After years of anticipation and 18 months since the Medicinal Cannabis Scheme (MCS) was set up, many who use cannabis medicinally are still missing out.

Affordability and persistent problems with accessing prescriptions are part of the problem. There is also a lack of clinical studies to prove the effectiveness of cannabis in treating many diseases.

But, given the equity and fairness of the whole system in question, a different approach may be needed. In particular, should we start thinking about medical cannabis as an alternative therapy rather than a pharmaceutical drug?

Slow progress and guilt

It’s been four years since the government announced its “Commitment to Make Medical Cannabis More Available” and nearly three years since a change in the Drug Abuse Act allowed the Department of Health to regulate the MCS to develop.

The regime was opened to product applications in April 2020, with local industry working on certification and product development. Extensions of the “transition period” were decided in order to continue sales of products imported from overseas. However, this ended abruptly on October 1, leaving only four Canadian products approved under the MCS available in New Zealand pharmacies.

Domestic manufacturers blamed the slow progress on regulatory thresholds, which were almost as tough as pharmaceutical products. In response, the health minister accused the industry of not working hard enough to meet these standards.

In the meantime, patients and prescribers have few legal products to choose from.

Lack of clinical evidence

Five percent of New Zealanders use cannabis for broadly defined medicinal purposes, with pain, sleep, and anxiety being the most common conditions. But evidence of the effectiveness of cannabis in these disorders from scientific and clinical studies remains limited.

For decades, prohibition by international drug treaties has blocked research into the potential medicinal properties of cannabis. But while more clinical studies are needed, the safety profile of medical cannabis – especially the non-intoxicating CBD products – is good and well tolerated.

Even so, many doctors are understandably reluctant to recommend and prescribe cannabis-based products.

Our survey of over 3,600 medical cannabis users found that only one in three patient inquiries for medical cannabis prescriptions was successful. Other researchers have only found a success rate of 20 percent.

This is unlikely to change until double-blind, gold-standard, placebo-controlled studies demonstrate the effectiveness of cannabis-based products in certain health conditions.