Medicinal Cannabis 101 – All Your Questions Answered

Have you thought about trying medical cannabis for a health problem? I love that you are wanting to try a natural, plant-based alternative! Read on as I explain the real science behind medicinal cannabis and it’s safe usage.

What is Medicinal Cannabis?

The terms ‘medicinal cannabis’, ‘medical cannabis’ and ‘medical marijuana’ can be used interchangeably. They all refer to the use of cannabis and the compounds (cannabinoids) in the cannabis plant to treat the symptoms of disease and health conditions. This is not to be confused with the use of recreational cannabis which people take to get ‘high’.

Yes, medical cannabis is legal as a prescription-only medication in New Zealand. This means that sourcing it online or from other sources without a script is illegal.

Medicinal cannabis is an unapproved medicine – what does that mean?

Medicines in New Zealand are approved by Medsafe for particular therapeutic purposes. For example, paracetamol is approved to be used for a headache. This is because there has been high quality scientific evidence of paracetamol’s benefit for headaches. However, apart from some rare forms of childhood epilepsy, medicinal cannabis is not an approved medicine for any health condition. This means that it should be used on a case-by-case basis.

Is There THC in Medicinal Cannabis?

Yes, medicinal cannabis can refer to the use of any of the chemical compounds or cannabinoids in the cannabis plant. The two best-known cannabinoids are THC and CBD. Whilst CBD is generally better known for its medicinal benefits, it’s important to remember that THC also has proven medical benefits.

What are Medicinal Cannabinoids?

As I noted above, any one of the more than one hundred known compounds or cannabinoids in the cannabis plant can be used medicinally to treat a health condition. Each cannabinoid has a different effect on the body and can be used to treat different symptoms.

What Can Medical Cannabis be Used For?

Our patients use medical cannabis for a wide variety of purposes. To give you an idea, in a recent poll of 2400 medicinal cannabis users, the main reasons for it’s use were:

How Does Medical Cannabis Work?

Medicinal cannabis is a plant-based medicine that contains chemicals known as cannabinoids. The human body also has its own cannabinoid chemicals and these are called endocannabinoids. There are many functions of the human endocannabinoid system, including effects on pain, mood, anxiety and inflammation. The main two endocannbinoids are called: 2-AG and anandamide (there are others also, but these are the most studied). The body also has many receptors in most major organs (including the brain, liver, skin etc) that respond to these cannabinoids.  The two main medicinal cannabis receptors are called CB1 and CB2. These receptors were only discovered as recently as 1995! It is thought that medicinal cannabis interacts with these receptors throughout the human body to cause it’s health benefits.

You can see in the image below all the different areas of the human body where medicinal cannabis interacts via the CB1 and CB2 receptors.

The cannabinoid system in the body, termed the endocannabinoid system. Reproduced from Terravida.

Is There Any Medicinal Cannabis Evidence?

Is this all hocus-pocus, or is there a real scientific basis to it? Good question! As a doctor, I am naturally biased and all about the science! Here we go:

Short answer: research is not conclusive but there definitely does appear to be a positive benefit when it comes to pain and seizures.

Long answer: Most of the research out there supports the use of medicinal cannabis for seizures and pain. However, because medicinal cannabis is not a pharmaceutical drug, the research currently present is limited in terms of proving a clear benefit from using it. There certainly is research out there, and a lot of it, but conclusive statements need a lot of high quality evidence. To get technical, there needs to be some double-blind placebo controlled trials to prove that medicinal cannabis has therapeutic value. The evidence out there does suggest health benefits, but we can’t say for sure. If you are interested in the nitty-gritty details of what evidence is out there, we suggest you read this study. Given its natural origin and very good safety profile, we have found very promising results from our patients who are using it. There is no doubt in my mind that medicinal cannabis has a role to play in modern medicine.

“When pure and administered carefully, (cannabis) is one of the most valuable medicines we possess”

Sir John Russell Reynold, published in Lancet 1890, Neurologist and personal physician to Queen Elizabeth

How Do I Access Medicinal Cannabis?

Medicinal Cannabis is a prescription-only medication in NZ. This means you need to talk to your GP about having it prescribed. However, chances are that your GP does not know anything about it, and so expect to do some explaining (or let us do the explaining on your behalf). You can also see one of our own medicinal cannabis specialists to discuss your health concerns with them if you prefer.

The Cannabis Clinic is here help guide you through this process of talking to your GP and educating them about medicinal cannabis. I have written a free guide to help you navigate this process with your GP. Alternatively, you can make a direct booking with one of our medicinal cannabis specialists.

In a recent survey of 469 GPs, 89% had no knowledge of the endocannabinoid system.

Is Medicinal Cannabis Safe?

Yes it is very safe. As a matter of fact, there have been no known deaths worldwide from medicinal cannabis exposure.

Medicinal Cannabis Side Effects

Every medicine has potential side effects, but those associated with medicinal cannabis are known to be mild and include:

  • somnolence
  • reduced appetite
  • diarrhoea
  • fatigue
  • asthenia (i.e. weakness)

When used in higher doses (i.e. >10mg/kg/day, so more than 700mg for an average 70kg adult), there is a risk of elevating a liver enzyme called transaminase. This threshold is lower for people using other medications that are metabolised by the liver, such as anti-epileptics. I suggest that people using such doses of medicinal cannabis have liver function testing (LFT) done prior to commencing medicinal cannabis and during treatment. Initially, this should be done after 1 month, 3 months and 6 months of treatment.

Can I get addicted to medicinal cannabis?

You may also be wondering if it is possible to get addicted to medical cannabis? The short answer is no. In a recent report published by the WHO on Medicinal Cannabis, the specialist panel were all in agreement that Medicinal Cannabis is non-addictive and has no potential for abuse if taken in larger quantities. It also cannot be used to manufacture other compounds that have psychoactive or addictive properties.

Medical Cannabis Dosage

This is a difficult to answer precisely because it is not black and white and there are no formal dose recommendations. I usually recommend people start by using a low dose first, 10-20mg per day and gauge the effect after one week. Depending on the result (if any), this dose can then be doubled. This process is repeated until the desired effect takes place. The exact dosage will vary from person to person but I have found good response at the 25 – 50mg once daily range. Some people find quite high doses (e.g. 200 – 300mg daily) are needed to get a benefit.

See below for a helpful guide in treating chronic pain:

What’s next?

Every person is unique and different. From treating many patients with different health problems, I am quite happy to suggest medicinal cannabis as an option and I encourage you to also have that discussion with your GP. If you find yourself stuck or need support, please contact us and we will be happy to help in any way we can.

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