Dr. Peadar O'Grady:

Deputy O'Connell made four points that I wanted to address. One related to a question about the Minister for Justice and Equality. The point is well made. In fact, the concentration on the Minister for Justice and Equality reflects the existing criminal law position. However, we are open to suggestions. As Deputy O'Connell suggested, we would far prefer if the relevant Minister was the Minister for Health. We would appreciate any input with regard to an amendment on that line. We would be very interested in that.

The issue of minors is currently complicated, as probably you well know, Chairman, with regard to the age of consenting to treatment. It might be something to consider further. For most conditions, except for mental health conditions, the age is actually 16 years and not 18 years. However, Deputy O'Connell is quite right to say that 18 years is the legal age defining a child, although under 18 years provided the person is not previously married is the full definition. Strangely, that is the case since an age will not do it on its own.

We are very interested in any input that amends the Bill to facilitate safe access to good quality cannabis-based products. We realise no Bill that gets past Second Stage is perfect. We want the Bill to move to the amendment stage.

Before I address the safety point, I wish to make another point relating to consultants. Deputy O'Connell brings up a good question. Why not treat it like other drugs? As Professor Finn has suggested, there are some reasons cannabis products are not as easy to treat in the same way. Some jurisdictions have used bodies like the HPRA to regulate the use of herbal products or whole plant products. It is possible that the HPRA could do so, but it appears that the HPRA may not be in a position to or may not want to do that.

For any other drug, even restrictor drugs, GPs prescribe. GPs are registered specialists and, as specialists, we did not see any reason it should be restricted when other drugs that are considered to be risky in whatever way are available to be prescribed by GPs.

There are many concerns about safety and knowing the physiology, the effects, the pharmacokinetics and the pharmacodynamics of a drug. For many drugs that work, particularly in my field of psychiatry, the way in which a drug acts is poorly understood and much of what is put forward as the way in which a drug works is merely theory, which is not particularly well-established. There is little long-term evidence of risk or benefit for most of the drugs we use. In the US, up to 10% of boys are on an amphetamine-like drug for which there is no long-term evidence of benefit or risk.

We are appreciative if anybody wants to raise the standard of safety but I refer to Deputy Buckley's question regarding who would benefit. In the US, where cannabis is allowed for medicinal use, the sale and use of opiate painkillers reduces as does the number of people who die from overdoses every year. That amounts to tens of thousands of people. If those figures are extrapolated for Ireland - we have asked the HSE for accurate figures but it does not seem to have them - we reckon hundreds die of opiate overdoses annually, many of whom are at the top end of the dose trying to relieve their pain, in particular. Unfortunately, as they increase the dose to try to get more pain relief, they exceed the toxic level and they die. Nobody has ever died from cannabis use. One of the answers as to who would benefit is people who are near the maximum of their pain medication and who are thinking of increasing it, thereby putting themselves at risk of overdosing. Hundreds of people probably die that way every year and, therefore, making an alternative available to reduce the toxic dose will save lives.

The Barnes report outlines all the people who would benefit if they were allowed access on the recommendation of their doctor. Professor Barnes has done fantastic work and his report is well worth reading. Every condition mentioned would be made available for access. Anyone suffering from those conditions would be able to access medicinal cannabis under this Bill. The answer to the question of whether Vera Twomey's six-year old daughter, Ava, would benefit is absolutely and categorically "Yes".