Frequently Asked Questions
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Medical cannabis or medical marijuana is a range of medicines sourced from the cannabis plant and made up of cannabinoids, the naturally-occurring chemicals found in the plant. In New Zealand medicinal cannabis is available in a number of pharmaceutical products such as oils and gels which are produced under strict controls with specialist manufacturing equipment. These products must meet international pharmaceutical standards and are rigorously tested for safety.
Medicinal cannabis in New Zealand can be currently prescribed for a patient by a doctor or specialist medical professional and is used to treat various conditions from chronic pain through to epilepsy.
Recreational cannabis is marijuana that is used without medical justification. It is generally higher in THC, or the psychoactive compound of the cannabis plant, and is usually used to intentionally alter an individual’s state of consciousness, inducing a state of happiness or euphoria.
Recreational cannabis is taken in a number of forms and is most commonly smoked.
In March 2020, the New Zealand government legalised the growing, manufacturing and distribution of medicinal cannabis.
New Zealand companies can be issued licenses to produce medicinal cannabis and GPs nationwide are able to freely prescribe medicinal cannabis.
Recreational cannabis is illegal in all forms. It cannot be grown, sold or consumed under the current laws.
The referendum in September is about recreational cannabis only. The referendum will have no effect on the legal status of medicinal cannabis.
Yes. Your local GP can access medicinal cannabis now.
The New Zealand medicinal cannabis industry is aiming to be in production from about October 2020. The Medicinal Cannabis Agency (a government agency and part of Medsafe) was established at the beginning of April 2020, and they are currently working on setting up the process for licensing for the cultivation and manufacturing of medicinal cannabis. Eqalis anticipates that those licences will be issued in approximately September 2020.
Pricing for New Zealand grown and extracted medicinal cannabis has not yet been determined.
Eqalis anticipates that the costs of locally-made product will reduce substantially for the patient as the industry gets underway.
As GPs develop a greater understanding of how to prescribe this new medicine it will be like any new form of medication, a period of learning followed by greater confidence and knowledge which will ultimately lead to better outcomes for patients. Eqalis believes that as demand for medicinal cannabis increases from local medical professionals, the prices will come into line with recreational cannabis.
The referendum in September proposes that New Zealanders be able to grow their own marijuana plants and that selected companies be granted a license to grow high-THC cannabis (i.e. cannabis that is used for its recreational effect, to ‘get high’).
Commercially-grown recreational cannabis will be sold by companies that will also need to apply for a special license.
At this stage, the expected cost of recreational cannabis products is unknown. In overseas markets, legal recreational cannabis is mostly more expensive than illegal, black market cannabis as producers have to meet significant compliance costs such as licensing, quality testing and taxes.
Eqalis will be voting ‘no’ in the coming referendum. We believe that the proposed timeline for the introduction of legal recreational cannabis does not give New Zealand’s health professionals sufficient time to work with this entirely new field of medicine.
Under the proposed legislation, people will only be getting access to up to 14g of cannabis flower daily or be allowed to grow two cannabis plants for themselves. They will not have access to oral cannabis formulations.
Smoking the flower does not provide people with appropriate medical relief. It may provide some help for their condition but it is not a properly formulated medicine and smoking means they will get a very short acting effect from it.
Self-medicating cannabis smokers will not have the right ratio of the major components THC and CBD in what they are taking. The ideal ratio is different for each medical condition you are trying to treat. This is why proper medical cannabis formulations need to be developed and doctors need to prescribe these formulations.
Overseas markets have shown that recreational cannabis is usually too highly-priced to significantly reduce the black market cannabis trade. Government red-tape and compliance costs as well as taxation on legal cannabis products mean they have become a lifestyle product, accessible only to those in high income brackets. In California for instance, 80% of recreational cannabis is sold on the black market.
Cannabinoids are the main active ingredients in the cannabis plant. More than 100 have been identified. These ingredients are similar to the endocannabinoids produced by the human body and can be used in prescription medications. Two of the most well-known cannabinoids are THC and CBD, but all the cannabinoids have therapeutic potential research is still determining the real value of them. Cannabis also has terpenes which have therapeutic potential and are useful to be combined with CBD and THC to achieve different effects.
THC (or delta-9-Tetrahydrocannabinol) is the main active ingredient in cannabis. It’s responsible for many of the pharmacological effects of cannabis – including its psychoactive effect.
CBD (or cannabidiol) is cannabis’s second most prominent compound. Unlike THC, it’s not known to cause intoxicating or euphoric symptoms. In fact, it helps counteract these effects.
Cannabis should be avoided in the following:
- Children except for CBD/low THC products for intractable epilepsy
- Adolescents (< 20years and < 25 in young males)
- Pregnancy and Breast-feeding Mothers
- Those with unstable psychiatric conditions and where high risk of psychosis or schizophrenia (including family history)
- History of suicide attempt or suicide ideation
- Severe cardiovascular disease (arrhythmia/post MI)
- Post stroke
- Immunological conditions (especially liver related)
- Cirrhosis-Hep C related
- Kidney Disease
- Cannabis Use Disorder (THC)
As THC works on receptors in the brain, there is the potential for medical cannabis to have an additive sedation effect with other medicines that work on the brain such as antidepressants, alcohol, benzodiazepines and opioids.
There are a number of potential drug-drug interactions with cannabis-based medical products and other medicines or substances that are, metabolised through the cytochrome P-450 isoenzymes. Therefore, caution should be taken when cannabis-based medicines are co-administered with any medications that are CYP inhibitors or inducers.
However, clinically significant drug interactions are rare and there is no drug that cannot be given with cannabis if necessary.
There are two medicines that do require extra monitoring if given with medical cannabis medicines:
- High dose CBD and clobazam, where a dose reduction of the clobazam may be necessary.
- Warfarin: TBC and CBD increase warafin levels so INR monitoring is recommended during starting medical cannabis and white increasing the dose until effect is achieved.
Inhalation or smoking produces a quick response but wears off within several hours. It is good for rapid effect.
When using oils or soft gel capsules it’s important to start with a low dose and take it slowly – as the effects can be stronger and last much longer than through inhalation.
Depending on your metabolism, and how recently you’ve eaten, medical cannabis oil and soft gels can take 1-3 hours or longer to start working. The effects can then last 6-8 hours or longer – which is particularly useful at night, when longer periods of relief may be required.
|Onset||5-10mins||5-10mins||1-3 hours||15-45 mins||Variable|
|Duration||2-4 hours||2-4 hours||6-8 hours||6-8 hours||Variable|
|Bioavailability||2-56%||40%||6-20% (due to 1st pass Metabolism)||20%||5% systemic|
Your doctor will start you on low doses and slowly increase to 2-3 doses each day. They need to consider whether you have had cannabis before, what condition they are treating and therefore what composition of cannabinoids or terpenes they feel will treat your condition best.
If you experience symptoms like anxiety, nausea, dizziness, vomiting, or fainting, it’s important not to panic. Focus on your breathing, stay hydrated, eat something, and find a safe place to relax. Depending on your method of medical cannabis consumption, the effects should wear off on their own within 2-6 hours.
If you experience a severe reaction – such as chest pain, or persistent vomiting or dizziness – call 111, or go directly to the nearest hospital. Let your doctor know as soon as you’re able to.
Decarboxylation is the process of heat-activating cannabinoids by smoking or vaporising the plant matter above 120°C. Decarboxylation changes the acid form of` the cannabinoids into the CBD and THC – and all Eqalis oils and soft gels contain cannabis oil that’s already been decarboxylated.
“Indica” and “sativa” are botanical terms that describe the morphology (i.e. the shape) of different cannabis plants. They’re also often used to describe the range of possible effects of a cannabis variety. Some use the term “indica” to describe more sedating effects, and “sativa” to describe more energising effects. These terms aren’t scientific but can be a useful reference.