The medical cannabis debate has arisen again in Australia and New Zealand, but what is its current status and how might liberalisation affect members of our communities? There are two fairly entrenched schools of thought on this issue. One is that total cannabis prohibition is denying people with cancer, HIV/AIDS or other chronic or terminal conditions access to biochemical compounds within the prohibited drug's pharmacological composition that might have medical benefits and that therefore, medical cannabis should be decriminalised specifically for the use of people with the aforementioned medical conditions. Accordingly, Compassion Clubs have arisen within the United States to dispense medicinal cannabis and some of the first were in the US "gay capital", San Francisco. Whether or not this leads to the next step, decriminalisation of recreational cannabis, is a moot point. There is some destigmatisation of cannabis use going on within the United States and several jurisdictions have done so recently. Many more US states have specifically decriminalised medical use, however. The alternative perspective is that medicinal cannabis is a public relations ploy to soften opposition to decriminalisation of recreational cannabis. Proponents of this view argue that research that suggests 'benefits' from medical cannabis use is poorly designed, short-term and provides meagre support for their position. However, it is difficult to counter adverse perceptions of cannabis prohibition that result from police or security agency raids on elderly or terminally ill 'medicinal' users. In the United States, venture capitalists have moved into the cannabis debate, enhancing its mainstream appeal and enabling distribution networks, whether for medicinal or recreational use. In Australia, it looks as if the Turnbull administration is moving toward decriminalisation of medical cannabis. Even United Future's Peter Dunne has stated some guarded support for a clinical trial of cannabis derivatives for the use of palliative and analgesic care. Recreational cannabis use is a distinctive area of debate in this context. It may offer specific threats and difficulties, as well as strengths and opportunities. If cannabis is decriminalised overall, it should still be an offence to provide teenagers under eighteen with cannabis, as well as knowingly supply it to people with schizophrenia and related mental health conditions, as the drug is developmentally injurious if subject to early use, and can induce cannabis psychoses amongst those genetically susceptible. Some might argue that in terms of magnitude and scale, the severity of cannabis use effects is secondary to that of P/crystal methamphetamine as the latter can also cause psychoses, but of greater magnitude and duration. Even if recreational cannabis use is decriminalised, there still needs to be interdiction of access to P/crystal meth, whose current Class A Misuse of Drugs Act 1981 status is wholly necessary. Particularly for gay and bisexual men, as it enables unsafe sex in our context and places us at HIV risk. Unfortunately, in New Zealand, the cannabis liberalisation lobby tend to be their own worst enemies. While the Aotearoa Legalise Cannabis Party commands fifth position within New Zealand party politics and indeed, outpolls ACT and United Future, it is a single-issue purist organisation, which has damaged the Greens voter share on more than one occasion, and the National Organisation for Reform of Marijuana Laws seems too diffuse to specifically focus on identifying pro-reform candidates in this context. Moreover, another problem results from the candour of ALCP and its addled "Mild Greens" offshoot. Incremental political reforms are usually the best way to achieve greater magnitude social change later. But no, Mild Greens ruminations have gone even beyond acknowledgement of recreational cannabis derivatives, even going so far as to advocate comprehensive drug decriminalisation. Whatever the merits or otherwise of the Dutch model's Revised Opium Act 1976, which did so, that policy debate lies decades in the future in the New Zealand context. New Zealand's cannabis decriminalisation lobby needs a strategic upgrade and focused incremental lobbying to achieve its various objectives. Sadly, its continued ineptitude means that some liberal social reformers have dismissed the cause out of hand and are campaigning on other issues. Which is a shame, given its utility for HIV+ people at least. Recommended: "Cannabis and HIV/AIDS" in Julie Holland (ed) The Pot Book: Toronto: Park Street Press: 2010. "Work on medicinal cannabis bill underway" 3 News: 02.07.2015: http://www.3news.co. nz/ nznews/work-on-medicinal- cannabis-bill-underway-2015070 216 Craig Young - 27th October 2015