Wednesday, 8 March 2023

Road Safety Amendment (Medicinal Cannabis) Bill 2023

Second reading

Debate resumed on motion of David Ettershank:

That the bill be now read a second time.

Harriet SHING (Eastern Victoria – Minister for Water, Minister for Regional Development, Minister for Commonwealth Games Legacy, Minister for Equality) (10:14): I rise today to speak on this really important subject matter and the bill that has been put before the Parliament. At the outset I do want to acknowledge the work of Ms Payne and Mr Ettershank in this place and indeed a former member of this place, Ms Patten, on this particular issue, which is complex, which has a sense of pressing urgency to it and which warrants very careful consideration of the matters at hand as they relate to the alleviation of pain and of symptoms of chronic illness – congenital and acquired illness and disease – as they relate to the rights of people to be able to get around but also to be able to get around safely, as they relate to the legal interface between presence and impairment and as they relate to our never-ending work and the never-ending work of every government, optimally, to recognise and to combat the road toll and the devastation of loss that is occasioned on our roads.

So there is a lot of context to this, and one of the things that we as a community and indeed more broadly across other jurisdictions have been grappling with for some time recognises the complexity of this issue around the interface between presence and impairment. In 2020 there was a debate in this place as a consequence of a related procedure and bill brought by Ms Patten, which was then the subject of work with a working group of which I was a part alongside Ms Patten and many stakeholders who have a very keen interest in this particular policy area and who bring a range of perspectives to it informed by expertise and by lived experience on the importance of medicinal cannabis to wellbeing and to opportunities to participate in a range of ways in life which we all take for granted and in the law enforcement components of any discussion around road safety and what that means.

It is appropriate that this particular bill is couched in terms of an amendment to the road safety legislation. I do want to acknowledge the work of advocates on the ground from a range of perspectives, whether that is road trauma survivors and their families or whether it is people who have access to and get the benefit of medicinal cannabis. We are proud to have worked to deliver medicinal cannabis access here in Victoria. There is a young man by the name of Cooper who would be well known to many people not only in this Parliament but more broadly. Cooper became a very real face for the case for medicinal cannabis. It was Cooper’s many conversations with the Premier and indeed with others, with the help of his parents and indeed a broader range of supporters, that brought this issue to the fore around the very, very real and significant benefit that medicinal cannabis can provide to people in a great deal of pain and people who want to be able to access freedom from seizures and from the symptoms of significant illness and disease and who want and deserve a better quality of life.

We have been really proud to lead in a progressive way the discussion on legalising medicinal cannabis. Today any doctor or medical practitioner or nurse practitioner in Victoria can prescribe medicinal cannabis when it is clinically appropriate to do so, with those appropriate levels of state and federal oversight and regulation. This comes down as much as anything else to clinical consistency of the available supply. We know that where we have a regulated process for delivering a product which has a specific range and level of chemical compound we get better and more consistent results throughout the medicinal cannabis access process. We also know that since 2017 patients who have been using medicinal cannabis for treatment – sufferers as I said earlier of severe epilepsy, those with chronic pain conditions – have been, amongst other cohorts, able to be treated safely and appropriately. Over time we have seen a really careful and considered expansion of access to medicinal cannabis to those in need.

So my contribution today is very much informed by the real-world outcomes of and rationale for providing access to medicinal cannabis. My contribution today is also made with those in mind who have lost loved ones on our roads. It is these particular issues coalescing which brings us to the point of this particular bill here today and which actually uncovers the complexity of this particular subject matter.

So there is a really important conversation to continue, and this is not the first time, as I indicated when I got to my feet, that this matter has been brought before this Parliament. It is not the first foray into a discussion about the distinction between presence and impairment. This work has been going on for a number of years now, and the working group has actually discussed at length the complexities of this matter and the options and opportunities that might be available. So we need to have that conversation around what it means to find a way through all of this so that all drivers are able to be safe on our roads and so that we can provide those medical supports that Victorians need and indeed deserve.

At the moment, there is no agreed standard or best practice when it comes to road safety and driving with medicinal cannabis. Unlike – and this was discussed at length in the working group – alcohol, testing for and defining impairment is not actually straightforward in a roadside environment. A universal access to, for example, a .05 limit for THC – an equivalent for the blood alcohol content standard that we apply to drivers here in Victoria – does not currently exist. Road users are responsible for safety on our roads, and every single member of this chamber and indeed the community wants to make sure and is driven by the importance of messaging and results that make it clear that when you get into a vehicle, when you take control of a vehicle, you are acting in a safe way and that when being a road user or being someone proximate to a road network you can come home safely to your loved ones and to your friends.

But as I said, this is a really complex area. Careful thought and consideration of this issue has been undertaken for some time now, and it is also necessary and appropriate that that work continue. We want it to be put to good use in this conversation about public health, about access to treatment and about making and keeping our road environments safe. We will, and want to, engage meaningfully in a process with Ms Payne and Mr Ettershank on this issue, and over the course of the coming months I am hopeful that that work established by the working group can continue. I know that Ms Payne and Mr Ettershank will be meeting with the Minister for Roads and Road Safety, or at least I am told that that will be happening, and the Minister for Roads and Road Safety will be in a position to engage on exactly the issues that make this subject matter so complex. In the next month there will be opportunities to progress this work. As I said in my opening remarks, there is a sense of purpose and there is a sense of urgency about how we progress this work, and this is a conversation which I am optimistic will enable this work to continue.

We also recognise that there is not presently a way to distinguish between medicinal cannabis and recreational cannabis. This is something that the working group has grappled with, and it is something which, at the heart of the issue, goes to the impact of impairment, irrespective of how that impairment has arisen. As I said earlier, we do not currently have a way of testing if people are taking medicinal cannabis as a consequence of a prescription or on the basis of recreational activity. We know – and it has been said in this chamber before – that there are more than 65,000 people who are currently using medicinal cannabis in Victoria with a script from their doctor or nurse practitioner and who cannot currently drive. It is important to recognise in this whole debate the impact of that prohibition on driving and therefore on participation in everyday life, without sustaining considerable cost and inconvenience to them, again speaking to the complexity of this issue. It is an issue that needs to be addressed, as I said. It is a significant priority for the government.

I have made comments in this place before, in speaking to Ms Patten’s private members bill in 2020, that are entirely consistent with what it is that I am saying now, and I have been further informed by the work of the working group. We do not want as a government to impede patients’ access in approved circumstances to medicinal cannabis. That would run counter to the objectives and the rationale for the introduction of a framework to enable medicinal cannabis access in this state. We do not want to make people’s symptoms worse as a consequence of a withholding of or a winding back of the framework by which medicinal cannabis is able to be accessed.

The government has been really grateful for the engagement that we have been able to have to date with crossbench members and particularly with Mr Ettershank and Ms Payne. It is acknowledged and indeed you have made us aware that you are staunch advocates for medicinal cannabis patients and the importance of the issues that they face and that they experience. Over the coming months we will as a government engage in good faith to make sure that we can progress this issue with a view to achieving meaningful solutions.

The bill itself is pretty self-explanatory, and we need to make sure that in talking about road safety we are also acknowledging the reality of the loss that is sustained across the state for a range of reasons and in a range of ways. We know that there are a range of factors that reduce or impede or impair drivers’ ability to operate very dangerous machinery, which is what vehicles boil down to, on our roads. Things like fatigue, the presence of alcohol, the presence of drugs, mobile phone use and distraction – these are the elements which are over-represented in fatal collisions on our roads. These are things which also need to be considered in this particular debate.

We introduced safety belts here in Victoria. We were leaders in doing that back in 1970 as a mandated requirement for road use. We introduced and legislated random breath testing in 1976, and we introduced speed cameras, which we know have an impact on reducing the speed at which motorists use our roads. These things in combination have seen the road toll drop and drop significantly, but tragically, people continue to be hurt and to be killed on our roads. Just today we have seen a report around the comparative increase in road deaths here in Victoria over the past three years. Around 67 people have lost their lives on Victorian roads this year. Obviously, we know that reduced road traffic over the last couple of years makes that figure somewhat challenging to analyse and to interpret, having seen the return in large numbers of motorists to our roads as everyday work and movement ramps up.

However, we have got a lot of work to do. We have got a lot of work to do to make sure that the families of those lost to road trauma have their views and perspectives recognised and to make sure, as I said earlier, that we recognise the users of medicinal cannabis – those 65,000 people with prescriptions, those 65,000 people whose carers, whose families and whose loved ones benefit from the impact of medicinal cannabis in pain management and in management of illness and significant disease.

What I would really encourage people to do in this work is to engage in good faith. As I have said, the government is committed to doing exactly that. I want to make sure that as we work alongside Road Safety Victoria and as we work alongside the framework for medicinal cannabis, which we know realises benefit for people who desperately need and indeed deserve it, we can continue our work to bring our road toll to zero to make sure that families are not left grieving, to make sure that our tables are not missing one person at Christmas and to make sure also that people living with significant illness and significant pain are respected in this conversation.

I do not intend to go to the chemical compounds of THC. I do not intend to go to the pharmacological breakdown of the impact of medicinal cannabis upon the physiology of users and the way in which that blocks pain receptors, reduces nausea and therefore improves and increases appetite. This is well known. It is well canvassed. The working group has gone to a lot of detail on the benefits of medicinal cannabis, and this is not a debate about the merits of the scheme, which we legislated. We do want to make sure, however, that we are working across various levels of government, that we are working across other jurisdictions, and make sure that we are reducing and eliminating risks across our road network. There has been a focus in what I have said today on the roads component of this issue. That is because of the anchoring of this proposal in the road safety legislation. I hope it will not be construed as anything else, and I also hope that the comments I have made about the validity, the importance and the benefits of medicinal cannabis are not lost in the context of what I have said here today.

I commend Mr Ettershank and Ms Payne on their work – you are here in the chamber; your work – to raise the voices as advocates for those who use and indeed rely upon medicinal cannabis. I commend the efforts of those people who tell often really difficult and painful stories about the extent to which pain and illness and disease impact upon people’s opportunity to live with dignity and with autonomy and with independence. I also commend, acknowledge and send my respect and ongoing condolences to those survivors and indeed the families, friends, colleagues and community members who still miss people lost to road trauma. We have a lot of work to do. We are determined to do it in good faith. Thank you for bringing this particular bill to the Parliament. I look forward to ongoing conversations and to continuing to engage not just with the Minister for Roads and Road Safety but across a range of other portfolios should that be a matter of relevance to this particular framework. It is a good starting point, as it is anchored in the road safety legislation, but thank you for your work and your advocacy. On that basis, I will leave my contribution there.

Matthew BACH (North-Eastern Metropolitan) (10:34): I am really pleased to rise to make a contribution on behalf of the coalition parties on the Road Safety Amendment (Medicinal Cannabis) Bill 2023, and in doing so I will seek to perhaps not match Minister Shing in terms of erudition but nonetheless strike a not dissimilar tone. I want to thank Mr Ettershank and also Ms Payne for bringing forward an important bill that deals with an important issue, and I think at the outset I would say that in our current system there is significant unfairness towards entirely legitimate users of medicinal cannabis. I echo the concerns that Minister Shing has put forward about safety on our roads – absolutely I do. I am also very hopeful nonetheless that technological advances will allow us, hopefully very, very soon, to be in a position where we can deal once and for all with the unfairness in our current situation, which Mr Ettershank and Ms Payne are highlighting in this bill, towards again entirely legitimate users of medicinal cannabis.

Members of the house of course are aware that in Victoria, police roadside testing currently tests for alcohol – quite rightly – and various illicit drugs via mouth swab tests, which presently can only test for THC, MDMA and methamphetamine, I am advised. But of course it has been central to the ongoing debate about medicinal cannabis and seeking to enable entirely legitimate users of medicinal cannabis to go about their lives and access opportunities in the way that other members of communities do that these tests only test for the presence of drugs. So a driver taking drugs or having THC in their system will test only positive or negative, and in any event, unlike alcohol, there is no agreed level of THC that relates to impairment. These are significant problems as we seek to ensure that our community is as safe as possible first and foremost while also dealing with the unfairness in our current arrangements.

It is a point that has been well made by proponents of these sorts of measures – Ms Payne, Mr Ettershank, Ms Patten, who it was great to catch up with this morning and speak to about these matters – that medicinal cannabis is the only legally prescribed drug that is screened for in swab or blood tests. Then users of medicinal cannabis, who have every right to be using medicinal cannabis and for whom medicinal cannabis is really important, could be charged or lose their licence if it is found in their blood system. Motorists taking other prescribed drugs like antidepressants, perhaps opiates, even antihistamines, may be impaired for driving purposes, but these drugs are not tested by police. I do not mind saying to the house, I do not mind saying on behalf of the opposition, that we see and we note the unfairness in that arrangement.

According to the government, and these were figures that Minister Shing quoted in her fine contribution, there are some 65,000 current users of medicinal cannabis in Victoria, so this is no small cohort. I suppose I would want to assure the ongoing proponents of legislation like this that on this side of the house, as is undoubtedly the case on the other side of the house, we do not see this as some niche issue; we are talking about a significant number of Victorians who currently have their freedom significantly restrained because of the current arrangements.

I note some different arguments from members of the Legalise Cannabis Party, and I do not discount those arguments, but I would say that my understanding is that any impairment after taking medicinal cannabis would normally only affect a person for a matter of hours. At the extreme end we know of course that THC can remain in a person’s bloodstream for up to a month. So then, if I understand correctly, for that entire length of time somebody who has taken medicinal cannabis, who seeks to move around in their car – and most of us move around in our cars most days – would be liable to significant fines, to significant penalties. In the media over recent days there have been any number of I think really quite compelling case studies of how users of medicinal cannabis have been heavily restricted in their day-to-day lives. I was talking to one journalist this morning who worked on what I thought was a very fine piece in the media just today about some of the case studies that she had been dealing with. I confess if that was me, I am not sure how I would be able to function. I do not think I could function. I could not do the sorts of things that I need to do in my day-to-day life. I could not have done the sorts of things that I needed to do in my day-to-day life when I was teaching just a few years ago, before coming to Parliament. So this is a very significant issue for the large number of Victorians, and growing number of Victorians if I understand correctly, who use medicinal cannabis.

Our view is that there is clearly an inconsistency in the current arrangements. A driver could take heroin, a driver could take cocaine or any number of prescribed medications before getting behind the wheel, but these would not be picked up. Unless they are obviously impaired, police would never know. Meanwhile a medicinal cannabis user could be completely unimpaired by THC, test positive and then lose their licence.

I will not necessarily recapitulate the points Ms Shing made on road safety, but I echo them and I agree with them. I know members of the Legalise Cannabis Party agree with those points – we all do – and that we want to seek to do everything we possibly can to continue to drive down the road toll in Victoria. There have been concerns raised by some groups about what a change like this would mean, notwithstanding the fact that the current arrangement is unfair. I hear those concerns, and as a chamber of course we would never want to do anything that might lead to an increase in the road toll. We want to continue to do everything we can, working together, and I agree with the points Ms Shing made about actions of the current government to seek to reduce the road toll. She was so good as to refer to a number of changes that have been made historically by former coalition governments. So we have worked together across the major parties and with minor parties of the day, all of us of course in good faith, to seek to reduce the road toll. So I will not recapitulate her arguments, but I do want it noted that I echo them.

I will just read briefly from a couple of points that have been made by certain groups about where they see we are currently in this important discussion. The Monash University Accident Research Centre has said this:

Given the recency of medicinal cannabis programs and the international experience on managing driving, there are a number of questions that remain outstanding.

I hear concerns of that nature, and not wanting to verbal the minister, she more or less said the same thing. The accident research centre at Monash said there are various international models that could be adopted but each has a social context that needs to be accommodated. The key point, said the accident research centre at Monash University, is that some further research needs to be carried out to understand this area properly, particularly understanding the relationship between levels of drug and impairment. I hear concerns of that nature.

In a briefing provided helpfully by the government to members of the opposition the government referred to analysis by the Victorian Institute of Forensic Medicine from 2019 of 5000 drivers injured in motor vehicle accidents. The government put it to us that it found any level of THC in the blood increased the risk of crash versus a drug-free driver. Okay, I accept that. But I would note again that presently users of medicinal cannabis, who undoubtedly, overwhelmingly, are community-minded citizens seeking to do the right thing while managing their own medical issues, do not seek to move around by car – of course, overwhelmingly, do not seek to move around by car – during a period of impairment. But we just do not have the tools presently, so says some information helpfully provided by the government to the opposition and so say some other groups, to properly test for that impairment.

On this side of the house, as Ms Shing said also, we are really keen to continue to work with Mr Ettershank and Ms Payne. It has been really good on a personal level to already have had some discussions with Mr Ettershank and Ms Payne, and it has been great to carry on discussions with a former member of this place who is really passionate about these issues. They are significant issues; they are not niche issues. There is significant unfairness in our current systems, and my hope and the earnest hope of the coalition is that we can continue to work together and continue to look at emerging technologies to deal with that unfairness in a way that not only does not make our roads less safe but indeed makes them more safe in the very near future.

Aiv PUGLIELLI (North-Eastern Metropolitan) (10:44): I am pleased today to speak in support of the Road Safety Amendment (Medicinal Cannabis) Bill 2023. The bill makes a very reasonable minor change that ensures medicinal cannabis is treated with the same standard as other prescription medication under the Road Safety Act 1986. That is it; that is the bill. This change really I think should have been made alongside the legislation passed in 2016 that enabled access to medicinal cannabis for some patients in Victoria. Instead we have seen I think an unfortunate delay in action on this issue. But now we have an opportunity, importantly, to collaborate and make change for the betterment of our community.

So let us be clear about what we are debating here. Currently there are people in Victorian for whom driving is an automatic criminal offence with drastic penalties if they have even trace amounts of their prescription medication in their body. We are not talking about levels that impair driving ability or levels beyond their prescription, we are talking trace amounts. Currently in Victoria people who are prescribed pain management medicine, opiates or benzodiazepines can drive safely, and they are allowed to drive, yet we see an exception to this with regard to medicinal cannabis. The bill before us simply makes a small change so that it would not be an offence in itself for a person to drive with blood or oral fluid containing THC from medicinal cannabis that is prescribed by a medical professional and taken in accordance with that prescription.

Would this mean that the person prescribed medicinal cannabis has a green light to drive in an impaired manner under the influence of drugs, risking safety on our roads? Absolutely not, because driving a motor vehicle while impaired by a drug would still be a serious offence under the Road Safety Act. Other jurisdictions with very strong road safety records already provide similar provisions, and I and my colleagues consider this bill to be consistent with the expert evidence and findings of the parliamentary inquiry into drug law reform in 2018 and inquiry into cannabis use in Victoria in 2021. There is still a long way to go, and we look forward to the implementation of more of the long overdue reforms that were canvassed in those inquiries.

We need a broader adoption of a sensible health-led drug policy in this state. We need the government to maintain an evidence-based pathway to establishment, for example, of safe injecting rooms. We need to follow the growing number of Australian jurisdictions which are introducing pill testing. It is a broad conversation, drug harm reduction. There are many areas of drug policy we need to see reformed to bring them into line with expert evidence-based advice. There are several that I would say to date we have seen a degree of neglect from the government on. However, we have now not a moment of expediency but an important opportunity to act on this issue. This oversight with regard to this particular legislation has existed since the legalisation of medicinal cannabis in 2016 and, as has been noted in the chamber, has already been the subject of a private members bill from Fiona Patten. This whole time the government has had the legislative lever to pull that could fix this issue affecting many medicinal cannabis users in Victoria, but again I note this is a time for opportunity. Here we are.

The Greens support this bill, and we commend the Legalise Cannabis Party for bringing this debate before the house today. I and my colleagues have always advocated for drug reform that focuses on evidence and harm reduction instead of punishment or more baseless moralising. We will keep pushing for the abandonment of the ‘tough on drugs’ approach in favour of one that recognises the reality of drug use in Victoria and sees it as a health issue rather than a criminal issue. We will keep pushing, for example, like I mentioned, for pill testing in our community, for legalised and regulated recreational cannabis and for a sensible approach to drug policy. This change certainly does not fix the aspects in which our current drug law system is broken, but it is a very good place to start, so I thank the chamber.

John BERGER (Southern Metropolitan) (10:49): I rise to express my opposition to the proposed amendment to the Road Safety Act 1986 that would allow for the treatment of medicines and cannabis in the same manner as other prescription drugs. The current form of the legislation does not consider the practical end point of its stipulations. I will always advocate for policies that prioritise the safety and wellbeing of our citizens, and this amendment goes against that principle. When the Andrews government legalised medicinal cannabis in 2016 we listened to the science behind it and its safety benefits in exceptional medical cases, because we believe in ensuring that Victorians have the best quality of life.

We also believe in listening to science. For example, the evidence supports the use of medicinal cannabis to treat severe pain associated with cancer and chemotherapy, severe muscle spasms, migraines and the worst one of all, cluster headaches, alongside other conditions. I believe I speak for my colleagues here and in the other place when I say that no Victorian should feel that they cannot seek care when they need to due to the road safety laws. We are a government that proudly backs health. We are a government that knows how to make tough decisions on health.

Our government listened to the Royal Commission into Victoria’s Mental Health System and has committed to implementing the recommendations. In 2016 our government legalised medicinal cannabis for those who need it. Yet our government knows that one life lost on the road is one too many. The amendment is to the Road Safety Act 1986, and therefore road safety needs to be at the heart of the matter and how we assess the bill. We are a state that has been a leader in road safety. We led the introduction of life-saving road safety policies, including mandating seatbelts, legislating random breath testing and introducing speed cameras. Our government will continue to put the lives of Victorians on the roads first.

Just like we listened to the evidence to support medical cannabis, we need to listen to the science with regard to our road safety. There is growing evidence of driving with THC increasing your risk, but how do we quantify it? Many aspects of medical marijuana usage are patient specific. The dosages, the effects, the pharmacology and the medicinal marijuana may be different based on the condition treatment plan or the form of medical marijuana. We cannot make laws on variables or that are patient specific. The motor skills impact of medicinal marijuana is heavily impacted by the dosage and the form of marijuana. A recent road safety study conducted by the Victorian Institute of Forensic Medicine investigated a sample of 5000 seriously injured Victorian drivers, showing that THC at any level almost doubles the risk of a car crash compared to the drug-free driver.

Moreover, this level of risk is comparable to a blood alcohol concentration of .05, which constitutes a drink-driving offence in Victoria. Yet unlike alcohol, a clearly recognised .05 blood reading limit for THC does not exist. This is because THC is handled by the body differently. On top of that, how do we enforce it? The preliminary impairment assessment usually requires two members of the police to conduct the testing and it then takes at least 20 minutes to complete. Should the preliminary screening return a positive result, a further sample is required alongside a forensic test. This makes it almost impossible for our law enforcement to make a fair and accurate judgement on the road. On top of that, how can testing be distinguished between recreational and medicinal cannabis use in this instance?

We have already lost 67 Victorians on the road this year; therefore our government cannot in good conscience agree to this. The existing settings are not intended to punish those under the influence of substances simply for the sake of punishment. This is supported by a survey conducted by Monash University Accident Research Centre, which found that while 93 per cent of respondents were aware that it is illegal to drive with cannabis in their system, 44 per cent of the respondents with a valid prescription had at least once previously supplemented their prescription by obtaining an illegal preparation of medicinal cannabis, which again introduces more variability in the effects on their system. Additionally, advice provided by health professionals about driving varied considerably, with 16 per cent of the respondents not receiving advice and 30 per cent told not to drive while feeling affected or to wait a few hours after taking medicinal cannabis before driving. The Department of Health is researching to measure the driving performance and cognitive function of Victorians prescribed medical cannabis in driving simulators, but it has been delayed due to COVID-19. But the reality is simple: rules are there to protect the community, to protect drivers and passengers, to protect pedestrians and to protect the hardworking drivers that work tirelessly, supporting our freight industry.

I have been fighting most of my life for the Transport Workers Union. Forty-one per cent of the transport workers know a driver who was killed at work, and 50 per cent of them have witnessed a serious accident at work. One in four have been involved in a crash while driving. The Transport Workers Union safe rates, safe roads, safe skies campaigns are testament to the importance of road safety, and we cannot allow this amendment to undermine the progress that has been made toward creating safer roads for all. At this point in time allowing the use of medicinal cannabis while operating a vehicle runs the risk of letting impaired drivers onto our roads. We must consider the potential risks this poses to other drivers on the roads. We know that cannabis use can impair judgement, reaction time and coordination – three attributes of a driver that are essential to keeping our roads safe. We cannot afford to have drivers under the influence of this drug on our roads.

Furthermore, this amendment would put workers at risk. The Transport Workers Union has long fought for safe working conditions for truck drivers, and allowing for the use of medicinal cannabis while driving would undermine their efforts. We cannot compromise the safety of workers who are already at risk of injury or death on the job. It would not be fair to the working people of the transport industry who call their worksite their home.

The amendment would allow individuals to use medicinal cannabis while operating heavy machinery. This is a serious threat to the safety of all our road users. This is unacceptable and goes against the principle of protecting the basic liberties and rights of all citizens. It violates their basic right to safety. We continue to make efforts to make the roads a safer place for those who work on them. This is shown in our efforts in cooperation with other states, the Commonwealth and the National Heavy Vehicle Regulator. It would be an insult to the workers in our transport industry to, while we are making these efforts to make our roads safe, then turn around and give drivers the go-ahead to operate vehicles when inebriated. It is wrong and it is unsafe.

We must consider the consequences of this amendment carefully. Our top priority must be to create safer roads for all, and this amendment would only serve to undermine those efforts. The risks are simply too great to ignore. Loosening the laws around inebriation on the roads sends a message that the right to drink and drive is more important than the right to safe travel for all road users. This is not only unjust but also irresponsible and dangerous. We must continue to strengthen laws around drug-driving, not take a backwards step. Any amendment that suggests that any form of inebriation while driving is acceptable sets a scary precedent.

A 2020 study at Monash University found that over a five-year period 41 per cent of motorists in fatalities were found to have illicit drugs in their system, including cannabis-based material. This bill proposed would legalise the operation of vehicles under the influence of these substances – substances found in the systems of 41 per cent of road accident victims. According to the Transport Accident Commission random breath testing has saved over 20,000 lives in Australia over the past four decades. The TAC also highlighted that Victoria was the first state in Australia to introduce RBT, leading to a 25 per cent reduction in fatal crashes involving alcohol within just two years. The numbers show it; the facts show it. RBT and the laws around inebriation keep Victorians safe; they keep Victorians alive.

The government is always open to debate on policy on this substance. This legislation must be more thought out. It does not consider company policies on inebriation for workers. It does not properly consider enforcement. It does not consider how it is to be judged. So let me be clear: we must reject this amendment. Until we can confidently and conclusively test for impairment our drug-driving laws must stay as they are. Our priority must be to create safer roads for all, and allowing for the use of medicinal cannabis while driving without the ability to test for impairment would undermine the goal. We cannot compromise the safety of our citizens, road users or transport workers. We must continue to prioritise the safety of all Victorians and do so by rejecting this amendment.

Georgie CROZIER (Southern Metropolitan) (10:59): I rise to speak to the Road Safety Amendment (Medicinal Cannabis) Bill 2023 presented by Mr Ettershank from the Legalise Cannabis Party in relation to this issue. I want to thank him and Ms Payne on the record for the briefing that was provided to me and the Leader of the Opposition in relation to this issue, which they obviously are very passionate about, having brought this bill into the house to be debated today.

I listened to Mr Berger then, who is in clear opposition and stated the government is in opposition to it and made some points around safety aspects. I understand those safety aspects, and I think there are some concerns in relation to those. I want to come to that, because I sat on an inquiry in the last Parliament into the use of cannabis in Victoria. That was not solely on medicinal cannabis, it was largely on recreational cannabis, but it did touch on the medicinal cannabis issue and the very real issue of what we are debating today.

What this bill is proposing is a simple amendment: the bill will amend the Road Safety Act 1986 to provide that medicinal cannabis that does not impair driving must be treated in the same manner as other prescription drugs. As has been pointed out, there are other drugs – benzodiazepines and other opiates – that are prescribed for medical conditions that have a clear warning when they are being dispensed to not operate machinery or drive if you are impaired, and there is no test for that. I understand exactly the argument around medicinal cannabis that the same should be applied. I think that is what is being asked here – that what applies to those drugs that are prescribed in a medical form should similarly be applied to medicinal cannabis that is prescribed.

Those in this house that have been here for some time know that I am a supporter of medicinal cannabis, and I have made my position very clear for many years. I understand that there is still some ambiguity for certain practitioners who have a different view. They do not think it has the aspects that some claim it has, and there is still some doubt about its efficacy in relation to pain management and other issues. I think over time we will be able to see more as more data comes out. It is important that we look at all those aspects, and I think Dr Bach outlined very clearly some of the concerns in relation to what has been put to us around this issue in relation to some of those safety aspects and driving and what Victoria Police have said. I want to note what Victoria Police said in the inquiry into the use of cannabis in Victoria, which I was on and Ms Patten, who introduced a similar bill in 2020, was also on. Assistant Commissioner Glenn Weir from Victoria Police told the inquiry:

As both illicit and medicinal cannabis contain the psychoactive constituent, Delta-9-Tetrahydrocannabinol (THC), they are both known to reduce a driver’s ability to have full control of a vehicle. Cannabis can slow down reaction times, distort perception of speed and distance, reduce concentration when driving, particularly in response to emergency situations. This creates a risk for the driver, but also other occupants of the vehicle and other vehicles on the roads around the affected driver.

I understand that, and I think that is the issue here, because we do not have an ability to really test that impairment or to measure the level of THC. I take the point that has been made in terms of THC that it can obviously be found in recreational cannabis but also in medicinal cannabis, and some have expressed their concerns around that very point. That seems to be where the concerns are.

I note also that the task force that has been spoken about – the medicinal cannabis and safe driving working group and its report Assisting Medicinal Cannabis Patients to Drive Safely – undertook an extensive inquiry, and there are some excellent points in that. I think they draw out these issues that I have just spoken about and also confirm that more data is coming on at an international level from international jurisdictions. I think that is prudent. We need more data. I think we need to see that. I think that we need to understand exactly the impacts of cannabis. We need to understand how it can be tested and the impairment levels. Of course there is another very reasonable argument being put: it depends on the size of the person, their make-up, the medical condition and a whole range of other aspects around the individual that might have a tolerance to one drug over another. I think that is a very reasonable point to be putting. That is why I think more needs to be undertaken in this area to see what is going on, because one person’s resilience in terms of being able to tolerate a drug based on their physical capacity will differ from another’s. It is a little bit like blood alcohol, but we do have a blood alcohol level, .05, and we can test it. I think that is the difference and that is the issue here.

I think there are some excellent points in this report. I note that this report is hundreds of pages long on this issue and that the Ryan report, which was released yesterday, had 25 pages around the injecting room in North Richmond. I make the comparison because they are two important areas of public health policy around drug use: 25 pages versus this report – hundred of pages – versus this report, many hundreds of pages. I was disappointed in that report, and I will say more about it later on in the day.

Returning to this important bill, there are concerns around some of those aspects. I certainly do want to acknowledge the work that has been done by Mr Ettershank and Ms Payne on this issue, because obviously they have, as I said, got a very clear opinion on what they think needs to be done. I note that when we did have that briefing Mr Ettershank told me that there were 75,000 prescriptions that have gone out from the TGA. The Premier said there are 200,000 users, or 200,000 that have use medicinal cannabis, that those numbers are increasing and that it is not just for pain, it is for insomnia and other conditions. We need to see why those issues are getting such big take-up as well in the use of medicinal cannabis and understand what other health aspects there are around people that have these conditions and require this.

With those few comments I would like to again reiterate Dr Bach’s comments around the work being done and the continuation of work that needs to be done on this issue.

David LIMBRICK (South-Eastern Metropolitan) (11:07): I rise to speak on the Road Safety Amendment (Medicinal Cannabis) Bill 2023. I would like to congratulate Mr Ettershank on his first private members bill and thank him for introducing this matter for the consideration of the Parliament.

Any members who were here for the last term of Parliament would know that our unjust drug-driving laws are something that I am very passionate about. In April 2021 I tabled a petition calling on the Legislative Council to give consideration to recommendation 24 of the inquiry into drug law reform and refer the matter to the Legal and Social Issues Committee to inquire into alternative drug-driving regimes and changes that address the concerns of medical cannabis patients. Things in politics move slowly, but the Premier’s statements over recent weeks in regard to this matter are encouraging.

I have been contacted by many constituents over the last four years who have been impacted by our drug-driving laws. Some of these people were medical cannabis patients. Others simply consumed cannabis for their own reasons. The fundamental flaw with our approach to drug driving in contrast to our drink-driving laws is that the mere presence of some illicit drugs in a person’s body can result in the loss of a licence. This occurs without any allegation that a person’s driving is impaired. In fact they can be the safest driver in the world with an unblemished driving record and completely sober, but if they have consumed cannabis, possibly the night before or even days ago, they are at risk of losing their licence. At its core this can only be described as an injustice.

Nobody would disagree that reasonable efforts should be made to ensure that impaired drivers do not create hazards on our roads. However, impaired drivers are not targeted by our drug-driving laws. For medical cannabis patients this injustice is even more pronounced. Many people are put in the position of choosing between effective medical treatment and mobility. They can either be well or drive without risk of losing their licence. Medical cannabis patients, prescribing doctors and others that I have met in the sector have explained to me that patients do their best to comply with road safety laws, often forgoing their medication during the day to ensure there is no possibility of impaired driving and consuming cannabis in the evening. This is no guarantee that they will not be charged with a drug-driving offence, however, as cannabis can remain at detectable levels long after its effects subside.

One patient that contacted my office last year told how this had impacted him. He was using medical cannabis to relieve symptoms of post-traumatic stress disorder related to his time serving in Australia’s defence forces. While driving one day, a truck collided at some speed with the vehicle behind him, causing it to roll into his vehicle. This was quite a serious collision, and while he was clearly not at fault, he made the mistake of honestly disclosing his status as a medical cannabis patient when asked by one of the responding officers. This led to a drug test, which detected cannabis, and an ongoing legal battle to retain his licence. I fully support this bill introduced by Mr Ettershank and hope that we see some policy reform in our drug-driving laws as soon as possible.

Rachel PAYNE (South-Eastern Metropolitan) (11:11): I am pleased to rise to speak to this, the very first bill introduced into this Parliament by Legalise Cannabis Victoria, the Road Safety Amendment (Medicinal Cannabis) Bill 2023. As brand new MPs in only the third sitting week of a new Parliament term, to have this private members bill introduced, second-read and now in debate speaks to our passion on this issue. I hope it is a signal of the work ethic we present as MPs and as a political party and of the work we intend to bring to this chamber.

Medicinal cannabis is a lawful pharmaceutical medicine, and this bill seeks to achieve one simple action: to treat this medicine in the same way as every other prescription medication under the Road Safety Act 1986. If you are prescribed a medicine by your doctor, you should be allowed to drive a car provided you can drive safely. But under our current law, a minute trace of medicinal cannabis can trigger a positive roadside test and lead to prosecution, conviction and the loss of a drivers licence, even days or weeks or even a month after the medicinal cannabis was taken or capable of having an impairing effect. It is unfair, it is stigmatising and it prevents Victorians from accessing the very medical treatment that can quite literally save their lives.

Being well or allowed to drive should not be a choice. Our bill aims to fix that. It provides a medical defence for a driver who is not impaired and whose blood or oral fluid contains a lawful medicinal cannabis product that is prescribed by a medical professional and taken in accordance with that prescription. This type of medical defence already exists for all other medicines in Victoria and exists for medical cannabis in Tasmania and in other jurisdictions around the world.

It will transform lives for many Victorians, like Alice Davy, a 33-year-old mother of two. Her eldest is primary school aged and her youngest is now almost two years old. Alice sadly suffers from multiple sclerosis. Without medication she visibly tremors, but with medicinal cannabis she is steady and she can function as a young mother and as a driver of a motor vehicle. Alice is prescribed an unimpairing CBD medication that she microdoses during the day. She takes a single dose of medicinal THC at night before sleep. Under that treatment regime she is unimpaired and safe to drive approximately six hours before she takes the wheel for her morning school run, and she would never compromise the safety of her young family. Alice is acting responsibly and taking the most effective treatment for her condition to live the best and most functional life she possibly can for her and her young family. She should not be punished for that. A roadside drug test that detects a trace amount of THC in her system should not cost her a financial penalty and the mandatory loss of her drivers licence. Alice is the reason our driving laws should change. She is not alone. Thousands of other Victorians find themselves in a comparable situation each day. In fact in Victoria there have been over 4300 prescriptions for medicinal cannabis issued in February this year alone. This needs to be a priority, and we need to find a solution for these patients.

Today I am heartened that in bringing this matter to the chamber we will see true progress. I thank the Premier for his positive public commitments and Minister Shing, representing the Minister for Roads and Road Safety, for reaffirming the government’s commitment in this chamber today. We are heartened that this is a priority for the government and look forward to working with them in good faith to find a genuine solution over the coming months.

I would like to acknowledge the opposition, Ms Crozier and Dr Bach, for acknowledging the significant unfairness for medicinal cannabis patients and the unfair testing regime that medicinal cannabis patients are subject to – the fact that there is either a positive or a negative result and it does not actually measure impairment. I would also like to particularly thank Ms Crozier for talking about and acknowledging the work that was done in the inquiry into cannabis reform and some of the findings that are in there. I think the government would be well advised to review some of those findings in due course. I think that we can find a sensible path forward for all Victorian patients, and the Premier raised this in the media this morning.

I would like to acknowledge Mr Puglielli and in particular acknowledge that he made reference to the fact that legalising medicinal cannabis was first enacted in 2016 and that this should have been part of that reform. This bill aims to fix that mistake.

Mr Berger, I do acknowledge your concerns in relation to testing impairment. But as with all medicine, your doctor provides that advice as to your ability, and no, we are not asking for patients to be allowed to operate a vehicle when under the influence. We all agree no-one should be operating a vehicle if impaired.

Mr Limbrick, I thank you for your reflection on your constituents’ experiences – some of them are obviously medicinal cannabis patients – and the fact that they are consciously consuming their medicine to ensure that they are not impaired when driving. I think that this story rings true for many Victorian patients.

We have seen significant advancement in the science of THC impairment over recent years. We are aware of, for example, some still unpublished research on real-world Victorian medicinal cannabis patients that demonstrates no measurable change in driving performance before and after those patients have used their prescribed medicinal cannabis. It is time for us to make this change. This is medicine. The stigma associated with cannabis creates bias, even if subconscious. It shifts perception. If we just remove the word ‘cannabis’ from medicine and just treat it like medicine, it should be treated like all other medicines.

What we are considering here is medicine prescribed by a doctor, where a doctor explains its side effects: how that medicine interacts and how it may affect a person’s ability to drive. It is a medicine, and we hope very soon it will be treated just like any other. We are buoyed by the progress that we have made today.

Jacinta ERMACORA (Western Victoria) (11:18): I am pleased to speak on the Road Safety Amendment (Medicinal Cannabis) Bill 2023. I congratulate David Ettershank and Rachel Payne for bringing this forward. It is an important piece of work, and it addresses challenges faced by a small group of people in the community who deserve our concentration and best efforts to get their rights met. I also appreciate the mix and diversity of contributions that have happened in the chamber so far. This adds value to the discussion and the next steps in this process. In particular I appreciate the perspective of the transport sector, which is one perspective and will be part of the ingredients of the whole outcome here.

The government’s position is that this piece of legislation is important to resolve, and it is supportive of the intent of this legislation. In fact the government is determined to find a way to make this happen. I will describe here the work that is being done – funded – by the government to achieve an evidence base that can support that, which we do not yet have.

The people that are affected by this are people legitimately prescribed cannabis as a medicine within the legal suite of medicines available, and it seems odd to all of us that a person can be legally prescribed a medicine but not allowed to drive with traces of that medicine in their system. Most of our lived experience is that prescribed medicines do not restrict your driving; there are only a small number that do. This is a group of people who have often been previously prescribed mainstream pain relief, but it has not worked. It is wonderful that they are now able to receive medicinal cannabis thanks to the Andrews Labor government. There are a small percentage of people who experience complex illness and complex comorbidities for whom this particular situation is very important.

The working group that emerged from the previous presentation of this bill came up with a number of recommendations that relate to exactly the concerns that we have, which we are yet to resolve on this. The working group identified the need for additional research, which is ongoing at this time, and I am very pleased that the Andrews Labor government has funded much of that work.

Today, as this bill is debated again in 2023, the role of medicinal cannabis is increasing as a therapeutic option for some individuals with chronic health conditions, and some of these patients have a genuine need to drive, whether it is for work, to stay connected with community, for treatment or just their right to drive. The information that we need to understand, and I guess you would call it a grey area, particularly relates to measuring the rate or the levels of THC in the blood system. As yet we are unclear about a scientific methodology that is evidence based and peer reviewed that will be able to be accepted as a legitimate measure on a roadside. It would be awesome if we could just use the same mechanism as we do for blood alcohol. The second point is: where is the line where capable driving ends and impairment starts? In that regard we are looking for that .05 line for THC. We also do not have that. One of the gaps that contributes to that is the difficulty of knowing whether THC or the medicine was ingested one day ago, 29 days ago or 30 days ago; it is difficult to know. At the moment we can only see externally the human being and whether or not we think they are impaired, but we are used to more of an evidence base with blood alcohol.

Trying to achieve that level of confidence so that we can enlist our community in being confident in this is really important. That is why the Andrews government through the deliberation of the working group has funded a number of further research projects to ascertain scientifically peer-reviewed studies on these questions. The questions have been already comprehensive but are not quite conclusive enough yet. Two such recent studies have been completed that assist us to gain more understanding of the effects of THC. The first study investigated the likelihood of detection of medical cannabis and THC using roadside drug testing. The second study, at Monash University Accident Research Centre, was a survey of over 270 individuals prescribed medicinal cannabis in the past two years. The results of both these studies produced very interesting data and demonstrate that there is a need to ensure patients prescribed medicinal cannabis are given consistent evidence-based advice on safe driving at the point of prescription.

So we are not there yet. The government has now commenced the development of a standardised decision support tool to support prescribing practitioners and patients. There is also a standardised clinical tool being developed for patients to safely self-regulate their driving patterns. This is clever, and it is smart to put tools in place that are addressing road safety for the whole community as we did with blood alcohol concentration. In addition, there is more work to be done ongoing, and in my opinion this complex issue needs to be followed through to the point where we are completely satisfied that we are ensuring road safety in Victoria. The government is committed to getting to that destination, and the evidence of that commitment is shown in the funding for the research and the position on this issue today.

Sonja TERPSTRA (North-Eastern Metropolitan) (11:26): I rise also to make a contribution on the Road Safety Amendment (Medicinal Cannabis) Bill 2023, and in doing so I have had the benefit of listening to all contributions in the chamber today. I just want to congratulate everybody in the chamber for the way they have conducted themselves during this debate. I think we are actually at our best at the moment, which is a really nice thing to see. It is rare in here sometimes when that happens.

In having listened to everyone speak today, I was actually finding myself agreeing with just about everything that everyone was saying in the sense that this is a complex issue. There is a lot of goodwill on the part of not only this government but also everybody in this room to recognise, perhaps, the role that medicinal cannabis has in the lives of people who are suffering, whether it be chronic pain or psychological symptoms, and this is a rare thing. I am actually going to say I agree with a lot of what Mr Limbrick had to say in his contribution. There you go. That will never happen again, Mr Limbrick. But I do agree with a lot of what you had to say as well. That is why I am saying that as legislators in this chamber what is being demonstrated today throughout the course of this debate is a lot of goodwill and really the intention to recognise the different circumstances of different people in our community and what they are going through and suffering, like I said, whether it is in a physical sense or a psychological sense.

What I am about to say is not really a criticism of our system, but when we develop rules, whether it is road rules or testing regimes for whatever it be, whether it is alcohol, drugs or whatever, things evolve. These things are fluid over time as we find that there are other things that come onto the market that might relieve suffering. It is appropriate that we review our systems and look at how we can make sure we accommodate people who are availing themselves of new treatments and the like. It is not the intention to punish people because they are suffering, it is just a function of our system perhaps having some rigidity or some inflexibility not to recognise these new things. I think sometimes as legislators we are a little bit slow to respond to things. We look at what happens around the world – there are some countries that are faster or quicker than others that respond to these things – but we have got to make sure that we get it right as well because, as Mr Berger said, there is a very important issue around road safety that we have got to make sure that we get right.

I think what everyone has essentially touched on in this chamber is the complexity and the difficulty around analysing impairment. What is impairment? As a motorcyclist I can tell you every day when I ride on the road I am hyperaware of what other drivers are doing. Why? Because not only do we have distracted drivers but we have people who are impaired, and they can be impaired just because they are tired. I know some drivers will be impaired to the same extent as someone who has a .05 blood alcohol reading, because they are tired. I know that when I leave this chamber after an all-nighter I am exhausted because I have not had sleep. It takes me two days to recover, and I am impaired for two days. So I get it. I get it. Again, it is a very challenging question. It is not an easy question to answer. We have heard Ms Crozier talk about a lot of work that has been done in some of the reports that have been done; I know, Ms Payne, you talked about all those things as well. So this is not easy.

The other part to it is that when we talk about alcohol, for example, I am a small female, and I know the way that I metabolise alcohol is quite different to perhaps a larger male and somebody who might consume alcohol and be quite functional at .05. I probably would not be in the same place. There are differences in physiology that people exhibit as well. I am not saying that is the case for cannabinoid and cannabis consumption. I do not know enough about it to make that comment, but I do know that having lived a life and having consumed alcohol in the past, my tolerance for alcohol is a lot lower. I really would not feel comfortable getting behind the wheel and driving even after I have had one drink, because I just do not metabolise alcohol well. So there are individual differences as well that are really hard to accommodate and take account of, and that is why trying to find an adequate test and how we determine what is impairment is going to be, I guess, the $64 million question. Like I said, what is impairment? How do we distinguish between recreational and medicinal cannabis use? It is all incredibly, incredibly complex.

I note some of the commentary about what the current regime is, and I guess for alcohol there was a lot of work done around .05 looking at what the test was. There was a legislated limit. That is the limit that we are going to determine for people – that it is not safe to operate a vehicle once you get to that point. Is that appropriate for this? I do not know. They are all the things that need to be explored.

I note in Ms Ermacora’s contribution she very aptly put what the government’s position is on this. Having said that, our government’s intention is pretty clear. We do not want to punish people for trying to alleviate their suffering. We know that there is lots more discussion to have, and we look forward to continuing the conversation in the weeks and months ahead on this particular issue. I know that many people have referred to the Premier’s comments this morning and earlier, really, on this matter in terms of saying that it is something that we need to look at. Like I am saying, there is a lot of good intention there, but we have got to get it right. Rightfully there are people who are concerned about road safety and the like – Mr Limbrick’s story about the guy who got rear-ended and then pushed into somebody else and then ended up being found to have been under the influence and lost his licence et cetera. There are going to be swings and roundabouts, for want of a bad pun, when we are talking about road safety, about people who are going to be okay out of this situation and people who are not and are going to be ill affected.

It is a difficult, complex situation, but like I said, I just want to congratulate everybody on the way they have conducted themselves in this debate today. There is a lot of goodwill, not only in the chamber. I just want to keep encouraging all of us to keep going. Just because something is a difficult issue it does not mean we should avoid it. Sometimes doing the right thing is a really hard thing to do, but we should never shy away from that. That is the responsibility we have when we get elected and come into this place to legislate. Doing the right thing can sometimes be incredibly hard, but we should never shy away from that.

Nicholas McGOWAN (North-Eastern Metropolitan) (11:33): I rise to laud the object of this bill. I find some sympathy with the arguments put. I am particularly moved in any public debate by the desire to seek a fair outcome, and it strikes me that currently there are no fair outcomes. It is not lost on me the importance of ensuring that when we do make changes, those changes are made – I think as the honourable member opposite said – on an evidence base. So I for one look forward to the work of the government and the crossbench and the Liberal Party in this case – all of us working diligently to make sure that it is done with some haste. For me what is critical is haste. If anything comes from this bill, it is haste – and that can be said for reforms needed across the board, including in bail reform, and we have talked about that over some days and some weeks – because as it currently stands, those who are afflicted with these, in some cases, diseases and chronic ill health, their lives I cannot begin to imagine, because if they are doing the right thing by the law currently, they are not driving. They are prohibited from driving or they are driving under threat of being pulled over and being prosecuted under the current law. So the time and the day where we can have a system and we can measure and we can ensure the safety of everyone is something that I would welcome. I welcome the bill today. I look forward to the work that needs to be done, and I hope that can be done, as I said, with great haste. I look forward to being part of that.

Lee TARLAMIS (South-Eastern Metropolitan) (11:35): I move:

That debate on this bill be adjourned until later this day.

Motion agreed to and debate adjourned until later this day.