WHAT IS MEDICINAL CANNABIS?
THE Ministry of Health says the term ‘‘encompasses several types of products containing extracts of the cannabis plant that may be used to treat various medical conditions’’.
That doesn’t mean the plant itself, though – the ministry takes pains to point out that the Government does not support the use of ‘‘cannabis leaf or flower preparations for medicinal use’’.
Instead, ministerial approval can be considered for three types of products – pharmaceuticalgrade drugs that have been ticked off by Medsafe, those that have been trialled overseas but don’t have consent here yet, and products that don’t meet pharmaceutical standards at all, and might not even be medicines.
Other countries use the term differently. ‘‘Medical marijuana’’ in the United States, for instance, usually means the voter-backed laws that have allowed patients in many states to smoke the plant (most famously in California, where some 300,000 people now have that dispensation).
Most medical research, in any case, focuses on pharmaceutical refinements of the plant. The first such drugs were produced in the 1980s without much effect, but now research is gathering pace.
There are early signs that cannabis derivatives can help treat the effects of neurological disorders such as multiple sclerosis and motor neurone disease, some forms of epilepsy, nausea and vomiting, ‘‘wasting’’ associated with HIV and cancer treatment, and chronic pain.
The influential Mayo Clinic in the US says cannabis offers the ‘‘possibility of many promising pharmaceutical applications’’, many yet to be understood.
The sole cannabis-derived medicine currently approved for prescription in New Zealand is Sativex, an oral spray that can help improve the symptoms of multiple sclerosis, and may have other applications. Pharmac is currently considering funding the drug.
Epidiolex, a pure liquid formulation of cannabidiol (CBD), one component of cannabis, is another promising treatment. It is undergoing clinical trials in the US after the high-profile success of such products in helping with seizure disorders in children.
Another treatment sometimes called ‘‘medicinal cannabis’’ is Elixinol, which was given to Nelson teenager Alex Renton earlier this year after being approved by Associate Health Minister Peter Dunne. However, University of Auckland pharmacology department head Michelle Glass points out that it was an ‘‘oil made from industrial hemp, which is not marijuana’’.
So ‘‘medicinal cannabis’’ is a blanket term covering a range of treatments. The laws around their approval are not simple: because of cannabis’ status as a Class B1 controlled drug, they often require the associate health minister’s personal intervention.
The psychoactive properties of the drugs also vary and can be in some dispute. For example, Sativex, the spray approved in New Zealand, ‘‘may produce sideeffects that are interpreted as a euphoria or cannabis-like ‘high’,’’ according to Medsafe.
However, the drug’s manufacturer, GW Pharmaceuticals, says ‘‘there is no evidence from Sativex clinical trials that patients obtain a high similar to that sought by recreational cannabis users’’.