Insights on Therapeutic Use of Cannabis-Based Products
Cannabis-based products are the subject of keen public interest due to their potential use for therapeutic purposes, says Dr. Stewart Jessamine, Director Protection, Regulation and Assurance, the Ministry of Health.Speaking at the Rotary Club of Karori on 9 May, Dr. Jessamine laid out the pros and cons of the case for therapeutic use, and the related roles of medical practitioners and the Ministry.
There is a growing body of evidence for the use of certain cannabinoids for a limited range of medical conditions: particularly the pain and muscle spasm that occurs in multiple sclerosis, nausea and vomiting associated with chemotherapy, the treatment of chronic pain, and weight gain in HIV infection. New research is also showing promise in the treatment of a range of severe forms of epilepsy that occur in children.
At the same time, the available evidence is that the clinical effects of cannabis in treating many conditions are not good enough to make it a first-line medicine for any condition. Access to cannabis for recreational use remains illegal. Whether used for medicinal or personal use, cannabis contains a number of cannabinoids that affect the brain and that can produce side effects. With chronic use, these side effects can be harmful.
Though some countries (and some states in the U.S.) allow access to cannabis-based products in response to social demand with low or minimal evidence of efficacy, New Zealand and Australia follow a therapeutic model where access is based on clear evidence of efficacy and/or clinical judgment.
The New Zealand approach allows clinicians to prescribe these products with prior approval from the Ministry, with the sole exception of a product targeting multiple sclerosis for which no prior approval is required.
The Ministry has a strong preference for products that are made to specifided standards, with a known and consistent composition of ingredients. These pharmaceutical-grade products allow a clinician and the patient to be reasonably confident that the product is true to label and contaminant-free and to accurately calculate the appropriate dosage.
Barriers to access remain - primarily the high cost of these products and the limited available range. As a result, getting these products into New Zealand can be costly and time-consuming.