Cannabis-based products

Cannabis-based products containing cannabidiol (CBD) have been used to help with seizures, muscle stiffness, pain and nausea (feeling sick).

Key points

  1. In New Zealand products made from the cannabis plant for medical use are Class B1 controlled drugs, which means they need approval from the Ministry of Health before they can be supplied or given. 
  2. The exception is Sativex which is used for spasticity (muscle tightness, stiffness or spasms) in people with multiple sclerosis.
  3. Overall the scientific evidence for the safe use of cannabis-based products is not considered strong and there is not enough information to fully recommend its use. 

What are cannabis-based products?

The term cannabis-based products means a product that contains cannabidiol (CBD). 

  • The main cannabinoid found in marijuana (cannabis plant) is tetrahydrocannabinol (THC), which binds to cannabinoid receptors in the brain and causes most of the psychological effects such as elated mood (feeling ‘high'), fast heart rate, dizziness, red eyes and slow reaction times.
  • Cannabidiol (CBD) is a non-psychoactive cannabinoid which means that it does not affect the mind or mental processes and does not have the ‘high’ like THC. 

Cannabis-based products either come from the cannabis plant (marijuana) or they can be synthetic. Synthetic products are man-made chemicals that have the same chemical structure as THC and can bind to cannabinoid receptors in the brain. 

  • In New Zealand products made from the cannabis plant for medical use are Class B1 controlled drugs. That means approval from the Ministry of Health is needed before they can be supplied or given.
  • The exception is for a product called Sativex which is used for spasticity (muscle tightness, stiffness or spasms) in people with multiple sclerosisSativex needs to be prescribed on a controlled drug prescription with approval from a neurologist. More information can be found on the Medsafe website.
  • The New Zealand Government does not support the use of unprocessed cannabis leaf or flowers for medicinal use. For more information see the Ministry of Health website

What are cannabis-based products used for?

Some CBD products have been used to help with seizures, muscle stiffness, pain and nausea (feeling sick).

  • Sativex is the only CBD approved in New Zealand for moderate to severe spasticity with multiple sclerosis if other medicines have not worked. Sativex is sprayed into the mouth. It is not funded so you would have to pay for it.
  • Cannabis-based products have also been used for nerve pain, usually with other types of pain relief, and for other conditions such as anxiety and loss of appetite. 
  • Other cannabis-based products are approved in other countries for nausea and vomiting after chemotherapy, and pain relief.

Do cannabis-based products work?

In some studies for chronic pain, there have been modest to moderate reductions in pain with cannabis-based products. Overall the scientific evidence for the safe use of cannabis-based products is not considered strong and there is not enough information to fully recommend its use. Synthetic products may provide some pain relief for nerve pain in 1 in 11-14 users, but may not be effective for other types of pain.

Dose

The recommended dose is difficult to be sure of because there have been a lot of different products tested. Some are synthetic, some are natural (plant-based and have different strengths from different parts of the plant). Different products have different amounts of cannabinoids, so until there are more reliable products available, it is difficult to know the right dose. There are side effects and dangers of using recreational cannabis for medicinal use because the right dose is unknown.

Side effects

Cannabis-based products are known to cause many side effects. Common mild side effects include:

  • nausea (feeling sick)
  • indigestion, stomach upset
  • stomach pain or cramps
  • diarrhoea (runny poos)
  • dizziness
  • confusion
  • tiredness
  • dry mouth.

Learn more

Sativex® Oromucosal Spray Medsafe, New Zealand
Savitex (Nabiximols) Multiple Sclerosis NewZealand
CBD products Ministry of Health, New Zealand
Prescribing cannabis-based products Medafe Prescriber Updates June, 2017

References

  1. Committee on the Health Effects of Marijuana. The National Academies Press. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
  2. Allan MG, Finley CR, Hauptman R, Beahm NP. Missing ‘high’ quality evidence for medical cannabinoids for pain? Alberta College of Family Physicians, Tools for Practice. 2017 
  3. Whiting PF, Wolff RF, Deshpande S et al. Cannabinoids for medical use; a systematic review and meta-analysis. Journal of the American Medical Association 2015;313(24):2456-73 
  4. Newton-Howes G, McBride S. Medicinal Cannabis, moving the debate forward. New Zealand Medical Journal. 2016; 129(1445)
  5. Walitt B, Klose P, Fitzcharles MA et al. Cannabinoids for fibromyalgia. Cochrane Database of Systematic Reviews. 2016
Credits: Angela Lambie, Pharmacist, Auckland. Last reviewed: 11 Dec 2017