Wednesday, 30 August 2023

Committees

Legal and Social Issues Committee

Reference

Debate resumed.

Tom McINTOSH (Eastern Victoria) (14:02): As I said earlier, I am glad to be speaking to this motion, number 155, moved by David Ettershank. It has been a couple of hours since I was stopped halfway, before question time, but I am glad to resume it and I am glad to restate the government’s support for this motion. It is looking to get the best outcome for working people dealing with pain, and I think it is a good thing that these issues are examined by the Legal and Social Issues Committee and that we are inquiring into medicinal cannabis in the workplace. I touched on earlier the importance particularly for people in workplaces, whether that be manual labour, who are dealing with injuries or who are dealing with physical trauma over time, or people who are in a workplace where they are responsible for the safety of others. Of course those two quite often overlay each other. The reason why I was talking so supportively earlier of the motion is the fact that I think it captures that fairness so that people can access the best quality and most appropriate pain relief. It is a justice issue. I think also it is an issue – one that I come to on this side quite a bit and that I believe our side keeps keenly in focus – of science. We want to make sure the science is informing the best outcomes for people so they can live their best quality of life.

Something else I want to talk a little bit about, which is rolled up in that, is the push-pull factor of giving people that support. We know this side is committed to supporting people in our community to get the best physical health outcomes, the best mental health outcomes – putting that support around people to ensure that they are able to achieve their most. I refer frequently to the Royal Commission into Family Violence and the Royal Commission into Victoria’s Mental Health System and everything that is being implemented and the investments that are being made to support people and to prevent trauma and remove trauma from our communities so that we do not see people not living their best lives and often ending up using a variety of substances to deal with where they are in their lives.

But I think the other side of this is we do not want to be pushing people unnecessarily into substance use that is not in their best interests and is not in our community’s best interests. I actually had the inverse of this, perhaps. I used to work up in the mines years ago, and we had to blow .00. We walked in at 6 am on the gates, so I took to drinking mid-strength XXXX, which is a trait that I still have today that I cop a bit of flack about from many of my Victorian comrades and colleagues and whatnot. It is a full-flavoured lager at 3.5 per cent, and at $1.23 a can, I do not think you can really complain.

But moving on, I think there is that push-pull factor, particularly around something like medicinal cannabis, where people are using it under medical diagnosis and medical support. You do not want to see people using another substance which perhaps will not be picked up, which is giving them worse health outcomes, which is giving worse outcomes in the workplace and which is setting a path that people can be pushed into that is not going to be the best outcome for them. I remember my first job ‍– and I spoke about this in my first speech in this place – working on a construction site, with guys during the smoko break cooking up speed on a teaspoon and injecting it. Now, that is not where we want to be. It is not what we want to see. It is not in their best interests. It is not in their employer’s best interests. It is absolutely what we are striving to stop and not see happen for a variety of reasons.

I think we need to have mature conversations about how we, as I said before, prevent physical or mental trauma. Preventing physical trauma in the workplace is really important. I have still got a long-term injury in my lower right arm that I took on from being on the tools which still gives me problems, but fortunately it is nothing I need to medicate for. Or it is that mental trauma taken on through circumstances that we can and are always working to prevent, whether that is in our families or in society or in the workplace, by being science based and open minded. We talked a little bit yesterday about our politics being for this century, not for last century. So when we bring that fairness, that openness of heart and that consideration for those in our community to try and get the best outcomes for everyone and when we are science led, we can come to conversations like those that will occur in this committee and find the right outcomes for Victorians – in this circumstance working Victorians – that, as I said earlier before the break, are going to give us that really good productivity and are going to give us that really good quality of life for those workers within their families, the families that build those communities and build our society, our state. I very much believe in society, even though some politicians last century did not. I will wrap up. I definitely, on behalf of the government, say that we support this motion. And although I am not on the committee, I hope that all those on it come to it with a fair and open mind and with a science-focused approach and get some really good outcomes for Victorians.

Ann-Marie HERMANS (South-Eastern Metropolitan) (14:08): I am also rising to speak on motion 155, standing in Mr Ettershank’s name, regarding referring matters on workplace drug testing and medicinal cannabis to the Legal and Social Issues Committee for further consultation, noting that the motion instantly notes the validity of medicinal cannabis as a legitimate and lawful prescription medicine for people suffering from a range of serious illnesses and conditions and then goes on to discuss issues in the workplace that will have ramifications on WorkCover. I am keen to take a cautious approach and to be free of vested-interest tampering. I am optimistic about the gathering of data. Obviously we do welcome the gathering of data before we make decisions but will reserve judgement as to how we will respond once this data has been received and thoroughly analysed.

As a person who has worked in forms of social work, in both youth work and case management, I have witnessed firsthand the profound effects that drugs can have on young people – on anybody in fact – and how that impacts the wider community. You have to remember that my area of expertise is more in ages 12 to 25 years, but you do need to consider with any form of drug use how that can impair a person, so I do welcome the opportunity for this to be further investigated. There are many prescription drugs that can prevent a person from entering the workplace because it is unsafe to operate machinery under certain prescribed drugs. We do need to have more information on the impacts and on the testing and the methodologies that are implicated in the workplace.

Obviously we have tremendous concerns about the pressures that are being played out at the moment in Victoria on small businesses, in fact on all businesses, in terms of WorkCover premiums, which have skyrocketed. Some people are paying 100 per cent more in such a huge increase that they have been expected to cough up by August – they just were not expecting such hikes. There are many small businesses that are folding or are having to rearrange the way they operate; they are moving interstate, they are moving overseas. We do not want to be putting people at risk, we do want to be looking after people, and I think all businesses recognise the importance of having something like WorkCover and having occupational health and safety standards. Legalising cannabis and having these health needs met is something that we need more evidence for to provide support for legalisation for drug purposes in the workplace. Occupational health and safety issues do need to be considered as to how they will impact the number of businesses that are out there and also the person that may or may not be impaired.

I do welcome the research; I think that is important: the investigation is important and the framework for workplace drug testing is important. We need to have a holistic approach, and we do, as I said, have genuine concerns for businesses given that the costs have inflated. We have 50 new or increased taxes under this government already and increased WorkCover premiums. We do not want to see discrimination in the workplace, I do agree with that, but we do need to make sure that no-one is impaired at work and that this is not going to impair judgement when they are using machinery. We do not want to see WorkCover premiums continue to increase. They have exploded under the mismanagement of this government already, and businesses, as I said, are already paying premiums that they cannot afford.

With that, I do say that we look forward to the scrutinisation of further investigation. In response to Mr Ettershank’s motion, I look forward to further information being reviewed and provided for discussion. Obviously we have at heart the best interests of not only the cannabis users who want to be able to work but also the businesses that have to cover the WorkCover premiums for them and provide a safe workplace for them. On that matter, that is about all I really have to say. I do appreciate that you have brought this forward into the house for further investigation, that it might be referred on. We look forward to reading the findings and considering those and analysing those in due course.

David LIMBRICK (South-Eastern Metropolitan) (14:14): I will be supporting this motion to have an inquiry into workplace drug testing for medical cannabis patients. I see the injustice with what is happening with workplaces as basically the same injustice as what has been happening with roadside drug testing. Mr McIntosh earlier spoke about science. Well, I will say this: there is no science linking impairment, which is meant to be the whole point of testing people both in the workplace and on the roads – there is no science linking a positive test for THC in your body with impairment. At the moment the government seems to pretend that this roadside drug testing is testing for people that are impaired – it is a total con, what is going on. They are pretending it is like the blood alcohol concentration testing, which does show good correlation between blood alcohol levels and impairment, but that is not the case for cannabis.

I will say this as well: the government must know that they are really just taking advantage of the stigma associated with drug use, because they do not test for other drugs that are legally prescribed. They do not test for opiates in roadside drug testing. They do not test for benzos. They only test for cannabis because they know that there is this stigma around it and if people were taking medication for pain relief or mental illnesses and stuff and it ended up on the news it would be a bad story, even though they do impair people when they are driving.

Ultimately I see this as a technology issue, in that both in workplaces and on the roadside when they do drug testing they must test for impairment, because what is happening now is we have an injustice where people are losing their licences and losing their jobs and they are innocent. They have hurt no-one. They were not impaired. They were not going to harm anyone on the road. There were not going to harm anyone in their workplace. It is a total injustice what is happening right now, and the government needs to fix it more urgently. I know that there have been these statements about roadside drug testing and things like this, but we need to move on this now because people are being criminalised and penalised and losing their freedoms. And I will say this: losing your licence in a regional area is an absolute catastrophe. Losing your job is a catastrophe. If people are impaired, by all means then they should be held to account for that, but our current drug-testing regime both in the workplaces and on the roads does not test for impairment. It is unjust, and we need to either end it or improve the technology so that it does test for impairment.

Michael GALEA (South-Eastern Metropolitan) (14:17): I also rise to speak on the motion put forward by Mr Ettershank today, and I rise to speak in favour of it as well. I have to say I have particularly enjoyed listening over the past half an hour or perhaps an hour of debate time to members from across the chamber on this issue. I think it has been a well-reasoned and collegial debate, perhaps a bit unlike the one that we had this morning, which was a bit more rambunctious. It has been a really interesting topic, and I do thank Mr Ettershank for raising it in the chamber today.

I do rise today to speak in support of referring this to the Legal and Social Issues Committee as a member of that committee myself, and I see a few of the members in here. In fact I believe we may even have a quorum of that committee here today, which is good to see. It is good to see that we are all engaged. I do very much support this coming into our committee, because this is the sort of issue that, as others have very well argued, is the sort of matter that the Legal and Social Issues Committee is best equipped to deal with and to examine the reasons for and also all the various other considerations that will need to be taken into account in looking at this motion. Whilst I do very much support this move in principle, going through this committee process is the appropriate way to do it to ensure that if any unforeseen foreseeables do come to light then we can address them and make various findings and recommendations in order to make this the best policy possible.

As members in this place will know, medical cannabis has been available to Victorians since 2016 when the Andrews Labor government brought in that reform. At the time it was quite notable. Like many here I was not in the Parliament at that time, but I do recall the significance of it. It was even in fact controversial, and it is hard to believe now, seven years later, that that would be controversial, because we have seen the enormous benefits of that initial trial in our program for medical cannabis use in Victoria for Victorians who need it and how much of a difference that has made to their lives. There are all sorts of conditions that cannabis is the best treatment for, and in some cases it is the only available treatment that people can find, so it has been really good to see. Some of the treatments I thought it might be instructive to outline briefly. Some of the most common conditions that medical cannabis can be used to treat in this state include paediatric and adult epilepsy; multiple sclerosis; nausea and vomiting, often as a result of chemotherapy and also HIV/AIDS therapy; various other types of pain; and palliative care, and I know from experiences not personally but from talking to others in relation to cannabis’s role as a treatment for epilepsy really just how profound a treatment that can be and how wonderful it is to see it helping them live their normal life.

Obviously, though, Mr Ettershank has brought a very worthy consideration into the chamber today – that is, you cannot quite live a fully normal life if you cannot work or if you cannot drive. As someone from an industrial relations background, I know the importance of work to people and of supporting people through whatever sort of injury, illness or unfortunate event that has happened to them – seeing their desperate desire to get back to work and seeing how being off work for a long period of time can really have a psychological impact. It gets to a point where it is not just the injury, it is also the feeling that you are not doing what you what to do; the feeling that you are not in some sense, for want of a better word, contributing, even though they obviously are; the feeling of loss of identity and loss of self, which these current restrictions basically do place on people; and having that fear, that threat over their head, because they will test positive for a drug that is under most circumstances illicit. That is a real burden for them to carry. And there is, as I believe Mr Limbrick said, the stigma attached to cannabis still because it is seen as an illicit drug even where it is prescribed for a perfectly appropriate medical purpose.

It is very good to see this motion come through. In supporting this I am very much hoping that the chamber will agree to support this motion today. I look forward, along with my colleagues on the Legal and Social Issues Committee, to that being the case. I do look forward to us commencing this inquiry. We know that the stigma that is applied to medical cannabis is not applied in the same ways to painkillers, to ADHD medicine, to PTSD medicines, to all sorts of other things. I will not go into that in too much detail, because I know Mr Limbrick spoke very, very well on that just before, but it is basically the simple principle of reducing harm. If we can show that the appropriate medical use of cannabis does not cause harm and does not cause impairment to a degree which would impact someone at work, then it is appropriate that this be looked at and remediated as soon as we reasonably can.

Victoria has not rested on its laurels when it comes to improving access to treatment options. Early access to medical cannabis for Victorian children with intractable epilepsy, the Victorian compassionate access to medical cannabis scheme, was initiated in 2017 or 2016. I do applaud that this government was at the forefront of that important reform and that it is such a non-controversial thing today that people can have medical cannabis treatment. There are all sorts of other conversations that I am sure we will be having in this chamber and in this Parliament about further measures, and I look forward to Mr Ettershank and Ms Payne bringing them forward to the Parliament. But for the time being, whilst cannabis does for recreational use at least remain an illicit substance, it is really important to step forward with this and show that it can bring a lot of benefit to people. It really is life changing. I know when the trial first came in 30 children were treated for some severe, severe illnesses, and what a difference it made.

In terms of further context for what it means to have epilepsy, about 30 per cent of children who are diagnosed with the condition will have what is known as intractable epilepsy. Any type of epilepsy can become intractable at some point, so there is no guarantee that even if someone does not have it, they will not then go on to develop it. But it is treatable. Some children may be seizure free even, with expert care. If a child still suffers from seizures after taking two carefully chosen seizure medications, the chances of success with a third medication are very low – only about 5 to 10 per cent. It can be a lifelong condition, and children, and later adults, face many potential effects from living with it – daily living skills; obviously, driving in and of itself; delays in speech and motor skills, such as walking; depression or anxiety due to worrying about when a seizure may occur; difficulty thinking and paying attention; not being able to drive a car or do other manual labour jobs, such as using a forklift or other machinery; reproductive issues; trouble doing schoolwork or other sorts of work; and trouble sleeping.

People of all ages, but especially children and their parents, must be careful due to the risk of accidents when having a seizure. I will not go into details of who, but a person very close to me was driving a car a few years ago, and the person in the car with them in the passenger seat had a very severe epileptic fit to the point where they had to pull over and physically hold and restrain this person on the side of the Monash Freeway. It was a very dangerous place to have an epileptic attack. They had to restrain this person while they were frantically calling for help and calling 000. These things, when they do happen, especially when they happen unexpectedly, can be very absolutely severe and potentially even life-threatening.

Gravely, there is also the risk of course of what is know as SUDEP, sudden unexpected death in epilepsy. Each year more than one in 1000 people who have the condition die from sudden unexpected death in epilepsy. This is the leading cause of death in people with uncontrolled seizures. One of the best ways we can help this situation and one of the best ways we can avoid these incidents is by reducing the frequency of seizures, and medicinal cannabis can really improve the quality of life of children and adults with epilepsy. It can quite literally save their life.

So I think it is important just to reflect on the context of why we have this scheme here in Victoria. For me, anything that we can do to reduce the barriers to access and the barrier of stigma to access and to living your normal life can only be a good thing. It is appropriate of course that we do it in a measured and considered way, and that is why I support this referral to the committee. I commend this motion to the house.

Rachel PAYNE (South-Eastern Metropolitan) (14:26): I rise to support this Legalise Cannabis motion. We have really only just begun to scratch the surface of what cannabis can offer in terms of therapeutic benefits. I note that many of my colleagues have referred to some of the effectiveness that medicinal cannabis can have as pain relief and in managing seizures, epilepsy and MS and as related treatment for depression, anxiety and sleeping disorders. We are now starting to see that detailed scientific evidence is out there. This medicine is effective, and it works for people. It has provided life-changing relief to patients where other medications have failed. It is no wonder that since Victoria legalised the use of medicinal cannabis in 2016 there have been over 370,000 prescriptions filled across the state. Medicinal cannabis is a great leap forward in pharmacology, and it is here to stay.

It really is time we addressed those Victorian laws and practices that continue to unfairly prejudice medicinal cannabis patients. In February we moved a bill to remove the discrimination against medicinal cannabis patients in the Road Safety Act 1986. At the time, the Premier said:

What we want to try and do is make sure anyone and everyone who would be better off because of medicinal cannabis has no disincentive, in fact is supported to access the medicines that will alleviate their pain …

That statement of principle applies equally to medicinal cannabis in the workplace. We need to end the disincentives that medicinal cannabis patients receive in the workplace. As my colleague Mr Ettershank so succinctly put it, patients do not choose to have a medical condition, and they do not choose which medicine is best for treating their symptoms. Lawfully prescribed medicinal cannabis patients are not behaving irresponsibly or trying to get away with anything, but they are testing positive in workplace drug tests, and then they are not treated with the understanding that the result is derived from medication. Instead they are being punished as if they were using an illicit drug, and this is simply wrong.

A positive test is not evidence of illicit drug use or impairment. We know the trace amounts of THC can stay in a person’s system for days and weeks after consumption and trigger a positive test result. We know that in a blood test result it can show up for a month. If a person is not impaired by their medication, they should not face dismissal because of an outdated testing regime that is not in step with modern medicine. I appreciate Mr Limbrick’s comments in reference to the fact that the scientific evidence is there and the evidence is clear, and it is time we got on with the technology and advancing that position. Many Victorians are prescribed medicinal cannabis after years of taking far more dangerous medications, such as opioids or benzodiazepines, which come with a host of debilitating side effects and are highly addictive, but these Victorians are being forced to choose between continuing the treatment that has given them back their lives and continuing to work.

We also must remember that this has real-life impacts, and I would like to reflect on a few of the patients that we have been in consultation with during this process. I would like to tell you about Elena. We are not using Elena’s real name; however, Elena is a successful software engineer. Elena has been prescribed benzodiazepine and she has spent many years on these harmful drugs, forming a dependency and enduring debilitating side effects. Elena was eventually prescribed a full-spectrum CBD–THC medication for her conditions. She credits medicinal cannabis with turning her life around. She takes the medication at night, leaving a 12-hour gap before attending work so that she will never be impaired.

Elena did the right thing; she disclosed her medicinal cannabis prescription to her employer. She even produced a letter from her doctor, but to no avail. Her employer treated her prescription medicine as an illicit drug, and she was immediately put on a work-from-home order and then suspended from her job. We also have to remember this is a software engineer, so she is not operating any machinery; she is working behind a desk. Feeling she had no option, Elena left her work. She was not impaired at work, but she was forced to make a choice between leaving her job and giving up the medication which enabled her to lead a fully functioning life again.

Sam is another medicinal cannabis patient who enjoyed a successful career until he produced a positive urine sample at work. Prior to being prescribed medicinal cannabis, Sam thought his company’s drug policy was pretty clear: for an employee who produces a positive drug sample, if they have a prescription they can go back to work – they are exempt. If they do not have a prescription, then they face disciplinary action. But Sam provided his prescription for medicinal cannabis, his sample was classed as illicit and he was suspended from work. Sam is now at a crossroads, and he must make that choice between taking his lawfully prescribed medication and keeping his job.

We have heard of so many examples of this type of discrimination. We have also heard of employees disclosing that they use medicinal cannabis and also being removed or suspended from their work pending an investigation or they have just simply been laid off because they do use medicinal cannabis, without any drug testing, just because of the stigma. We have also heard from people who have been prescribed medicinal cannabis by their GP and feel it would strongly benefit them but will not take it for fear of losing their jobs, and this is what we hear from the prescribing doctors and patients as well.

Medicinal cannabis should be treated like any other prescription medication, and it is a fairly simple proposition. I note that Mr McIntosh talked about fairness and workers, particularly around pain and injury. I think what is really important for everyone to remember is that when it comes to being prescribed medicinal cannabis you have to show to the prescribing doctor that you have tried every other option of medication to alleviate your pain – that you have tried opioid-based medications and that you have tried other forms of medication. What we are finding is that medicinal cannabis patients finally have their agency back. This is medicine that is working for them, and yet they are being discriminated against for accessing a legal medicine. It has to be the last port of call. We all agree around impairment – no-one should be impaired while they are at work – but people correctly taking their prescribed medication in a safe and appropriate way should not be punished for doing so.

I also note my colleague Mr Galea referred to children with epilepsy and how this medicine has been life changing for them. Well, what are we going to do when they get a job and get a drivers licence? Are we going to say to them, ‘You can’t drive and you can’t work because you can’t take your medicine at the same time’, or are we going to say, ‘You have to access your life-changing medicine and you can have those liberties of living a normal, full life’? We at Legalise Cannabis believe the Legal and Social Issues Committee will be able to tease out the complexities of this issue and make sensible recommendations for law reform, so I ask the house for their support of this motion.

Sarah MANSFIELD (Western Victoria) (14:35): It is with pleasure that I rise to speak in support of Legalise Cannabis’s motion today. In 2016 medicinal cannabis was recognised in Australia as a legal medical treatment. Qualified health practitioners were given the green light to prescribe medicinal cannabis products for patients experiencing a range of conditions. We have heard about many of them already today, but just to reiterate, these include anxiety, epilepsy, chronic pain and cancer-related symptoms. However, our workplace laws have not caught up. Unlike other legal prescription medications, in many settings medicinal cannabis is effectively treated as an illicit substance. In workplaces where drug testing is performed, employees risk instant dismissal if they return a positive test for cannabis regardless of whether it is medicinal cannabis or whether it produces any level of actual impairment.

To understand why workplace drug testing is problematic for people using medicinal cannabis, it is helpful to have an understanding of how it is handled by our bodies. I am very excited about this because it is where pharmacology meets policy. Cannabis contains two main compounds, or cannabinoids, of relevance: tetrahydrocannabinol, or THC, which we have heard about; and cannabidiol, or CBD. THC is the substance associated with the psychoactive effects, including sedation and euphoria, or a high. Clinically, it can have benefits in chemotherapy-related nausea and vomiting, spasms associated with multiple sclerosis and chronic pain. CBD is not associated with intoxication, although it can have side effects that are relevant in the workplace. Evidence supports its use in some forms of epilepsy, anxiety, chronic pain and some other neurological disorders.

There are a variety of medicinal cannabis products used for different conditions, and they contain different combinations of THC and CBD. Some have only THC, some have mostly THC and others have mostly CBD. Currently none are 100 per cent pure CBD. Workplace drug tests only check for THC, not CBD, and are generally performed on saliva or urine. Drug tests are a blunt instrument that only show the presence or absence of a substance. They do not tell you when or how the substances were taken. They do not tell you the current effect on an individual’s capacity to perform a task. Inferences about the timing of administration of the drug or its effects can only be drawn if there have been established and predictable correlations between the presence and level of a drug and its effect.

All drugs behave differently, both in terms of how they are dealt with by the body and what effect they have on different parts of the body, including the brain, at different concentrations. Some drugs are relatively predictable, and you can make some reasonable assumptions about what detection of drugs at different levels means. Alcohol is a pretty good example, as I will explain later. Others, like THC, are much more difficult to draw such inferences about.

Peak levels of THC depend on the route of administration. If you inhale cannabis, it causes relatively high levels of THC in the bloodstream and a fast rise and fall in the blood and saliva THC concentrations. Taking it orally leads to a slower and lower peak level and a relatively slow fall. Of key importance is that THC is highly lipophilic, which literally means it likes fat. It is readily absorbed into fatty tissues, which make up a reasonable proportion of our bodies. It varies between individuals obviously, but THC stays stored in the fat for a long period of time – days to many weeks – and it is gradually rereleased into the bloodstream before being broken down by the liver and excreted from the body. The half life – that is, the time that it takes for the blood concentration to fall to half the level of the peak – can be long and varied, from one to two days to weeks. This is the same whether it is THC from medicinal cannabis or illicit cannabis. This is why THC can be detected on drug tests, particularly urine tests, for days or weeks after it has been taken. A positive test is therefore not an indication of recent intake of THC. It is also not an indicator of the level of impairment, and that is what is really important here.

Multiple studies have not been able to convincingly demonstrate a reliable relationship between THC blood concentrations and tests of impairment, whether they are subjective assessments of impairment or more objective measures. Evidence supporting a relationship between concentration and impairment is particularly weak for regular users, which would include pretty much all medicinal cannabis users. THC is quite different to many other drugs in this regard. Compare it to alcohol. Alcohol is handled by the body in a relatively predictable way, which is why we can give advice about the number of standard drinks that is likely to produce a problematic blood alcohol level. It is also not stored in the body and recirculated like THC, and therefore the presence of alcohol in the blood or on a breath test indicates recent consumption. Importantly, there is a pretty reasonable correlation between blood alcohol concentration and the level of impairment, with reasonable studies to back this up.

Impairment is what is actually important in a workplace setting to ensure safety. It is the justification given for workplace drug laws and testing. Impairment is a risk with THC, but it is with many other medicines, and there are systems and processes to handle this risk. Many medications that are not screened for as part of workplace drug tests can have side effects that pose a safety risk. Take, for example, some types of antihistamines, epilepsy and nerve medications and antidepressants. These can all cause drowsiness and alter judgement, but we have ways of dealing with this risk. Doctors regularly have discussions with their patients about the potential side effects of medications, including the impact they might have on their abilities in different situations, such as driving and working, and where precautions need to be taken.

Employees taking prescription medication that may have impairing side effects are generally encouraged to discuss their ability to complete their work with an employer, and in some cases medical professionals specialising in occupational health may be consulted to develop a safe work plan. Unfortunately, because medicinal cannabis is not treated like other prescription medications in the workplace, particularly by those workplaces that engage in drug testing, it is difficult for doctors to give appropriate advice. As I have outlined, there is a poor relationship between the timing of doses and the duration of risk of a positive test, and there is also a poor correlation between the presence of THC on a drug test and impairment.

The lack of protections for medicinal cannabis users also makes it very hard for them to disclose their use to their employers due to stigma and the risk of loss of employment on disclosure. Ironically, this may actually be promoting a less safe workplace. Some people will take medicinal cannabis and not disclose it, potentially creating risks that could have been avoided if we had treated it like any other prescription medication. Other people will choose not to use medicinal cannabis to avoid risking a positive drug test and losing their job and instead just deal with debilitating symptoms or have to take alternative medications that may have worse side effects. It should be acknowledged that for many people medicinal cannabis actually makes life much more manageable. It enables them to manage symptoms that would otherwise prevent them from working. The benefits of medicinal cannabis mean they can safely and productively participate in the workforce, when they might otherwise have been impaired by the symptoms of their medical conditions.

That is why I am standing in the chamber today on behalf of my Greens colleagues in support of the inquiry being put forward by Mr Ettershank and Legalise Cannabis. We hope that this inquiry will lead to practical and much overdue reforms of workplace laws and regulations; provide certainty for employers, employees and prescribers; reduce discrimination experienced by medicinal cannabis users; and provide safer workplaces for everyone.

Jacinta ERMACORA (Western Victoria) (14:43): I want to thank my parliamentary colleagues Mr Ettershank and also Ms Payne for bringing this motion forward. I have learned a lot, even just researching for this speech, and I have certainly learned a lot listening to you, Sarah Mansfield. I really appreciated your excitement about the intersection of pharmacology and policy and the solutions that you came up with. In particular I note and support part (3) of this motion, for the Legal and Social Issues Committee to consider how the needs of medicinal cannabis patients can be more fairly and appropriately managed by employers, which is almost like a good conclusion statement to Dr Mansfield’s speech.

It is important to recognise that patients using medicinal cannabis often face challenges in balancing their medical need with other aspects of daily life, such as maintaining regular employment – again, a familiar theme. The Andrews Labor government took the pioneering step of legalising medicinal cannabis in 2016. This set a benchmark for further advancements in this field across Australia. Today medicinal cannabis is not only legal but also accessible by prescription, transforming the lives of so many Victorians who now rely on it for therapeutic reasons. This government is committed to aligning Victoria’s occupational health and safety regulations with current medicinal guidelines and therapies whilst also balancing workplace safety.

It is critical to emphasise that no employee should be impaired while on the job, whether due to legal or illegal substances. Workplace drug testing is an essential tool for mitigating risks and hazards in certain work environments. However, such measures should not disproportionately affect those using medicinal cannabis provided they are not impaired while working. The aim of any workplace drug-testing protocol should be to minimise or eliminate hazards associated with drugs and alcohol, ensuring a fair and consistent approach.

Our record on medicinal cannabis shows continued progress, advancement and reforms since 2016. In 2017 we launched the Victorian compassionate access to medicinal cannabis scheme. This scheme initially granted 30 of Victoria’s most critically ill children with intractable epilepsy access to imported cannabis. This commitment helped families secure medicinal cannabis treatment for children suffering from an extreme drug-resistant epilepsy, particularly when all other treatments had been exhausted. I am proud of the compassion shown by this government, and these groundbreaking treatments have had tangible impacts. Medicinal cannabis has led to a significant decrease in seizure episodes for many involved, and by 2020 the program had expanded to include 90 children.

Victoria’s efforts in advancing medicinal cannabis have also been instrumental in driving national reform. Patients can now obtain both imported and locally manufactured medicinal cannabis products. Since 2017 the Victorian government has channelled over $5 million into research related to medicinal cannabis, focusing on areas like driving impairment, palliative care, cancer, endometriosis and autism. Today Victoria stands as a frontrunner in Australia’s medicinal cannabis sector. This is largely due to our government’s collaboration with local growers and manufacturers, especially in the development of CBD, or cannabidiol, products.

Agriculture Victoria has the distinction of being the first entity authorised by the Commonwealth government to cultivate and manufacture medicinal cannabis outside of a strict clinical or research environment. Agriculture Victoria is also collaborating with companies like the Cann Group and Canopy Growth Corporation to delve deeper into the medicinal properties of cannabis. We have achieved a significant milestone by successfully developing, manufacturing and safety testing a pharmaceutical-grade, purified CBD product, the first of its kind in Australia. This CBD product is now supplied to local research organisations for clinical trials, contributing to research capabilities and expanding the evidence supporting CBD’s therapeutic benefits.

Victoria’s lead has encouraged other states and jurisdictions across our nation to conduct their own research, and philanthropic bodies have become increasingly supportive. I was intrigued by a recent study funded by a philanthropic grant from Wesley Research Institute and the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney. As cited by the University of Sydney on 9 June 2023:

Australian researchers have published the first robust clinical study proving that medicinal cannabis effectively treats the debilitating effects of Tourette syndrome.

The research was published in the New England Journal of Medicine, and the findings show a statistically and clinically significant reduction in motor and vocal tics in just six weeks. Study co-author Professor Ian McGregor said:

We were delighted … to deliver this important clinical trial showing the efficacy of oral THC and CBD in treating Tourette syndrome.

He said:

This is such a difficult syndrome to treat. It severely impacts the quality of life of 1 in 100 young Australians.

One of the participants in the trial said in the paper that his tics were really painful, not to mention embarrassing, making him self-conscious. He said:

The oil has reduced my tics by about 50 per cent and I have been able to read a book for the first time in 10 years.

He went on to say:

Some days I get home from work and realise I haven’t focused on my Tourette syndrome for the entire day. It’s changed my life.

Stories such as these are so encouraging and reinforce this government’s commitment to the CBD program. With the successful completion of our government-backed CBD development program, we are now shifting our focus to encouraging local manufacturing of medicinal cannabis products.

As we debate this motion it is critical to note that on our side of the house workplace safety is an uncompromising priority. In Victoria we uphold stringent OH&S laws to mandate employers to establish and maintain a secure and healthy work environment for their staff. This includes identifying and managing risks in the workplace associated with alcohol and drug use. We know that the consumption of alcohol and drugs can have repercussions on workplace safety. This can also have a negative impact on productivity and interpersonal relationships, both in work settings and beyond. In the workplace the use of substances where they are prescription medicines, illicit drugs or alcohol can evolve into an OH&S concern. All of the above can compromise a worker’s judgement, motor skills, focus and alertness. This becomes especially crucial in high-risk settings where failure to manage such risks can have dire, even fatal, outcomes. Take, for instance, long-haul truck drivers, drill rig and mine operators and those who work in heavy machinery. I do know a woman who works regularly offshore in a highly complex environment. The drug-testing procedure prior to boarding the helicopter is similar to an international immigration process, and so it should be. The tolerance for anything in the bloodstream is very low. We know the potential for grievous harm or fatalities is considerably elevated when individuals are impaired at work, even if that is illness or lack of sleep. It is an employer’s obligation to adequately manage these workplace risks and hazards to ensure employee safety and avert work-related injuries. It is also equally vital that our OH&S regulations are modernised and sensitive to the requirements of those using prescription medicines.

In conclusion, I support this motion because on this side of the house we believe in a just and fair treatment for all Victorian workers. No individual in Victoria prescribed medicinal cannabis should be forced to make the difficult choice between taking their prescription medicine and going to work, provided they are unimpaired. This government acknowledges the importance of drug testing in the workplace, especially in industries where risks are high, as a measure for employers to fulfil their OH&S responsibilities. We also stand in favour of investigating ways to accommodate the specific needs of medicinal cannabis patients within these work environments. I support the motion, and I look forward to hearing the results of the inquiry.

Aiv PUGLIELLI (North-Eastern Metropolitan) (14:53): I rise today to support this Legalise Cannabis Victoria Party motion and to echo the comments of my colleague Dr Mansfield. It is great; we should all do this again sometime. Victoria needs to get smarter on drugs. When it comes to cannabis we need to move away from a presence approach to workplace drug testing and instead to a focus on impairment. It is frankly nonsensical that people are being unfairly penalised in the workplace for using a medically prescribed substance.

As we know and have heard today, cannabis has been found to assist with the management of a number of health conditions. Its prescribed use is having a positive impact on the lives of many Victorians. We know the benefits. That is why it is now available as a legal medication, and as such it should be treated the same when it comes to workplace drug testing – and of course driving laws, but that is a discussion for another day, given the wording of this motion. With the use of medically prescribed cannabis we are not talking about being impaired at work. That absolutely is a health and safety risk and should be managed appropriately, but there are already safeguards in medical advice that is provided to all people when they are prescribed medication, whether it be cannabis or pain medication or sleeping pills or any other legally prescribed medication. However, today we are talking about the presence of prescribed cannabis showing up in a workplace drug test and people being treated differently and discriminated against on the basis of their use of their prescribed medication.

We heard in a federal inquiry earlier this year that there is evidence that suggests that people are choosing to substitute cannabis for other drugs for fear of testing positive in workplace drug tests. People are aware that cannabis may stay in your system for longer and are instead choosing to use other drugs, particularly novel psychoactives, to avoid detection in workplace testing. This can make the situation much more dangerous. The system in Victoria needs to be changed and updated to reflect our current laws. This current situation that treats users of medically prescribed cannabis the same as illicit drug users when it comes to workplace drug testing is discriminatory. I support this motion and changes that support the use of medically prescribed cannabis here in Victoria. To be honest, let us legalise it more broadly – but again, that is a conversation for another day.

Sheena WATT (Northern Metropolitan) (14:55): I rise to speak on this motion from my colleagues here in the Legalise Cannabis Party and in doing so would like to take a moment to thank and to recognise the strong advocacy of Ms Payne and Mr Ettershank on this important issue. I really am very much proud to be part of the Andrews Labor government, who have a proud history of positive reform in access to medicinal cannabis for those that need it most. We heard some of the stories in the chamber while this motion was being debated earlier today, and thank you to those folks who have shared their stories. I too, as we go on, will have some to share as well.

Indeed our government led the way in 2016 as the first state in Australia to legalise the use of medicinal cannabis, and in doing so we have improved the lives of so many Victorians who need it for their treatment. The data shows that it works; our reforms have led to a reduction in seizures for many, many participants. Our work in medicinal cannabis cultivation and access has been groundbreaking and has supported national reform, with patients now able to access imported and locally produced medicinal cannabis products. Since 2017 the Victorian government has invested over $5 million into medicinal cannabis research in subject areas such as driving impairment, palliative care, cancer, endometriosis and autism.

Victoria is one of the leading jurisdictions in Australia for the medicinal cannabis industry, and this has been strongly supported by our partnership with local cultivators and manufacturers throughout CBD product development. Agriculture Victoria was the first entity authorised by the Commonwealth government to undertake cultivation and manufacture of medicinal cannabis outside of narrow clinical or research settings, and Agriculture Victoria continues to undertake research into the medicinal cannabis plant in partnership with companies including Cann Group and Canopy Growth Corporation.

We are continuing to lead the way in medicinal cannabis treatment and now have successfully completed the development, manufacture and safety testing of a pharmaceutical-grade purified CBD product, the first product of its type to be produced here in Australia. This CBD product is being provided to local research organisations for use in clinical trials, and I have had the good fortune of visiting some of these research centres. These trials will build local research expertise, provide more patients with access to CBD and expand the evidence base for its therapeutic use, and with the successful completion of the government-supported program to develop a CBD product, the Victorian government has transitioned and now encourages the local manufacturing of medicinal product.

The government has been working with road safety experts about how to best support medicinal cannabis patients so they do not have to choose between taking their medication and driving on the road. Current roadside drug testing only identifies if THC is present in someone’s system and does not differentiate between medicinal or recreational cannabis, and there is no test at the point of detection that tells us the level of THC and how it relates to impairment. I actually recall this. Last year I was on the Legal and Social Issues Committee inquiry into legalising cannabis in Victoria, led at that time by the chair of that committee Fiona Patten. I do recall a range of experts presenting evidence to the committee on that, and I would say that that particular inquiry was one that really opened my eyes to what the opportunities are, what the models look like overseas and how we in Australia can really embrace the opportunities presented.

There is of course more to say on that, but I will come back to the motion at hand. This is why the Victorian government has established a closed-track trial to investigate road safety risks associated with the use of medicinal cannabis. The trial will not occur on public roads – that is really important for folks to know – and will be conducted on a closed track to ensure there is no risk to trial participants or indeed to the public. The trial will not change the fact that in our state it is illegal to drive under the influence of THC on our roads. Initial scoping work for the trial has now commenced, and the government will introduce a bill to Parliament later this year to enable the trial to happen. We await the outcomes of the trial, which will deliver us the best available evidence when determining government policy for the future.

As other speakers have said, safety on our roads is just so very important. This closed-track trial will help expand the evidence base on the impairment medicinal cannabis may cause drivers, while ensuring the safety of all road users. But the truth is that no Victorian should have to choose between taking their medication and going about their daily life. Those on this side of the house understand that for medicinal cannabis patients, balancing their treatment requirements with other life factors, like simply going to work each day, can be really difficult. I am now recalling the example provided by Ms Payne. It really does reinforce the fact that no Victorian should have to choose between taking their medication and going about their daily life. Thank you, Ms Payne, for sharing that.

Of course this government is overwhelmingly committed to ensuring that our OH&S laws remain consistent with contemporary medical advice and that treatments are appropriately balanced with workplace safety risks and considerations. It is important to note that no-one should be impaired at work, whether by a legal drug or otherwise. Workplace drug testing can be a critical tool to manage risks and hazards in particular workplaces, and I am thinking about some of those very high-risk workplaces and recalling that some of my friends are working in some particularly high-risk workplaces. I know how important it is that they not only are safe but have the assurance that everybody else around them is safe as well. Of course the focus of any drug-testing policy should be to eliminate or reduce the risks associated with alcohol and drugs in the workplace in a way that is consistent and fair.

We are supporting this motion today for the Legal and Social Issues Committee to consider how the needs of medicinal cannabis patients can be more fairly and appropriately managed by employers. With that, can I recommend that members of the Legal and Social Issues Committee take the time to read the report of the previous Parliament’s Legal and Social Issues Committee, which considered cannabis use in Victoria. That was a very substantial piece of work, and I am recalling a series of meetings and some of the expert evidence that was presented at those meetings. I would just recommend that to members of this new committee to consider.

Of course there is more to say on this, but I know that we have only a few minutes to go and I understand that the mover of the motion perhaps has some final remarks that he would like to add. With that, thank you for the opportunity to speak today to this motion. Again, I reinforce my support.

Sonja TERPSTRA (North-Eastern Metropolitan) (15:04): I rise to make a contribution on motion 155, bought by David Ettershank. Effectively, this is a referral motion asking the house to require the Legal and Social Issues Committee to inquire into, consider and report by 30 June on a range of things that have largely to do with the regulatory framework for workplace drug testing: the treatment of prescription medicinal cannabis as compared to other prescription medications under the workplace testing framework; whether the framework for occupational health and safety workplace drug testing may be improved to benefit medicinal cannabis patients, ensuring due process and natural justice in workplace settings; and other matters. It is a long motion. I will not read it all in, because it is obviously on the notice paper.

It is an interesting area for inquiry. It is quite a vexed area for inquiry. Having been a trade union official for many, many decades and having worked in blue-collar workplaces and occupations where heavy machinery is in fact used, I understand some of the consequences that may flow from some of this. However, it is an interesting question that I think the debate today really centres around. I know I have only got 4 minutes or so on the clock, so I am going to bring it home strong. But I think it is an interesting area for inquiry.

There will hopefully be a lot of evidence presented about impairment, because that is what we are really talking about. What does impairment look like? I know we have actually had debates in this chamber about when we sit late in this chamber and whether we are impaired because we are tired. Oftentimes alcohol and drugs are not the only things that cause impairment. You can be tired, and it can take days to recover from being tired. I note I have had cause to read some information previously about the fact that if you are impaired due to lack of sleep it can be the equivalent of having a .05 blood alcohol concentration. The question really is: what is impairment and to what level will it impair someone?

As I said, as a former trade union official I have represented workers in occupations and workplaces where the operation of heavy plant equipment and machinery is part of that workplace, and I know that those workers in those industries and occupations take occupational health and safety in the workplace very seriously – for very good reason, because we want workers to get home safe from work. We do not want workers to be injured at work, and we do not workers who might be impaired to injure other workers. These regimes have been hard fought for. I know employers wanted them, but also the unions have been at the forefront of negotiating those arrangements to make sure that they are fair and that workers who may be picked up in any testing regime also have their right to natural justice and also to see what the full facts and circumstances around what may be impacting those employees look like so that those things can be taken into consideration. If I think back to when workplace alcohol and drug testing began, it was actually quite a different landscape in the beginning to what it is now. It is a much more compassionate space, I believe. It is still not without its lumps and bumps, but nevertheless it is something that has evolved, and that has been through the hard work of not only employers but also unions to make sure that workers are heard in that space.

Nevertheless I do think the Legal and Social Issues Committee will have its work cut out on this one. I think it definitely will be an interesting inquiry. As I said, the motion is asking for it to report by 30 June 2024. As is always the case, our committees in the Legislative Council have a full board of work. There is lots of work going on. As usual, it is brought by crossbenchers asking this chamber to refer these matters for inquiry to the different committees.

Of course the government is supporting this motion today. I should have said that at the beginning. I was remiss in not doing that, but yes, the government is supporting this inquiry. I mean, if you look at our government’s record on medicinal cannabis, we have done a number of things. Just recently we have announced a medicinal cannabis driving trial. We have got a good solid record, as I said, on occupational health and safety in the workplace. We know that alcohol and drug use can impact relationships, safety and productivity in the workplace, and we have had many policy initiatives, particularly in the case of high-risk workplaces where risks posed to employees can be fatal. With things like long-haul truck drivers, drill rig operators, mine operators and employees who operate heavy machinery and equipment and from the things I have just talked about, we know that these things can impact workers in the workplace. I know that in Victoria employers understand their obligations only too well.

I have 26 seconds left on the clock, so I am not going to get to talk about all of the things that our government has done, but nevertheless I think that our record speaks for itself. As I said, we do support this motion, and I look forward to the committee undertaking its important work and reporting by the due date.

David ETTERSHANK (Western Metropolitan) (15:09): First of all, could I just open by expressing my profound appreciation to all the members who have participated in the debate for their thoughtful and heartfelt contributions. When I was reading my copy of the dummies guide to parliamentary procedure, this moment, it said, would be an ideal opportunity for me to both capture the discussion and rebut the points of difference, and there seems to be a definite lack of rebuttals to be made.

I would like to just note a couple of comments: could I compliment Mr McIntosh, Mr Galea, Ms Ermacora, Ms Watt and Ms Terpstra on their recognition of the changing role of medicinal cannabis and the fact that it is expanding rapidly – I think currently we are running at about 5000 new prescriptions by the TGA every month in Victoria alone. Quite clearly the law and a lot of workplace practice has not kept up with that.

I also note the comments from Ms Crozier and Mrs Hermans, which struck at the question of the mindfulness of employers and the need to control questions of WorkCover cost and employer liability. Can I just note and I hope provide some reassurance there that to my mind, given the literally dozens of reinstatement applications that are currently before industrial tribunals as well as the Federal Court over these very questions, consideration as to what represents good practice and what represents fair practice with regard to medicinal cannabis will be to the benefit of workers and employers, and that will be reflected in long-term practical application.

I also just note the comments both from Ms Terpstra and from Mr Limbrick about the conundrum here and the conundrum of on the one hand weighing up the rights of the primacy of the relationship between the doctor and their patient and on the other hand attempting to try and come to grips with this issue of the level of impairment and what that means practically on a day-to-day basis, and that will obviously be central to the committee.

I note Dr Mansfield’s valuable explanation. It is certainly the first time I have heard that linkage of pharmacology and politics, and maybe that gives a new meaning to the concept of polypharmacy.

Sarah Mansfield interjected.

David ETTERSHANK: Do you like that one? Yes, anyway, on that note, I thank everyone concerned for the process, and I commend the motion to the house.

Motion agreed to.