Cannabis-based products containing cannabidiol (CBD) have been used to help with seizures, muscle stiffness, pain and nausea (feeling sick).
- Currently there is only one pharmaceutical grade cannabis-based product available in New Zealand called Sativex, for use in people with multiple sclerosis. Authorisation from the Ministry of Health is not required for this use.
- Sativex may be prescribed for people with other conditions but they need approval from the Ministry of Health before it can be supplied or given.
- Overall the scientific evidence for the safe use of cannabis-based products is not considered strong and there is not yet 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, and slow reaction times.
- Cannabidiol (CBD) is a non-psychoactive cannabinoid which does not seem to 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.
What is medicinal cannabis?
The term ‘medicinal cannabis’ refers to cannabis used to treat a medical condition or symptoms. This includes unprocessed or partially processed plant material and products from natural or synthetic cannabis.
Cannabis-based products in New Zealand
Products for which Ministry of Health approval is not required
- Currently, there is only one pharmaceutical grade cannabis-based product in New Zealand called Sativex, which can be prescribed for people with multiple sclerosis to improve symptoms of moderate-to-severe spasticity (muscle tightness, stiffness or spasms). Its use must be endorsed by a neurologist. Sativex is available as an oral spray and is not funded, which means that you have to pay for it.
- Cannabis-based products with 98% or more CBD (a non-psychoactive component of cannabis), and containing no other controlled drug or psychoactive substance, do not require Ministry of Health approval. Currently, there are no products like this approved in New Zealand.
Products that require Ministry of health approval
- Sativex may be prescribed for people with other conditions but it needs approval from the Ministry of Health.
- Cannabis-based products that are manufactured by pharmaceutical companies overseas needs approval from the Ministry of Health before they can be prescribed.
- Non-pharmaceutical grade cannabis-based products, (manufactured by a company outside of the pharmaceutical industry) need approval from the Ministry of Health before they can be prescribed.
To prescribe an unapproved cannabis-based product
- The patient must have had an adequate trial of all available conventional treatments for their condition, at appropriate doses and duration, and these treatments have not provided benefit, are not tolerated or are contraindicated
- The patient must provide informed consent that they understand the nature of an unapproved product, including a reasonable estimate of its benefits and risks.
- Applications must be endorsed by a relevant specialist, e.g. a neurologist for the treatment of a patient with epilepsy. Applications need evidence of potential beneficial effects of the product for the treatment of the condition and known adverse effects, and a plan for how the treatment will be administered and withdrawn if the patient has adverse effects or does not benefit from the product.
- Once an application has been approved, information will be provided on how to obtain the product.
Unprocessed cannabis leaf or flowers
The New Zealand Government does not support the use of unprocessed cannabis leaf or flowers (marijuana, also called pot, dope and weed) for medicinal use. For more information see the Ministry of Health website.
Do cannabis-based products work?
Overall the scientific evidence for the safe use of cannabis-based products is not considered strong and there is not yet enough information to fully recommend its use. One of the main issues is that there are limited pharmaceutical grade cannabis-based products available for use. Limited evidence suggests that cannabis-based products may provide some improvement in symptoms for people with:
- seizures associated with refractory epilepsy such as Dravet syndrome or Lennox-Gastaut syndrome
- chronic pain, especially nerve pain
- nausea and vomiting caused by cancer therapy
- weight gain with HIV infection
- Tourette syndrome.
Trialing a cannabis-based product is only a suitable option for people who have ongoing symptoms after trying available conventional treatments. Evidence is lacking to support the use of cannabis-based products for depressive disorders, post-traumatic stress disorder (PTSD), Parkinson’s disease, Alzheimer’s disease, glaucoma and Crohn’s disease.
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.
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)
- dry mouth.
No studies have yet assessed the long-term adverse effects of cannabis-based products.
Traveling with cannabis
New Zealand law allows people arriving in New Zealand to bring up to one months’ supply of a controlled drug, as long as they have been lawfully supplied in the country of origin for the purpose of treating their medical condition. Cannabis-based products supplied in the United States are not considered lawfully supplied under federal legislation and cannot be carried into New Zealand from the United States. Some other countries also have limitations in place restricting people from leaving the country with cannabis-based products. For further information on bringing medicines into New Zealand, see bringing-medicines-new-zealand.
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
Summary of approvals required to prescribe cannabis-based products Ministry of Health, 2017
- Medicinal cannabinoids: current regulations for prescribing BPAC, 2018
- 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, The National Academic Press, 2017
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- 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
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- Walitt B, Klose P, Fitzcharles MA et al. Cannabinoids for fibromyalgia. Cochrane Database of Systematic Reviews. 2016