol (CBD) tetrahydrocannabinol (THC).
THC is the main psychoactive compound found in cannabis. Essentially, THC is responsible for the high associated with marijuana use.
CBD is a non-psychoactive element in cannabis.
Over the years, CBD has gained a reputation for its potential medical benefits especially in the treatment of chronic pain, cancer, epilepsy, depression, and cerebral palsy.
THC is outlawed in Ireland under the Misuse of Drugs Act 1997 but CBD oil can be bought from health food shops and from specialist online retailers.
At the most recent Right2Water protest in March, Vera Twomey told the crowd that Ava started taking Charlotte’s Web CBD oil in October and had experienced a significant decrease in seizures.
However, she said that she wanted THC medication and full plant cannabis to be available for medical use in this country.
Ms Twomey was recently stopped at Dublin Airport while attempting to bring THC into the country from Spain on the afternoon of 21 April.
She travelled to Barcelona with TD Gino Kenny and Independent MEP Luke ‘Ming’ Flanagan.
She met with a specialist in Barcelona who prescribed THC oil for Ava which she declared upon arrival in Ireland.
The product was confiscated and Ms Twomey was held for questioning by Gardai for about 45 minutes.
Barriers are coming down
Simon Harris can grant a special licence for access to cannabis in individual cases but the application has to be endorsed by a consultant responsible for the management of the patient.
Vera Twomey told Ray D’Arcy on RTÉ that Ava’s neurologist supported her application for THC medication but would not sign the application due to lack of knowledge about the drug.
“The person who has put in the compassionate exemption application for us is not a paediatric neurologist,” she said
She added that “the neurologists state that they do not know enough about the actual medication itself.”
An application for compassionate exemption must be endorsed by a consultant doctor with expert knowledge of the illness.
She said that the family contacted several neurologists around the country to find someone who would be willing to manage Ava’s case but with no success.
Tristan Forde from Dunmanway, Co Cork also suffers from Dravet syndrome.
In December 2016, three-year-old Tristan was granted a special licence for cannabis by Simon Harris after he started treatment in Colorado, USA.
In an interview with the Independent in March, Tristan’s mother Yvonne Cahalane said that since he started the medication he has had no “drop seizures (where he would suddenly lose muscle tone) and absence seizures (where he blanked out for a time).”
A report by the Health Products Regulatory Authority (HPRA) concluded that if cannabis is to be permitted for medical purposes it should only be allowed for specific medical conditions that have failed to respond to all other treatments
The specified medical conditions are:
“1. Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions whilst under expert medical supervision;
2. Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes whilst under expert medical supervision;
3. Severe, refractory (treatment-resistant) epilepsy that has failed to respond”
HPRA also noted that the use of cannabis to treat medical conditions in children would have to be carefully considered due to “evidence linking cannabis use in adolescence with the development of psychosis in later life”.
Given these concerns, a panel of expert doctors was formed at the end of March to draft guidelines on how the drug will be dispensed in the future.
The doctors specialise in a range of areas including oncology, anesthesiology, neurology, psychiatry and pharmacy.
Vera Twomey addresses the crown at the 9th Right2Water protest in Dublin on 8 April, video by Hannah Lemass
GreenLight Medicines, a pharmaceutical start-up based in South Dublin, secured €500,000 in funding last year to develop medicines using cannabis extracts.
In addition to the €500,000 from a group of private Irish investors, the Swiss-American CBD producer Isodiol contributed €1.25 million in CBD oil over a five year period.
GreenLight Medicines provides treatment for eleven-year-old Billy Caldwell.
Billy from Co. Tyrone also suffers from extreme epilepsy and travelled to the United states to receive cannabis treatment before it became available to him in Ireland.
The founder of GreenLight Medicines. Dr James Linden told the Irish News in February that “in Billy’s case, a little bit of THC is all that’s needed, so there is no going over the legal limit.”
On JOE.ie’s Capital B programme, Dr Linden said that Ireland has the ideal climate for growing cannabis and that the country has the potential to be the next cannabis growing capital of the world.
There are plenty of voices out there pleading for the drug to be made commonly available, but it looks like they will have to wait a while longer.
In the meantime, hopefully, they can take some solace knowing that research is being done.
If the research is positive, it will make a good case for the legalisation of medical cannabis in Ireland.