Medicinal cannabis: Why Kiwis are slow on the uptake

New Zealand doctors have been able to prescribe medicinal cannabis since 2020. Doctors say the price is coming down. Photo / NZME

Although prescribed medicinal cannabis use is legal in New Zealand, a recent Massey University study has revealed an emerging pattern of users resorting to unconventional channels to get their medication.

Dr Marta Rychert, lead researcher at Massey University’s Shore and Whāriki Research Centre, said the survey data was collected from a diverse sample of 13,000 participants.

The NZ Drug Trends Survey (NZDTS) was conducted from August 2022 to February 2023.

“We discussed some of the reasons why people may not ask for a prescription on the phone, including stigma, existing illegal and grey market supplies, and other factors,” Rychert said.

“The survey results revealed one important reason, was many general practitioners’ reluctance to prescribe.”

Rychert said a key factor behind this is limited scientific evidence for the efficacy of cannabis as a medicine.

“The survey results show that there has been a slight increase in the number of people with prescriptions since 2020,” she said.

“I worked in Canada where legislation for medicinal use was introduced more than 20 years ago and the uptake there was also slow in the first years. The pace here is about the same at this stage.”

Whanganui-based Lisa Gadsby is the business development manager for the Auckland-based Cannabis Clinic.

Cannabis Clinic business development manager Lisa Gadsby promotes the benefits of medicinal cannabis from her Whanganui home base. Photo / Bevan Conley.

Gadsby said despite the Medicinal Cannabis Scheme legislation introduced by the Government in 2020, there was still a lot of stigma and misunderstanding.

“Many people are unaware that legally medicating with cannabis is an option, let alone the possibility of a tailored treatment plan from a doctor, which can often be far more effective,” she said.

“Cannabis is a complex plant, with a wide range of medication options, making it crucial to have specialist knowledge on board.

“Having someone who comprehends your health, body, and cannabis medicine can make a significant difference in your treatment journey.”

Dr John McMenamin, Whanganui GP and clinical director of the Health Solutions Trust, said people curious if medicinal cannabis could help them could have confidence in local doctors and nurses.

“In our region, primary care clinicians have had training and education in the role of medicinal cannabis in helping their patients,” he said.

“A common approach is to work with the patient to understand what symptoms might respond to treatment and then to monitor the benefit against these symptoms.”

McMenamin said there is a growing literature on the role of medicinal cannabis and each person was managed on a case-by-case basis.

Over 50 per cent of survey respondents said they had not asked their doctor for a prescription and didn’t believe they would be given one.

Waimarino GP Dr John-Paul Schwartz with his wife Emma Hughes. Photo / Supplied

Waimarino Health Centre GP John-Paul Schwartz said he was not yet licensed to prescribe medicinal cannabis in NZ but would happily do so.

Schwartz - who hails from Texas - has been practicing in Ruapehu for 18 months and said he would need to complete the NZ training.

“I don’t think it would be difficult, it’s just a matter of finding the time,” he said.

“Some of my patients have asked me about medicinal cannabis and they are interested in using it to treat pain, anxiety, and sleep disorders.”

NZDTS respondents identified mental health conditions as the main reason for wanting to use medicinal cannabis.

Conditions such as depression, attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) elicited a 76 per cent response while 73 per cent said they wanted to use it for sleep.

Pain relief was the next highest result at 65 per cent.

Schwartz said medicinal cannabis was particularly effective for regulating seizures. It was also a safer alternative for some medications prescribed for neurological conditions, known to have detrimental side effects.

In Schwartz’s home state, eligible Texans have access to medicinal cannabis through the compassionate use program (CUP) administered by the Texas Department of Public Safety (DPS).

“It is expensive though, so people go over the border to New Mexico where stores are selling a huge range of cannabis-based products. The people who work there are not necessarily medical experts but they have great product knowledge so they give advice on which products are popular for certain conditions.

“The prescription costs in the US are just as expensive as they are in NZ and that is the big concern. We wouldn’t want to see commercial interests taking over.”

Schwartz said price gouging had been a big problem in the US and he hoped the industry would be carefully regulated in NZ.

Respondents to the NZDTS survey cited cost as a prohibitive factor with 56 per cent saying it was too expensive.

Pharmac does not subsidise medicinal cannabis prescriptions. However, Rychert said the number of available products had increased since 2020, leading to a slight reduction in prices.

Cannabis Clinic founder Dr Waseem Alzaher said the average cost of a prescription was about $200 for a one-month supply.

“Contrary to popular belief, there has been a notable decrease in cannabis prices recently,” he said.

“In some instances, it is now cheaper to access medicinal cannabis through legal channels, challenging the misconception that it is more expensive than illegal markets.”

Alzaher said the only way to ensure a product was safe and effective was to have it prescribed by a doctor.

“Your doctor is the best person to decide whether a medicinal cannabis product is a suitable treatment for you. They will know your medical history and any medicines you are taking and have the expertise to assess the risks and benefits.

“Once you have a prescription, the doctor or a pharmacy will dispense the product. The prescription will state the kind of medicinal cannabis products and the amount you can obtain.”

Gadsby, who founded her NZ Hempress company in Whanganui in 2018, said the Whanganui community had shown her great support in her Cannabis Clinic work which she began in June last year.

“We recently hosted a community event with the local Arthritis Liaison group, and the turnout was fantastic. It didn’t surprise me that so many were keen to learn about medicinal cannabis.

“It was a great opportunity to have an open and lighthearted discussion about its potential benefits.”

Personal imports of medicinal cannabis products are legally prohibited in NZ. It is illegal to purchase medicinal cannabis products (that are not legally prescribed) online or from anyone other than a doctor or pharmacist.

Liz Wylie is a multimedia journalist for the Whanganui Chronicle. She joined the editorial team in 2014 and regularly covers stories from Whanganui and the wider region. She also writes features and profile stories.