Renewed calls for medicinal cannabis to be funded as study reports pain relief

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Ninety-six percent of those who used cannabis for pain said it helped them in some way. (File photo)

MARK TAYLOR/Stuff

Ninety-six percent of those who used cannabis for pain said it helped them in some way. (File photo)

New Zealanders who use cannabis to help with chronic conditions have told researchers the drug allowed them to come off other pain medications, including opioids, prompting renewed calls for drug policy changes.

A University of Otago-led survey of 213 people examined the therapeutic benefits of cannabis on people with medically diagnosed conditions such as chronic pain, anxiety, ADHD, PTSD, mental health issues or reported difficulty sleeping.

Across the sample, 96% of those who took it for pain said cannabis helped them in some way. Self-reported therapeutic benefit was even higher in those with difficulty sleeping (97%) and people with mental health conditions, autism, ADHD, PTSD and difficulty eating (98%).

Half of all participants said they had been able to reduce or stop prescription pain medicines such as tramadol, pregabalin and codeine, or anti-depressants and antianxiety medications.

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“If you’ve tried everything else and nothing’s worked and you’re at your wit’s end, then you try this and for whatever reason, believe it works, that’s when you go: ‘Well, I’m going to do this and not that’,” lead author Dr Geoff Noller from Otago medicine school’s bioethics department said.

Two participants told researchers the pain and sleep relief literally saved their lives: “I was ready to finish my life before that. I had had enough,” one said.

Noller stressed his team of researchers were not advocating for people with diagnosed conditions to reject other prescribed drugs in favour of cannabis, but rather there was a place for both – and policy and funding changes should follow to allow easier access.

No medicinal cannabis products are funded or subsidised, but there is some indication this may change.

Bioethicist Dr Geoff Noller, lead author, says the high cost and strict regulations of legal medicinal cannabis means “we've got ourselves into a bit of a straitjacket”.

Hamish McNeilly/Stuff

Bioethicist Dr Geoff Noller, lead author, says the high cost and strict regulations of legal medicinal cannabis means “we’ve got ourselves into a bit of a straitjacket”.

Pharmac recommended a funding application for Sativex be declined in 2015, but since then the application has not budged. However, Hughes confirmed it was still an active application and new evidence could still be considered.

Sativex costs between $1100 and $1400 per month, compared with an ounce of cannabis the cost of which ranges from $300 to $450, Noller said.

The high cost and strict regulations of legal medicinal cannabis had meant “we’ve got ourselves into a bit of a straitjacket”, Noller said.

Last August, a Pharmac committee considered a cannabidiol treatment (Epidyolex) for Dravet Syndrome, a specific epilepsy disorder. This was recommended with high priority, so the next step is to prioritise this as an option for investment, Pharmac’s chief medical officer, Dr David Hughes, said.

Robyn Edie/Stuff

Southern Medicinal executive director Greg Marshall says his team hopes to reduce the price of medical cannabis to make it more accessible. (Video first published June 2022)

To date, nine people have been provided funded medicinal cannabis based on exceptional clinical circumstances criteria, Hughes said.

Chairperson of General Practice NZ, Dr Bryan Betty, said there was “no doubt” individual people experienced benefits from medicinal cannabis, but strong long-term data on its effectiveness and safety was lacking.

“There’s a degree of uncertainty with that … so prescribers make individual decisions.”

That’s not to say strong evidence won’t emerge, but at the moment it wasn’t there in the form of a robust, double-blind study, Betty said.

Pharmac's chief medical officer Dr David Hughes says there is a pathway for funded medicinal cannabis on a case-by-case basis.

Supplied

Pharmac’s chief medical officer Dr David Hughes says there is a pathway for funded medicinal cannabis on a case-by-case basis.

This was in line with existing medical advice for New Zealand prescribers from the independent Best Practice Advocacy Centre (bpac NZ), which states there is low quality evidence for pain improvement in people with chronic pain, and no evidence that medicinal cannabis reduces opioid use in people with chronic pain.

The centre acknowledges evidence that cannabis may reduce chemotherapy-induced nausea and vomiting, epileptic seizure severity and symptoms of multiple sclerosis (MS).

Researchers from Victoria and Auckland universities also worked on the study, published in the journal, Drugs, Habits and Social Policy.

The Best Practice Advocacy Centre (bpac NZ) states there is low quality evidence for pain improvement in people with chronic pain. (Stock photo)

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The Best Practice Advocacy Centre (bpac NZ) states there is low quality evidence for pain improvement in people with chronic pain. (Stock photo)

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