For many people, medicinal cannabis is a godsend: for sufferers of chronic pain, fibromyalgia, mental health conditions, migraines and more, cannabis-based products can provide welcome relief from debilitating symptoms.
Growing research has indicated cannabis can be an effective medicine for a range of health issues, with cannabis clinics currently prescribing medicinal products for a number of life-altering conditions, the most common being chronic pain.
However, accessing medicinal cannabis in Aotearoa remains difficult. Cannabis-based products are only available to patients on prescription from a doctor. These products are also currently not subsidised, meaning legally obtaining medicinal cannabis is inaccessible for many New Zealanders due to the cost.
In 2022, the Ministry of Health approved the prescription of New Zealand-grown and manufactured medicinal cannabis, which was expected to cut costs for Kiwi patients. Manufacturers and importers are required to provide evidence to the Medicinal Cannabis Agency that they consistently meet minimum standards of quality before they can be supplied.
Although homegrown and imported products can be prescribed by health professionals here in Aotearoa, there is also said to be a lack of understanding and education around medicinal cannabis in the field that can lead to hesitation to prescribe the products, with Cannabis Clinic CEO Dr Waseem Alzaher telling Newshub in 2022: "There are plenty of misconceptions in New Zealand about medicinal cannabis. I believe it's a very misunderstood product, a very misunderstood medicine."
Due to these barriers, it's estimated only 6 percent of medicinal cannabis in Aotearoa has been sourced through legal channels, with many turning to black markets and 'green fairies' for unregulated products.
RestoreMe, Aotearoa's newest online medicinal cannabis clinic, was established with the aim of solving the accessibility issues faced by many medicinal cannabis patients. Launched by a group of qualified health professionals, its goal is to make access to high-quality products easier and more affordable.
First, patients register for and undergo an online consultation with a health professional to determine whether medicinal cannabis is a suitable treatment option. If approved, patients are given a relatively low-cost prescription that is delivered to their doorstep.
To provide more understanding around the benefits of cannabis-based medicines and what conditions they can help with, Newshub spoke to RestoreMe's practice manager, Dominique Wells, to get the scoop on the most common conditions the clinic is prescribing medicinal cannabis for.
Wells, a registered nurse for 14 years, began her career in paediatrics and now runs the day-to-day operations at the clinic.
"There is growing evidence that cannabis-based medicines have some therapeutic effect in specific clinical situations. Our knowledge and understanding will only continue to grow the further down the track we go, as is the case with all medicines and treatments," Wells told Newshub.
"From what I hear from patients coming to our clinic, stigma and discrimination around medicinal cannabis is occasionally about the product itself - eg, the belief that it is addictive or will lead to recreational use - but also the stigma actually attached to the legitimacy of the illness requiring someone to seek medicinal cannabis as a treatment option."
Chronic pain
Currently, the number one condition RestoreMe is prescribing medicinal cannabis for is chronic pain. About one in six New Zealanders are living with chronic pain, which can be defined as persistent pain that lasts from weeks to years, caused by injury, illness or inflammation.
"Chronic pain is often complex and difficult to treat as there is no one test or scan to diagnose it, and as a result it can take some time to find an appropriate and effective treatment," Wells said.
"We see patients that have been on the 'hamster wheel' of pain and inflammatory medications, and while some short-term relief can be gained from some medicines commonly prescribed, they often are not very useful at treating long-term chronic pain and when used for prolonged periods, can have more side effects."
Last year, cannabis buds, or dried cannabis flowers, from Australian pharmaceutical company ANTG were approved by the Ministry of Health to be prescribed to patients with chronic pain, but only in the form of a tea.
"For patients suffering from chronic pain, MS, arthritis, sleep and anxiety problems, it's really good for those who suffer," Green Doctors co-founder Mark Hotu told Newshub at the time. "At least you know what's in it."
Published in 2020, a University of Auckland study of the first 400 patients assessed for medical cannabis in New Zealand suggested potential benefits for people suffering with chronic pain. For patients living with non-cancer-related chronic pain, the study found that taking CBD oil for four weeks significantly improved the self-reported quality of life.
After taking the oil, patients with non-cancer-related pain symptoms reported on average improved mobility and ability to complete their usual activities and less pain, anxiety and depression. Overall, patients with cancer-related pain reported less pain, but no other improvements.
Anxiety
As the second most common condition the clinic is prescribing medicinal cannabis for, anxiety will affect approximately one in four New Zealanders at some stage in their lives.
"While we know a degree of anxiety can be helpful to overcome stress or potential threats, when the 'fight or flight' feeling just doesn't go away even after the catalyst event has passed, it can make it hard to cope with daily life," Wells explained.
"Anxiety can be extremely debilitating for some people and can lead to physical symptoms such as pain, stomach cramps and headaches. Anxiety can also overlap with depression which can affect your thoughts, behaviours, motivation, and overall quality of life."
The aforementioned University of Auckland study also suggested potential benefits for the thousands of people suffering with anxiety. The study found that taking CBD oil for four weeks significantly improved the self-reported quality of life for patients living with anxiety-related mental health conditions. Patients with mental health-related symptoms reported improved ability to complete activities and reduced pain, anxiety and depression after taking the oil.
"Our findings show that CBD is well-tolerated in most patients and can markedly ease symptoms in a range of hard-to-treat conditions," Professor Bruce Arroll, senior author in the study and head of the Department of General Practice and Primary Healthcare at the University of Auckland, said at the time.
Depression/low mood
After an unprecedented few years with a pandemic and cost of living crisis, New Zealanders' mental wellbeing has seen a decline. Last year, Stats NZ reported a significant increase in the proportion of people with poor mental wellbeing, up from 22 percent in 2018 to 28 percent in 2021.
The data found the proportion of people with poor mental wellbeing equated to more than a quarter of the population.
"A low mood and/or depression may have some relation to chronic pain and anxiety, a bit like the 'chicken and egg scenario', but this can also be a standalone issue," Wells said.
"A low mood can affect how you think, feel and behave, including feeling sad or not enjoying things as much as you did, feeling anxious or panicky, being more tired than usual or sleep problems."
Insomnia/sleeping difficulties
A study published in 2007 concluded that approximately one-quarter of adults in New Zealand may suffer from a chronic sleep problem, highlighting insomnia as a major public health issue. Insomnia is a set of symptoms and commonly includes having trouble falling asleep, repeatedly waking up, having trouble getting back to sleep, waking up too early in the morning, and waking in the morning not feeling refreshed.
The most common medical response to sleeping difficulties is the prescription of sleeping tablets, many of which have well-documented adverse effects. There is a consensus among sleep specialists that efforts should be made to limit the duration of their use. Alternative therapies may include relaxation techniques, sleep hygiene education and cognitive-behavioural therapy.
"Difficulty sleeping or insomnia is repetitive trouble getting to sleep or staying asleep. It is waking up feeling exhausted and saps your energy and mood, impacts your physical health, work performance, relationships with others and leads to poor quality of life," Wells explained.
Studies are finding that CBD may improve sleep for some patients and help manage common disorders, such as insomnia and sleep apnoea. According to the Sleep Foundation, preliminary research suggests CBD can help with a number of sleep disorders, including insomnia, REM sleep behaviour disorder, and excessive daytime sleepiness disorder.
Other initial studies of CBD and sleep disorders suggest positive outcomes, however, it's been noted that not everyone will experience the same benefits with CBD use, and different doses might lead to different effects.
A survey in 2019 found one of the most common causes for using cannabis medicinally in New Zealand is poor sleep, with 66 percent of respondents citing it as their primary reason for using cannabis. Pain was the most common at 81 percent, and mental health conditions were third at 64 percent.
The sleep conditions represented in the survey were insomnia, sleep-related movement disorders (such as restless leg syndrome), parasomnias (such as sleepwalking), sleep apnoea or other sleep-related breathing disorders, and narcolepsy or other hypersomnia.
Wells urges anyone suffering from an ailment to investigate whether medicinal cannabis is a viable treatment option, noting the more open the discourse is around cannabis as a medicine, the less stigma will be attached to it going forward.
"I would recommend anyone wondering if their ailment could potentially be helped by medicinal cannabis to at least investigate it as a treatment option. The more we are open to, for lack of a better word, 'alternative medicines', the more we can help remove the stigma attached to it," she said.
"We are not peddling 'black market' or 'backyard grown' products, these are the only products that have been verified and approved to be prescribed in New Zealand."
