Getting high may be legal, medically speaking, but it helps if you're rich.
Ministry of Health figures show that almost nobody is using the medical cannabis mouth spray Sativex.
Medical cannabis users and advocates say that with a price tag of about $1300 a month, most patients were ignoring the spray and opting for the cheaper, but illegal, option of smoking cannabis instead.
At present, only four people have an active prescription for the spray and only 48 have ever received ministry approval.
The medication has been available with a sign-off from the health minister since 2008. In 2010, it was approved more widely for treatment of multiple sclerosis, but all other medical uses still require ministerial sign-off.
The low uptake of the spray has sparked renewed calls to subsidise Sativex and in the meantime, to treat people who break the law for medical reasons more leniently.
The renewed calls also come as the Green Party seeks to reignite debate on the legal status of cannabis, with co-leader Metiria Turei saying it would push for decriminalisation in any post-election talks.
Medical cannabis activist Billy McKee said he gained approval to take Sativex several several years ago but was put off by the cost.
"It was like thousands of dollars. I can't afford that," he said.
"They don't really want people to do the right thing. They don't really want people to have safe medicine."
McKee had his leg amputated 30 years ago after a car accident and smokes cannabis to relieve phantom pains. Last year, he fought charges of selling and cultivating cannabis all the way to the Supreme Court but lost and is now serving a six months' home detention sentence.
He said he knew of several people who had been prescribed Sativex but none could afford to stick with it, even though it often proved effective.
Drug Foundation executive director Ross Bell said there had been a muddying between can nabis dependency and genuine medical need.
"There's a lot of people who use cannabis recreationally who will say they are doing it for medical reasons," he said.
But for people with chronic pain and in genuine need the high cost of Sativex meant illegal cannabis was the only viable option.
"We do need to fund proper medicine and, until we do, having a little compassion will go a long way."
Cannabis' medical effectiveness, in spray form or otherwise, is also still up for debate, and some claim it has been vastly over stated.
In a paper published in the Australian and New Zealand Journal of Psychiatry this month, Otago University academics said although cannabis could help relieve pain, sometimes it was often no better than legal alternatives.
It recommended never pres cribing raw cannabis and using tablets or sprays, such as Sativex, to treat pain only when all other options had failed.
But extra funding for the drug appears unlikely. Despite complaints about the cost, a Pharmac spokesman said no one had lodged an application for the agency to subsidise Sativex.
"It is not something we have ever looked at but the first step would be for someone to lodge a funding application."
WHAT IS SATIVEX?
Sativex is a cannabis-derived mouth spray manufactured by British company GW Pharmaceuticals, designed to help multiple sclerosis patients.
As well as treating pain and muscle spasticity, one of the spray's side effects is a "cannabis-like high".
In New Zealand it is classed as a scheduled B drug, like cannabis, but your doctor can prescribe it, subject to Ministry of Health or ministerial approval.
It is only technically approved to treat multiple sclerosis but, with ministerial approval, it has been prescribed for patients with neuropathic pain and spinal cord injuries.
Sativex is not subsidised by Pharmac and, according to the agency, a typical yearly prescription costs about $20,200.
A doctor can ask the health minister for special permission to prescribe a patient raw cannabis, but so far all such applications have been rejected.
- The Dominion Post
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