‘Clearly defined’ Med-use in NZ

I downloaded a recent Govt. statement on medicinal use of cannabis in Aotearoa/NZ. Whilst much of it seems ‘fairly reasonable’ at first glance..it does seem to be overtly complicated & unnecessarily restrictive to me. Here are several statements to highlight this :

‘Cannabis products are Class B1 controlled drugs and Ministerial approval is required before these can be prescribed, supplied or administered, in accordance with regulation 22 of the Misuse of Drugs Regulations 1977.’
* Surely a registered medical doctor (GP) should be qualified to prescribe it as they see fit, without higher approval ?
** Cannabis (unprocessed) is a Class C drug under the MODA 1975

‘Please note that the Government does not support the use of unprocessed or partially processed cannabis leaf or flower preparations for medicinal use’
* Many other OECD countries DO allow this.. what does our Govt. know that excludes this use ?

‘There are three types of medicinal cannabis products that may be considered for Ministerial approval:
1. Pharmaceutical grade cannabis products that have consent for distribution in New Zealand. Consent for distribution means that the product has been determined by Medsafe to meet acceptable safety and efficacy requirements for distribution in New Zealand. The only product meeting this criterion currently is Sativex® for the treatment of multiple sclerosis. It may also be prescribed as a non-consented product for some other medical conditions.
2. Pharmaceutical grade products that do not have consent for distribution in New Zealand, for example a product that has been manufactured by a pharmaceutical company overseas.
3. Non-pharmaceutical grade products, that is products that are not manufactured to internationally recognised pharmaceutical manufacturing standards.They may, or may not, have been intended to be used as medicines.’
* points 2 & 3 almost sound contradictory

Non-pharmaceutical grade medicinal cannabis products. The criteria used to guide Ministerial approval are:
1. severe or life-threatening condition
2. evidence that all reasonably applicable conventional treatments have been trialled and the symptoms are still poorly controlled
3. evidence that the risk/ benefit of the product has been adequately considered by qualified clinical specialists – that is, the risk of treatment with an unproven product is less than the risk of non-treatment and account has been taken of any evidence of potential benefit and weighed against known adverse effects
4. patient hospitalised when treatment is initiated
5. patient or guardian has provided informed consent
6. application from a specialist appropriate to the medical condition being treated or the Chief Medical Officer of a District Health Board
7. applicant or specialist prescriber has sought adequate peer review eg, Hospital Ethics Committee approval, Drug or Therapeutics Committee review
8. provision of a Certificate of Analysis, preferably from an accredited laboratory, so that the concentration of the active ingredient(s) is known
* actually just sounds like 8 huge hoops to jump through. Also it appears to set a ‘double-standard’ when I understand that more addictive opiates do not require most of these restrictions for prescription.

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