In New Zealand, medicinal cannabis can be supplied to patients as CBD Products containing cannabidiol (CBD) with less than 2% tetrahydrocannabinol (THC). Both of these pharmaceutically active compounds are found in the cannabis plants. While THC has an intoxicating effect, CBD does not. A CBD Product is a prescription drug that must be manufactured under strict international guidelines (PIC/S). The most common dosage form available in NZ is CBD oil to be applied under the tongue.
CBD is considered generally safe and well tolerated. Some people (less than 10% of the population) may not tolerate cannabinoids and can suffer mild symptoms upon taking them. People with liver impairment and patients on other medications should take CBD while being monitored by their healthcare professionals.
Medicinal cannabis is a prescription medicine available from your GP. Some GPs do not have enough information to feel comfortable prescribing CBD and may refer you to a medicinal cannabis specialist.
Every person is different. This depends on your genetic makeup, any conditions you may have, how you take the medicine and what you have eaten. The effect should last for several hours. Your doctor will advise an appropriate dose tailored to your condition.
Oil drops are taken orally (ingestion), sublingually (under the tongue) or as buccal (inner cheek) spray. When taking the medication through the sublingual or buccal route, keeping them in the mouth as long as possible (while rubbing in the medicine with the tongue for better absorption) without swallowing them would enhance absorption through the blood vessels for the best effects.
All medicines potentially have side effects. Those associated with CBD are generally mild:
- Changes in appetite
- Changes in mood
- Gastrointestinal problems
- Altered liver enzymes – care must be taken if you have a liver condition
- Is it appropriate to take for my medical conditions?
- How would it interact with the medicine(s) I am currently taking?
- What (& how much of it) is in the bottle other than CBD?
- If plant based, how can I be sure it is pesticide-free?
- What is the expiration date?
- Which pharmacy should I get it from?
People use it for a wide range of conditions and report that it gives them relief from:
- Chronic pain
- Joint pain
- Muscle tension
Yes it can (as is the case in many other drugs). It is important to consult with your doctor before taking CBD. Some of the common medications that can be affected by co-administration of CBD are:
- Sodium valproate
- St John’s Warts
CBD inhibits the cytochrome P450 enzyme, which is involved in metabolising many drugs. Compounds in grapefruit inhibit the same enzyme group, which is why doctors advise patients not to eat grapefruit shortly before or after taking a medication. By inhibiting cytochrome P450, CBD can either reduce or increase the effects of other drugs. In some situations, it may be advisable for your doctor to monitor blood levels of other medications while taking CBD.
CBD Products allowed to be distributed in New Zealand is a medicine that is produced to pharmaceutical standards so that you can be confident that the product you buy is consistent and safe. It is important to take the correct dose – you don’t want to take more than you need. Be aware that the cost also depends on which pharmacy you take your prescription to – some charge more than others for the same medicine.
For a medicine to be approved by Medsafe in New Zealand, there must be demonstrated safety and therapeutic effect. This is done by clinical trials with people in scientifically controlled studies. However, decades of cannabis prohibition have hampered scientists and companies from conducting clinical trials on cannabinoids. There is one CBD product already approved by the US FDA (Epidiolex), but this medicine is not available in New Zealand. Auxilio will be conducting clinical trials for specific disease indications with the purpose of gaining product approval.
Not if you are using a pure CBD product. Drug tests are geared toward identifying THC (hallucinogenic), not CBD (non-hallucinogenic) or other cannabinoids. However, be aware that some medicinal cannabis products from plants (especially those directly imported from overseas by patients or doctors) may contain small amounts of THC and these products may cause a failed test.
CBD is metabolised into an analogous compound, 7-hydroxy-CBD, by the liver. Some 6-OH-CBD may also be formed. But scientists know relatively little about the activity (or lack thereof) of these compounds. There is strong evidence that CBD does not convert to significant amounts of THC in the stomach.