Prescription of cannabis-products for medical purposes must be based on robust scientific evidence, says Associate Health Minister Peter Dunne.
Cannabis generally remains a class C controlled drug in New Zealand, but in certain limited circumstances doctors may apply for Ministry of Health permission to import, prescribe and treat their patients with cannabis-derived products.
Mr Dunne says the guidelines used to assess applications (typically made by doctors at the request of a patient or patient's family) have received "strong clinical support" from experts, including practitioners with experience prescribing cannabis-based products and the New Zealand Medical Association (NZMA).
In March this year (not long after the highly-publicised death of Nelson teenager Alex Renton, who had been treated with a cannabidiol – cannabis-oil derived – product called Elixinol in his final weeks of life) the Ministry of Health consulted with specialists to determine "whether the guidelines were still fit for purpose".
"The consistent feedback from experts in their field was that cannabis-based products should be treated no differently to other medicines - evidence-based principles should and will continue to be followed", Mr Dunne says.
One point of contention previously raised by medical marijuana advocates (such as Alex's mum Rose Renton) – the apparent requirement that a patient must be "hospitalised" before treatment with a "non-pharmaceutical grade cannabis-based product" would be allowed – has been removed, with the approval of those consulted, Mr Dunne says.
Another key amendment has been the removal of the word "all" from the guideline that previously required "all reasonably applicable treatments to have been trialled", as it was considered potentially too onerous on patients and prescribers.
"As I said in New Zealand's National Statement to the UN General Assembly Special Session last month, identifying the greatest therapeutic benefits and determining the most appropriate ratios, dosage and delivery mechanisms will only come through a robust, scientific approach.
"Otherwise we are essentially flying blind and hoping for the best, an approach that flies in the face of evidence-based medicines policy.
"It is my hope that by releasing this feedback it will go some way to balancing out the irresponsible and ill-informed messages being passed off as fact, and provide a degree of reassurance to those who are genuinely looking for respite to significant health issues."
The Ministry of Health's report to Mr Dunne following consultation on the guidelines says clinicians want cannabis, if it is to be used like a medicine, to be treated like any other medicine; they wanted to know a cannabis-product's active ingredients, the most effective form and dose to prescribe, any interactions with other medicines, and evidence of efficacy for its use by a particular patient.
However, lack of efficacy data, the cost of pharmaceutical grade products and the lack of products on the market were continued barriers to doctors prescribing cannabis-based products, the report says.
The report also notes that the use of cannabis (either in its raw plant form, or non-pharmaceutical grade derivatives such as cannabis oil and teas) by New Zealanders with terminal illnesses is widespread, albeit outside of the legal framework.