Commonly asked questions about cannabis-based products

The term cannabis-based products covers several types of products that may be prescribed to treat various medical conditions.

On this page, you can find the following information:

What are cannabis-based products?

Cannabis-based product is the preferred term for any product containing cannabis or a cannabinoid. Cannabinoids are chemical compounds found in the plant Cannabis sativa, also known as marijuana. They can also be human-made (synthetic). There are more than 100 identified cannabinoids. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the most studied of the cannabinoids and the most commonly included ingredient/s in cannabis-based products. They may be present as individual ingredients or together in a combination.  ​

Cannabidiol (CBD) Tetrahydrocannabinol (THC)
  • This is a non-psychoactive cannabinoid, which means that it does not affect your mind or mental processes and does not give you a ‘high’ like THC does.
  • This is a psychoactive cannabinoid.
  • THC binds to cannabinoid receptors in your brain and causes most of the psychological effects such as elated mood (feeling ‘high’), fast heart rate, dizziness and slow reaction times.
  • Potency or strength depends on a number of factors such as the plant age, plant genetics, harvesting and processing.

What is medicinal cannabis and is it different to recreational cannabis?

Medicinal cannabis is a dried cannabis product or a product in a pharmaceutical dosage form (eg, tablets or capsules) containing one or more cannabis-based ingredient(s) and no other prescription medicines or controlled drugs. Medicinal cannabis is used for medicinal purposes to relieve the symptoms of a medical condition. It should only be trialled when conventional treatments have been unsuccessful. You must have a prescription from a doctor registered to practice in New Zealand before you can be supplied any medicinal cannabis product. 

Recreational cannabis is the use of cannabis without any medical reason for the purpose of getting ‘high’.

In what forms is medicinal cannabis available?

Medicinal cannabis is usually available as:

  • oral drops, lozenges or capsules
  • mouth spray
  • a form that can be inhaled via a medical vapourisor device (non-combustion)
  • gel or patches that are applied to your skin.

A product does not classify as a medicinal cannabis product if it is in a form intended for smoking, a food or a sterile dosage form (eg, eye drops).

Do medicinal cannabis products in New Zealand meet a quality standard?

On 1 April 2020, the Ministry of Health's Medicinal Cannabis Agency began accepting applications from medicinal cannabis product suppliers to assess their products. The purpose of an assessment is to establish whether the product meets the medicinal cannabis minimum quality standard. The minimum quality standards provide prescribers with confidence in the quality and consistency of any medicinal cannabis products they prescribe to their patients. It also improves patient access to quality products.

For a list of medicinal cannabis products that meet the minimum quality standard, or are approved, see medicinal cannabis products that meet the minimum quality standard. A range of further medicinal cannabis products will become available over time as suppliers of medicinal cannabis products apply to the Medicinal Cannabis Agency to assess whether their products meet the medicinal cannabis minimum quality standard.

The Medicinal Cannabis Agency does not at present assess products for their safety or efficacy. However, one brand of cannabis, SativexTM (oral spray containing cannabidiol + tetrahydrocannabinol), is approved for safety and efficacy (in addition to quality) in patients with multiple sclerosis.

Do I need a prescription for medicinal cannabis?

You need a prescription from any doctor registered to practice in New Zealand before you can get any medicinal cannabis product. With a prescription, your doctor or a pharmacy will dispense the product. You cannot buy medicinal cannabis products online or from a third party.

Your doctor knows your medical history, including any other medicines you are taking, and is best placed to advise you on the risks and benefits of using medicinal cannabis products.

If the medicinal product is approved

If the medicinal product is approved to be prescribed by the Medicinal Cannabis Agency, you need a prescription from any doctor registered to practice in New Zealand to get the product. Also, the doctor needs to be satisfied that there is a clinical need for the product and that prescribing it is within their scope of practice. The medicinal cannabis product can only be dispensed from a doctor or a pharmacy.

For products that have not been approved

For products that have not been approved by the Ministry of Health, the prescriber needs to apply for approval from the Minister of Health on specialist recommendation for a particular patient for a specific use. For more details on the considerations when assessing these applications, see ministerial approvals

Savitex

Sativex contains both THC and CBD. It is available as an oromucosal spray (mouth spray) and is not funded, which means that you have to pay for it. Savitex is approved in New Zealand for use in people with multiple sclerosis to improve symptoms of moderate-to-severe spasticity (muscle tightness, stiffness or spasms). Any other use of Sativex is an unapproved use of this medicine in New Zealand. Any New Zealand-registered medical practitioners can prescribe Sativex. Read more about Sativex.

Can I import medicinal cannabis products from overseas?

Personal imports of medicinal cannabis products are not allowed. You can only get medicinal cannabis products from a New Zealand-registered medical practitioner or a New Zealand pharmacy that is importing the medicinal cannabis products on behalf of the medical practitioner.

At this time, any medicinal cannabis product is considered to have a therapeutic purpose and will be treated as a prescription medicine when imported. This means that you cannot import medicinal cannabis products for personal use, such as cosmetics, beauty products, jewellery or any other products that contain cannabis.

Do cannabis-based medicinal products work?

The scientific evidence for the effectiveness and safe use of cannabis-based products is not considered strong. In general there is not yet enough information to fully recommend their use. One of the main issues is that there are limited pharmaceutical grade cannabis-based products available for use and there is a big variability in the quality of products used.

Certain cannabis-based products may provide some moderate improvements in symptoms for people with:

  • multiple sclerosis-associated spasticity
  • seizures associated with refractory epilepsy such as Dravet syndrome or Lennox-Gastaut syndrome
  • chronic pain, specifically nerve pain
  • nausea (feeling sick) and vomiting (being sick) caused by cancer therapy.

Trialing a cannabis-based product is only a suitable option for people who have ongoing symptoms after trying available conventional treatments. Medicinal cannabis is not considered a first option for any medical condition.

Evidence is lacking to support the use of cannabis-based products for depressive disorders, post-traumatic stress disorder (PTSD), Parkinson’s disease, anxiety, obsessive-compulsive disorder (OCD), autism, ulcerative colitis, Alzheimer’s disease, glaucoma and Crohn’s disease.

What is the dose of medicinal cannabis?

The recommended dose is difficult to determine due to individual differences. Some people are very sensitive to it whereas others need to use more to produce an effect. Other reasons that make dosing difficult to determine include the following: 

  • Products are not equivalent and have different ratios of CBD and THC, which can affect your body in different ways when used in a combination. This means that finding the right dose needs trying first and then adjusting.
  • Individual differences exist and some find that their dosage needs to change when the product brand is changed.
  • Cannabis-based products intended for inhalation are harder to dose. Flower-based products require the use of a medical vaporizer, which helps control the dose received by adjusting the temperature and amount of product used. However, this is not an exact science and it makes dosing harder to determine.

Doctors usually recommend starting a cannabis-based product at a low dose and gradually increasing it to reduce the chance of side effects. Your doctor will also provide you with guidance on titrating your dose.

What are the side effects?

Cannabis-based products can cause side effects and these differ between products. No studies have yet assessed the long-term adverse effects of cannabis-based products.  Common mild side effects include:

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

The THC component of cannabis-based products is not appropriate for people who:

  • have a personal or strong family history of psychosis
  • have an active mood disorder
  • are pregnant and breastfeeding
  • have heart rhythm problems
  • have had recent heart attacks or strokes
  • have severe liver or kidney problems. 

Can I take cannabis-based products with medicines?

Cannabis-based products have several interactions with medicines and herbal products. This is mostly because of the way they are broken down (metabolised) in your body. Some combinations can have serious effects. Your doctor or pharmacist will be able to check for interactions. If you are taking medicinal cannabis, remember to tell your healthcare provider before starting any medicine or herbal product. 

What are the cautions when travelling with medicinal cannabis?

Entering New Zealand

If you are travelling, you may bring a medicinal cannabis product into New Zealand if:

  • the product has been prescribed to you by a doctor
  • you have a copy of the prescription or a letter from your doctor stating that you are being treated with the product
  • you declare the product on your passenger arrival card
  • you carry the product in its original container, and
  • you are bringing no more than a 3-month supply of a CBD product or a 1-month supply of any other medicinal-cannabis product.

For more information, see bringing medicines into New Zealand.

Taking medicinal cannabis products overseas

Before you travel overseas, make sure you check how medicinal cannabis products are classified in any places you plan to visit or transit through. In some countries, possession of cannabis is a criminal offence, with no exemption for medicinal cannabis products.

Other terms you may come across

  • Cannabinoids: These are the chemical compounds found in the plant Cannabis sativa. There are more than 100 identified cannabinoids. THC and CBD are the most recognised and studied among these.
  • Cannabis: This term refers to the cannabis plants Cannabis sativa cultivated as the source of THC. Cannabis has a THC content of more than 0.35%.
  • Cannabis-based product: This is the preferred term for any product containing cannabinoid. This includes products derived from natural or synthetic components of the Cannabis sativa plant. 
  • Hashish/hash: This refers to the resin derived from the cannabis plant that has a psychoactive effect.
  • Hemp: Cannabis that contains very low amounts of THC in its flowers and leaves (less than 0.35%) is classified as hemp.
  • Marijuana: This is an alternative name for cannabis when it is used as an psychoactive substance. It usually refers to the dried, crushed flowers and leaves.
  • Medicinal cannabis: This refers to the use of all forms of cannabis-based products for medical purposes, that is, to treat a medical condition or symptoms. ‘Medicinal cannabis’ is not a preferred term as the majority of products do not meet the criteria associated with a medicine.
  • Hemp seed: These are the seeds of the Cannabis sativa plant. The seeds do not contain THC or CBD. Other parts of the plant (eg, leaves and flowers) contain THC and CBD that could contaminate the seed if not processed correctly.
  • Hemp seed oil (also known as hemp oil): This is obtained by pressing hemp seeds. Classified as a food, it does not contain THC or CBD. It is not to be confused with CBD oil.
  • Synthetic CBD products: These are CBD products that have been synthetically manufactured or isolated other than from the cannabis plant. Currently, no non-cannabis-derived CBD products have been approved by Medsafe.

Learn more

Sativex® Oromucosal Spray Medsafe, NZ
Savitex (Nabiximols) Multiple Sclerosis NZ
CBD products Ministry of Health, NZ
Medicinal cannabis scheme Ministry of Health, NZ
Medicinal cannabis agency Ministry of Health, NZ

References

  1. Medicinal cannabinoids: current regulations for prescribing BPAC, NZ, 2018
  2. Committee on the Health Effects of Marijuana. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research The National Academic Press, 2017
  3. 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
  4. 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.
  5. Newton-Howes G, McBride S. Medicinal cannabis: moving the debate forward New Zealand Medical Journal. 2016; 129(1445).
  6. Walitt B, Klose P, Fitzcharles MA et al. Cannabinoids for fibromyalgia. Cochrane Database of Systematic Reviews, 2016
  7. Mouhamed Y, Vishnyakov A, Qorri B, et al Therapeutic potential of medicinal marijuana: an educational primer for healthcare professionals Drug Healthc Patient Saf. 2018 Jun 11;10:45-66.
Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 25 Jun 2021