GPs shy on medicinal cannabis

Medicinal cannabis is legal for more Kiwis than ever but good luck finding a doctor who will prescribe it.

Research published in the New Zealand Medical Journal shows more than half of New Zealand GPs surveyed had been asked by patients for a medicinal cannabis prescription during the past year.

However, of 76 GPs surveyed only eight managed to get their patients access to medicinal cannabis and most had concerns about prescribing in the future.

Separately, GPs told Stuff requests from patients for medicinal cannabis were increasing, amid loosening laws and a looming referendum on recreational use.

GPs’ top concerns about prescribing cannabis included poor evidence, convoluted regulations, and prohibitive costs

Lower Hutt GP Larry Jordan, who was not part of the study, said his patients were increasingly asking about medical cannabis, but he had declined to prescribe. In most instances, people wanted to be treated for chronic pain or insomnia, two areas where Dr Jordan said the evidence was not there yet.

‘‘I think the recent media exposure has prompted people to think more about it,’’ he said. ‘‘I’m not part of the group [of GPs] that said I would never do it. But if I’m going to get involved, I have some learning to do.’’

Porirua GP and Royal College of GPs medical director Dr Bryan Betty said his patients had also been asking about cannabis, but he had not prescribed partly because of the high cost and partly because of a lack of evidence that the drug was an effective treatment.

Reluctance to prescribe the drug comes despite law changes in 2018 that partially decriminalised the use of medicinal cannabis.

One survey last year, commissioned by medicinal cannabis company Helius, claimed 400,000 Kiwis would to rush to acquire a prescription when the drugs became widely available this year.

Dr Betty said that figure was overblown. ‘‘Individual GPs will have to make a decision based on the patient in front of them, but there is absolute need for more quality research.’’

Study lead author Dr Karen Oldfield, from Medical Research Institute of New Zealand, said many GPs in the study reported feeling nervous about prescribing a drug with little evidence.

‘‘Normally when you prescribe medicine, you know what’s in it, it has been through medical trial. It’s quite difficult to prescribe something where you don’t have that.’’

However, not all GPs were so reticent. Dr Graham Gulbransen has been running a medicinal cannabis prescribing centre in Auckland since early 2018, and even offers patients assessments via video. Dr Gulbransen most commonly prescribed CBD, a cannabis-based medicine that does not produce a ‘‘high’’ but can relieve pain or reduce anxiety.

Since opening, he had prescribed medicinal cannabis for more than 1000 patients, many of whom came to him after being turned downed by their GP.

‘‘There is absolute need for more quality research.’’

Dr Bryan Betty