When medically prescribed cannabinoids are inaccessible or ineffective, ‘green fairies’ step in to help. Those in chronic pain deserve better than an ad hoc, black market system, writes Kevin Dew.

“Green fairies” are dealers who provide cannabis products to those who want to access them for health purposes. As well as cancer sufferers, these include people with chronic fatigue, chronic pain and epilepsy.

People with cancer might use cannabis for many reasons, including to relieve pain, to help with the anxieties a cancer diagnosis can provoke, to help deal with adverse effects of chemotherapy or other treatments, and, for some, the (scientifically unfounded) hope that it may extend life and combat the cancer itself.

There are two main routes people can take to access cannabis products for health purposes. One is to have a cannabis product prescribed by a medical doctor. Many New Zealanders do this; the main brand names in this country are Tilray and Sativex. But to use such products requires getting a medical practitioner (many of whom are still dubious about cannabis) to prescribe them in the first place, and then finding the necessary funds to pay for them – because they do not come cheap.

The other route is to somehow find a person who will supply the cannabis from the black market; ideally, the person will know something about the ways cannabis can be used for health-enhancing purposes. People like this are known as green fairies.

I don’t know who first coined the term green fairy or where it comes from, but it nicely distances the activities of green fairies from drug dealers, a distinction that is important to make.

Green fairies are likely to know about the potency of the products they supply, what the different varieties of cannabis are good for, and how to prepare and use the products. Cannabis products for health purposes are not only the dried plant, but also oils and other forms that can be delivered by smoking, consuming and applying.

Some in the medical profession argue it’s unnecessary to legalise cannabis on the grounds of its potential therapeutic properties because cannabis compounds can now be prescribed by doctors. But this is a very narrow view of how cannabis can be used for health-enhancing purposes.

That is not to say that extracting specific compounds or synthesising compounds for mass production can’t be useful. Those prescribed a product like Tilray or Sativex have clearer information about the potency of the drug they’re taking, and they have the added assurance that it has gone through clinical trials.

But this process makes the products expensive and inaccessible to a majority of potential users. Futhermore, for some, the whole herb is regarded as a superior way of enhancing health – because, for example, ‘entourage’ effects are at play. This is the idea that some of the cannabinoids in the plant may not have any effect on their own, but can function to make other cannabinoids in the plant more effective.

Those with medical needs usually require a green fairy to access whole-herb cannabis or cannabis products that are affordable. Green fairies are not found in the Yellow Pages; they have to be encountered through networks and products must be supplied covertly.

This will continue if the New Zealand public says no to legalisation at this year’s referendum. For cancer sufferers and others with chronic health issues, a no vote will decrease their opportunities to try out cannabis, and will mean these sufferers experience ongoing anxiety about breaking the law if they do try that option. And it will continue without oversight from health professionals who could advise on potential side effects and adverse events from cannabis usage.

A yes vote will bring the activities of green fairies into the open – and no doubt attract other entrepreneurs likely to push the current crop of green fairies out of the market. The fairy tale might end, but it’s a trade-off worth making.

Professor Kevin Dew is a health sociologist and Associate Dean Research in Wellington Faculty of Humanities and Social Sciences at Te Herenga Waka–Victoria University of Wellington.