When people talk about cannabis, it falls into one of two categories: Medicinal cannabis (legal) or Recreational cannabis (currently illegal in New Zealand).

Medicinal Cannabis is comprised of two main cannabinoids: Trans-delta 9-tetrahydrocannabinol (THC) and Cannabidiol (CBD)—the New Zealand Ministry of Health’s Medicinal Cannabis Agency defines medicinal cannabis products as the following: A medicinal cannabis product can be a dried cannabis product or a product in a pharmaceutical dosage form (e.g., tablets or capsules) that contains one or more cannabis-based ingredient(s) and no other prescription medicines or controlled drugs. You will also read about cannabis for therapeutic use.

CBD products are the most common type of medicinal cannabis product. CBD products have potential therapeutic value and contain little-to-no psychoactive substances. These products are typically available as capsules or in a liquid form suitable for taking orally. CBD products are prescription medicines and are in no way breaking the law.

Other medicinal cannabis products may contain THC or other psychoactive substances found in cannabis. These products may be available as tablets or capsules or in a dried form that can be administered through a medical vaporiser or for use as tea. These products are also legal.

Dr. Jason McDougall, from Dalhousie University (Canada), offers a very useful definition of cannabis:

“Cannabis is a very complicated plant. There are hundreds and hundreds of different chemical entities that are in cannabis, and we are only just scratching the surface of understanding what those different cannabinoids are and what they can do. The two main ones that are investigated are THC, which is tetrahydrocannabinol, and that’s the psychoactive part of cannabis, that’s the part that gives the feeling of euphoria and highs…. The other main component is cannabidiol or CBD, and CBD is non-psychoactive. It can make you feel a little sleepy, but it doesn’t have that euphoric effect associated with it.” The psychoactive part of cannabis, that’s the part that gives the feeling of euphoria and highs…. The other main component is cannabidiol or CBD and CBD is non-psychoactive. It can make you feel a little sleepy, but it doesn’t have that euphoric effect associated with it.”

Cannabis was first made available in New Zealand for therapeutic purposes in 2010, although under strict guidelines – approval was required from the Minister of Health to prescribe. In 2017, CBD products could be prescribed more widely by General Practitioners (GPs) without the approval of the Minister of Health – although the Ministry of Health still required approval to prescribe from 2017 until 2020. It took a further three years for products containing THC, the principal psychoactive cannabis compound, to be prescribed by GPs without government approval.

Even though some prescription products have a THC component, you shouldn’t feel “high” or “euphoric” from these. Products with a THC component over 15% can lead to the “high” feeling that some want to avoid, and in New Zealand, there is one product with 8% THC is available through prescription, so you can rest assured that when you are getting a prescription, you won’t be getting “high”.

Different concentrations of THC and CBD correlate to different pharmacologic effects, and having higher concentrations of CBD does not take away the “high” or “euphoric” effects of THC, so the THC concentration matters most. High-potency cannabis (>15% THC) is counter-indicated for medical use, meaning it is not advised and could have more negative than positive effects.

If you have any adverse reactions when taking cannabis or any other medication, notify your GP as soon as possible.
Visit the Medsafe website for further information about adverse reactions. You can also report adverse reactions to the Centre for Adverse Reactions Monitoring (CARM).

Why are more people using therapeutic cannabis than there are people accessing prescription (legal) cannabis products?

While the number of products becoming available under the 2020 scheme is increasing, the number of people accessing legal prescription cannabis products isn’t as many as those who are using cannabis therapeutically for two main reasons;

1. Doctors aren’t confident in prescribing or are hesitant to prescribe due to the lack of scientific evidence and
2. They are expensive. Primarily due to the regulatory regime that includes licencing fees (these can be more than NZD$20k and need to be renewed periodically) and stringent compliance requirements with significant financial burdens, including the security of cannabis production sites, quality compliance and product assessments.
Going down the prescription route is safe but expensive and the only way to access cannabis legally in New Zealand currently.

References

Medicinal Cannabis Agency – Information for consumers | Ministry of Health N.Z.

 

‘Why does my knee hurt’, https://www.jointaction.info/podcast/episode/e629f8d1/why-does-my-knee-hurt, 20 April 2020.

Pennypacker SD, Cunnane K, Cash MC and Romero-Sandoval EA (2022) Potency and Therapeutic T.H.C. and CBD Ratios: U.S. Cannabis Markets Overshoot. Front. Pharmacol. 13:921493. doi: 10.3389/fphar.2022.921493

Hutton, F.Noller, G. and McSherry, A. (2023), “Patients experiences of therapeutic cannabis consumption in New Zealand”, Drugs, Habits and Social Policy, Vol. 24 No. 2, pp. 117-132. https://doi.org/10.1108/DHS-12-2022-0049

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