Inside Queensland’s medicinal cannabis farm
We are travelling along roads that dip and curl around bends, rain drumming on the car's roof. To take this route, we have turned off the main highway, driving deep into the belly of the Sunshine Coast's hinterland, where it is easy to get disorientated on roads that begin to look the same through the rain-smeared windows.
Eventually, we come to a wooden guardhouse at the bottom of a gully, flanked by mossy banks and looped, dipping vines. The car slows as windows are lowered, identification is checked, and a heavy gate slides slowly open.
A long driveway snakes uphill to a compound ringed with security fences, and when we get out of the car, a guard with shoulders the width of an armchair checks our identification once more. In a courtyard, workers wearing white lab coats look up from their lunches as we pass and are led to a long, low building, the security guard shadowing us.
It all feels very James Bond-esque, as if Doctor No is about to emerge from the building. Instead, the man who drove us to this secret lair and who looks more like a bushie than a Bond villain, smiles broadly as he swipes a security card at the entrance and the doors open.
"So this is Medifarm," says founding director Adam Benjamin, and behind him is what looks a little bit like a Christmas tree farm, but on closer inspection is a sea of thousands of shimmering green cannabis plants.
POTTED HISTORY OF MEDICINAL CANNABIS
While a rose by any other name is still a rose, cannabis - known by a plethora of other names - actually refers to its plant genus and its three species; sativa, indica and ruderalis. Slang terms such as weed or pot refer to the plant's products - its stems, leaves, flowers and extracts, which can be smoked, eaten, ingested, brewed, baked or vaporised.
While these products can be used for recreational purposes - the psychoactive effects resulting in what is commonly known as a "high" - the cannabis plant can also be used for medicinal purposes.
Cannabis can be genetically controlled to produce plants without the main compound that produces the "high", Tetrahydrocannabinol (THC). These plants are genetically modified to produce the active ingredients or compounds, which reportedly ease and treat specific conditions, but largely without the THC - although some strains may contain very small quantities.
It's an important distinction to make because medicinal cannabis is once again on doctors' prescription pads after decades in the pharmaceutical wilderness.
A potted history (pun intended) of non-recreational cannabis use shows that it can be traced back to at least 2737BC when the Chinese Emperor Shen Neng reportedly sipped marijuana leaf tea and prescribed it to others to treat gout, rheumatism, malaria and poor memory.
Queen Victoria's personal physician is believed to have used it to ease the monarch's severe menstrual cramps and migraines. It continued to be prescribed in western medicine until 1937 when the US introduced the Marijuana Tax Act. While not criminalising its use, this Act placed such an exorbitant tax on cannabis products - allegedly because of lobbying by the petrochemical industry who viewed pharmaceutical cannabis as a competitor - that production largely ceased.
Films such as 1936's Reefer Madness terrified conservative America by showing wild-eyed youths going on violent rampages after a single puff of a "marijuana cigarette". In 1961, the United Nations, at its Single Convention of Narcotic Drugs, placed marijuana in its most restrictive category, Schedule IV, effectively labelling the cannabis plant a poison. Subsequently, cannabis became illegal in many countries, including Australia, its medicinal purposes largely forgotten or practised covertly, outside of the law.
But in the past 15 years, there has been a global resurgence of interest and research in the cannabis plant's medicinal abilities. In many countries, legal restrictions have eased or been removed, and its use is now legal (with varying approval requirements) in, or in parts of, Israel, Canada, the US, Germany, Greece, the UK, Africa, South America and Asia.
In Australia, the Public Health Bill (Medicinal Cannabis) was passed under Federal Law on October 31, 2016, allowing approved medical professionals to prescribe medicinal cannabis, and approved pharmacists to dispense it. The Bill opened the doors to a multibillion-dollar industry - with international market research company Global Market Insights recently estimating its worth by 2024 at $77.4 billion.
For sufferers of conditions such as epilepsy or Tourette Syndrome, it also opened doors to an alternative, and some say, more effective, treatment of their symptoms. The most recent sign of the growing interest in medicinal cannabis is the announcement last month by the Australian Resource Centre for Post-Traumatic Stress Disorder (PTSD) of a 12-month clinical trial of 300 people investigating its possible role in treating the disorder, particularly within the armed forces.
All of which means for Queensland companies such as Medifarm - the first of more than 20 Australian companies licensed to cultivate and manufacture medicinal cannabis by the Department of Federal Health's Office of Drug Control - that after months, even years of planning and planting, it's almost harvest time. But producing medicinal cannabinoids is a multi-layered process. So we slip on a hair net, button up a lab coat and duck behind the security doors of Medifarm's huge, connecting greenhouses to see where from little things, big things grow.
FROM LITTLE THINGS, BIG THINGS GROW
Here are the mother plants. They are quite beautiful but they are never allowed to flower. All of the potency of the cannabis plant's 100 or so compounds comes out in its flowers, so this keeps the concentration within the plant.
Cannabis plants are highly light sensitive, so this section of the greenhouse uses controlled lighting to inhibit the flowering process, thus extending the plant's potency for up to a year. Each of these plants has been genetically bred from seedlings to treat specific conditions - from epilepsy to pain relief and nausea, vomiting and sleep disorders.
Medifarm is in partnership with the Israeli medicinal cannabis company Tikun Olam, which is a stakeholder in the company along with a third silent partner. It is Tikun Olam's genetic strains that Medifarm grows, accessing the Israeli's genetic intellectual property, cultivation and production methods - in industry circles this is known as "brains and strains". This includes accessing Tikun Olam's criteria for optimum growing conditions, from the amount of sunlight, specific temperature, amount of water and space needed for prime production.
Hence, in part, the need for such secrecy surrounding the farm's location - these strains are worth money in the lucrative medicinal cannabis market. And for those who don't appreciate the low THC qualities of many of the plants that are grown here, this abundant crop may prove too tempting.
The next chamber in the greenhouse is called "The Incubator". Here, cuttings from the mother plants are placed in rows, and tagged with a letter and number, corresponding with the genetic strain of the mother plant. This is known within the industry as "pharmaco vigilance". In other words, when a patient eventually receives their little brown bottle of cannabinoid oil, they will know its genetic and growing origins; that this oil comes from this plant grown in this place under these conditions and from this mother source. This is helpful, Benjamin says, for keeping track of which particular strains have helped a patient, and maintaining supplies. Each patient may get a unique strain.
Tiny water droplets being sprayed from hoses in the ceiling shower over the plants in the next two sections; the nursery, where smaller cuttings are being coaxed into robustness, and the flowering room, where workers are moving up and down the rows picking off every leaf from each plant. These are thrown into a bucket and destroyed immediately, leaving only hundreds of sticky clusters of buds on each plant, packed with potency, and making this particular section smell a little bit like Woodstock might have.
From here, another set of security doors lead to a purpose-built, manufacturing plant. This is where the flowers are dried, vacuum packed, sealed and stored in a vault until needed for their oil. Then they are brought to a place that looks like a mad scientist's laboratory, all silver gleaming machines and tiny glass bottles. Here - finally - they are placed into an extraction machine to be transformed from agricultural products into medicine; from flowers into cannabinoid oil.
This is what will eventually be prescribed by a doctor for a patient, who will take the script to a pharmacy, to be dispatched by Medifarm, or one of the other licensed producers, and hopefully make someone's life a little easier.
"Are you having a focal?" Lanai Carter asks her son Lindsay. "No mum," he says smiling. "I was actually just trying to remember something."
When Lindsay, 20, has "focals", which he describes as "clouds in my head", he loses the ability to speak or comprehend what is going on around him. They are, in essence, small seizures (although they can last up to three hours) leaving him with a vacant look in his eyes, which make him appear like he's trying to recall something.
But as distressing as these focals are, they are less confronting than the tonic-clonic seizures he also experiences, during which the Loganholme man loses consciousness while his body convulses violently. Usually lasting one to three minutes, a tonic-clonic (once known as grand mal seizures) that lasts longer than five minutes is considered life-threatening. Both types of seizures are caused by a tumour in Lindsay's brain.
He was diagnosed at Brisbane's Mater hospital in mid 2013, after the then-healthy and active 14-year-old suddenly collapsed, and his life since then has been a waiting game from one seizure to the next. It's also been a blur of doctor and specialist visits, trips overseas seeking treatments to reduce his seizures, which, at their worst, can be up to 20 focals a day.
When he is taking his cannabinoid oil, which he ingests orally, or his cannabinoid flowers, which he inhales through a vaporiser, his focal seizures are reduced to between two to three a week and his tonic-clonics to one or two a year. "My life becomes far easier to manage," he says.
Lanai, 46, and her husband Gavin, 48, took their son to the US in 2014, travelling to Washington State, where they had been given the name of a medical clinic that specialises in cannabinoid treatments.
Lindsay lived in Washington State for a year with his parents, travelling back and forth between Australia and the US to fulfil visa requirements. During that time, both types of Lindsay's seizures reduced dramatically.
Back home, one of the frustrations that both he and his mother share is, despite the passing of the Federal Government's Public Health Bill, he is having trouble accessing his specific strains of cannabinoid oil and flowers in Australia.
Lanai says the problem is two-fold - supply and cost. "Lindsay first received medicine from a pharmacy here in August 2016. Since then the supply has fluctuated. At the moment he has a script that can't be filled here. His Australian importer cannot supply it - but even if they could, it is prohibitively expensive."
Supplying their son with medicinal cannabis has come at a huge cost for the family. Lanai, a business student, and Gavin, a control systems engineer, have "wiped out all our savings and all our super".
"The current retail costs for Lindsay's products work out to about $170 to $200 a day if we use licensed importers into Australia, but if we access it from Canada, it's about $132 a day. (If we were in) America, it's about $32 a day - but we have to get to America first," Lanai says.
She is hopeful domestic companies may be able to help Lindsay once they are producing cannabinoid oils. But like many other parents of desperately ill children, she has been on the bureaucratic and medical roundabout for so long, she is cynical about how efficient the supply will be and whether the cost will be prohibitive.
Meanwhile, Lindsay, who is unemployed but says he would love a job if someone is willing to take him on with his condition, has a girlfriend Ella, who he calls "wonderful", and parents he says "have never given up on trying to help me".
"This medicine works for me, and I hope that very soon, people like me will be able to access it easily because I know the difference it can make."
THE PATH TO PRESCRIPTIONS
Carol Ireland, chief executive of Epilepsy Action Australia and a member of the Federal Government's Australian Advisory on the Medicinal Use of Cannabis, says the organisation first "began hearing murmurs" about medicinal cannabis in 2013.
"We were extremely cynical at first," she says. "I'd have to say, we were highly sceptical when we first starting hearing about the use of cannabis to help with epilepsy." But there are now "a considerable number" of examples of medicinal cannabis "greatly helping" some of the 250,000 Australians diagnosed with epilepsy.
"There was a young girl in the United States called Charlotte Figi who has Dravet's Syndrome, which is a very rare and severe form of intractable epilepsy, and whose parents went to great lengths to access medicinal cannabis for her after they had exhausted all other options.
"Her case became quite well known because Charlotte experienced very positive results. When some of our parents, who had children with similar conditions, heard of it, all day every day, parents whose kids experience shocking side-effects and developmental issues - well those parents started to get their hands on medicinal cannabis any way they could.
"They would do mail order, get it on the black market here in Australia, some learnt how to make it themselves. We saw some of the results ourselves, we had patients who were not verbal and not walking, being able to attend school, and so the line we took and take, is that we support them. The problem we have now is not legislation it is access (to the medicine). But I believe that as time passes, this will improve greatly."
In February 2018, the Federal Government relaxed some of its prescription restrictions, and as of last month, 3100 medicinal cannabis scripts have been approved by the Therapeutic Goods Administration. Doctors who wish to prescribe medicinal cannabis can now do so via a TGA online application. Ireland also believes as the Australian market for clinical cannabis expands, competition will increase and prices will drop.
As for the Australian Medical Association, the tone they take is both supportive and cautious. Addiction Medicine Specialist Dr Jim Finn, who is the AMA Queensland past vice-president, says the organisation is "very supportive" of clinical trials currently being conducted across Australia to test the safety and efficacy of medicinal cannabis for several conditions.
Medicinal cannabis advocates and producers say it can improve (in varying percentages) the severity of pain, quality of life, frequency of symptoms and severity of side-effects of other treatments, for patients with cancer, spasticity, epilepsy, Parkinson's, irritable bowel syndrome, Crohn's disease, fibromyalgia, inflammatory conditions and dementia.
Finnsays that while the AMA believes there is some evidence that medicinal cannabis does have efficacy with childhood epilepsy, the organisation is waiting for further Australian results about other diseases and conditions.
"We do have a very open mind on this, but it is very early days in terms of the clinical trials. We need to know exactly what this is effective for, and if it is more effective than the current treatments available. We do not believe it is a panacea, but yes, we do expect it to have some value in some cases in the future.''
HEALTH MEETS AGRICULTURE
For Medifarm founder and co-owner Adam Benjamin, who has a Bachelor of Science and a Masters of Commerce from the University of New South Wales, the proof is in the pudding. Or rather, the research.
Before committing to the medicinal cannabis market, Benjamin, 42, spent months looking into the industry, studying clinical and anecdotal evidence, and researching the history of medicinal cannabis and its potential for the future. He is also founding director of Medicrew healthcare centres - but says his investment in the medicinal cannabis industry is not purely financial.
Benjamin moved to the Sunshine Coast from Sydney in 2012 and married his wife, Stacey, a schoolteacher, in 2015. The couple now has a three-year-old daughter. "Stacey and I have some good friends here on the Coast who lost their eight-year-old boy, Sam to an aggressive cancer," he says. "These are very law-abiding, very respected members of the Sunshine Coast community, and they told me after Sam had passed away that they had given him medicinal cannabis to help with the nausea and side-effects from his chemotherapy, and that it had really helped him.
"He was always going to die, but they said he looked much better and felt much better and that they were willing to do just about anything to help him. So they accessed some (cannabis) for him, and being the people that they are, they went to the police and told them about it.
"The police said 'Mate, we understand but if you are found with it on your possession then we will have to prosecute, it's the law'."
When the law changed in 2016, Benjamin, who had been looking for a business that combined his business and science backgrounds decided he had found it.
"It all added up for me. This is the sweet spot between health and agriculture, and it's both a business and a privilege. It's a very young business but my aim is when we produce our very first oils - by August this year - we will be providing affordable medical cannabis to people that need a consistent supply.
"Costs and accessibility are challenges we are facing, but there will come a day when what once was very confronting and unknown is standard practice. There are a lot of Sams out there."