Medicinal Cannabinoid Products

Discover the regulations that control the use of medicinal cannabinoid products, how to take them, some of the product options and advice on how to talk with your doctor about medicinal cannabinoids.


 

Medicinal Cannabis Scheme

 
 

The Medicinal Cannabis Scheme (MCS) regulations came into force on April 1st, 2020. The regulations:

  • impose a minimum quality standard for medicinal cannabis products and related material and ingredients; and

  • provide for medicinal cannabis licences that authorise various activities relating to medicinal cannabis products and related material and ingredients.

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Objective of the MCS

The primary objective of the MCS is to increase access to quality medicinal cannabis products. Government intervention is required to establish a regulatory scheme for the commercial production and import of products under licence. Regulations specific to medicinal cannabis will set minimum quality standards for products and set out a licensing regime.

Expected benefits of the MCS

The main expected beneficiaries are patients, health practitioners, medicinal cannabis cultivators, manufacturers and suppliers. Products regulated under the scheme will be made to a quality standard with a known composition (ie ratio of THC / CBD).

Now that the scheme has come into force doctors continue to be able to prescribe CBD products and will also be able to prescribe products containing THC without the need for Ministry of Health approval. Products containing THC will need to be approved medicines or assessed by the MCS as meeting the minimum quality standard.

 

Regulations

The laws relating to Medicinal cannabinoids changed recently in New Zealand. CBD products are now regulated as prescription medicines and it is now possible for terminally ill patients to possess and use cannabis if they have certification from their medical practitioner.

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Misuse of Drugs Amendment Act

The so called Medical Cannabis Act came into law on December 17th, 2018 in New Zealand. It introduced 3 major changes:

  1. CBD products are no longer controlled drugs and can be prescribed like any other medicines by medical practitioners.

  2. With a certificate from a medical or nurse practitioner, terminally ill people can possess and use cannabis without fear of prosecution.

  3. Recommendations to determine how medical cannabis will be regulated in the future including minimum quality standards are to be proposed no later than 1 year after the act came into effect (by December 2019).


CBD now a prescription medicine

All medical cannabis products used to be controlled drugs with access to them extremely restricted. Now CBD products are regulated as prescription medicines, just like anything else your doctor can prescribe.

There are rules around what a CBD product actually is. A product is deemed to be a CBD one if:

  • it contains 98% or more CBD as a % of the total cannabinoid content

  • the amount of THC and psychoactive related substances doesn’t exceed 2%


 

How to take Medicinal Cannabinoids

 
 

There are three major subcategories of dose forms for Medical Cannabis.

Oral

Oral administration is an obvious and convenient method and something all of us are familiar with from other medicines. The most common forms are drops you take under the tongue or capsules you swallow. We describe them in more detail below.

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Inhalation

Inhalation is smoking, vaping or the use of an inhalation medical device. Smoking cannot be recommended in general and is being phased out in Israel and other medical cannabis jurisdictions due to side effects and difficulty controlling doses.

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Transdermal

There is interest in the use of medical cannabis for some skin conditions and local joint or muscle pain. A cream or patch could be a useful solution where you want only a local action and not an effect on the entire body.

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Oil

A common way to take Medicinal Cannsbis is oil drops under the tongue. This is called sublingual administration and is a good way to get MC into your body because it is absorbed, at least partly, in the mucous membranes in your mouth.

This method allows you to slowly increase the dose by changing the number of drops. This is called dose titration which we explain more on below.

There are a couple of downsides to taking MC as oil drops. It can be difficult to remember to take the right number of drops and some people just don’t like the taste. If that’s you then consider MC capsules.

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MC Capsules

When available, Medicial Cannabis capsules are an increasingly popular option as it is a way of taking medicines and supplement that we are all used to.

MC capsules allow for accurate, easy and reliable dosing especially once you have found your optimum dose but you can still titrate by changing the number of capsules you take or choosing a product with a higher amount of MC per capsule.

Finally MC capsules are a great solution for people who simply don’t like the taste of MC oil.


Side Effects from CBD

All medicines have benefits and side effects. The best information we have about the side effects of CBD come from the clinical trials that were run for a CBD medicine in the USA that was used to treat epilepsy.

Common Side effects reported with use of CBD

The most common side effects that occurred in patients treated with CBD were:

  • somnolence (drowsiness)

  • decreased appetite

  • diarrhoea

  • elevations of liver enzymes

  • fatigue

  • difficulty sleeping

Most Side effects did not lead to treatment withdrawal

A good measure of the severity of side effects is whether they lead to patients stopping their treatment. In trials there was no difference in the likelihood of study withdrawal for any reason between patients given CBD and those whom received placebo.

Talk with your doctor if you want more information about side effects.


How much MC to take?

One of the challenges with taking MC is that dosage depends somewhat on individual variability and what you are taking MC for. For this reason your doctor will likely discuss titrating the dose with you.

Dose titration

The best dose of any medicine is the lowest one needed to provide the effect you are looking for. This is because all medicines have side effects and they are usually related to the dose you take. In addition some of the potential side effects of MC can be minimised by starting with a low dose and slowly increasing (titrating) it until you have the desired effect.

Start low, go slow

Read the package insert of the product your doctor prescribes you (if it has one) as it may suggest a convenient method to use to titrate the dose. The golden rule is start low and go slow. Talk with your doctor as they know you and your health history best and can give you the best advice.

Product Options

Despite all the recent news in the media there are still only a limited number of MC products available in New Zealand. Some of the newer products offer additional dosing flexibility and more competitive pricing. Here are some of the things to consider when looking at your options. As always, we recommend you talk with your doctor to get the best and latest information.


Dose forms

Oil drops and oral capsules are two of the most common methods of taking MC. There can be advantages in choosing a product which offers both forms.


Farm to pharmacy

Some but not all companies maintain a tight total control over the entire process of making MC products owning their own farms and plants so they know exactly what is going into your MC product.


Laboratory testing

Studies have shown that there are many cases where CBD products are not always what they seem as written on the label. For this reason its best to choose products from a company that commits to laboratory testing of their product. These check for pesticides and other impurities also ensure the MC content is exactly what is on the label.


Organic

Some manufacturers offer organically grown MC that is GMO and pesticide free.


Available in NZ

Not all MC products are available in New Zealand through the normal pharmaceutical distribution channels. These products are immediately available and have the local support you may need and can only have been imported into New Zealand by showing laboratory test results. Some other products are only available online and there are not the same guarantees in place.


Talking with your doctor

Medicinal cannabinoids (MC) have certainly been in the news recently in New Zealand. Recent changes in the law have resulted in CBD products being classified as prescription medicines and the Medicinal Cannabis scheme means that GPs can also prescribe products containing THC. This section has been designed specifically to help you prepare you for a discussion about MC with your doctor.

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If you have found yourself at our site you probably have already done some research into MC. If you have, you’ll know MC shows promise as a treatment option for a variety of health conditions. You’ll also know that, although MC is a natural product, it is still a chemical that interacts with the body and as such it has risks as well as benefits. Your doctor is the best person to talk to about MC.

If you are considering MC here are some important questions you may want to ask yourself as well as your Doctor.


Questions to ask yourself

  • Do I have a good understanding of MC? Having a good understanding of MC and their benefits will help facilitate your discussion with your doctor. If you are unsure, there is some great information available on this site to help you understand Medicinal cannabinoids, potential Medicinal cannabinoid uses and MC products.

  • What results am I expecting from MC? Do you have a specific purpose for which you want to take MC? It maybe for chronic pain, anxiety or to improve your sleep? Being able to define exactly why you want to take MC will help you with your discussion with your doctor.

  • Do you have any issues about MC that you want to raise with your doctor? Your doctor is the best person to talk to regarding any potential concerns you may have, so it is best to have these ready in preparation.

  • What products am I already taking? It is very important to let your doctor know all the medicines, supplements and the products you are currently taking because all medicines have the potential to interact with the others that you are taking. Before talking to your doctor you need to be armed with this information.


Questions to ask your doctor

Your Doctor is the best person to determine whether MC is right for you. If they do recommend MC here are some questions you may want to ask.

  • How often should I take MC? 

  • Can I take MC if I’m taking other medications?

  • What are the risks of MC?

  • In what form does MC come?

  • How much will this cost?

Make a list of questions before you go into your doctor, and don’t be shy to ask. If your doctor wants more information about MC feel free to direct them to this site. We have specific content designed for doctors.

Check out our guide on How to get a Medicinal cannabinoid Prescription for more advice and information.