Medicinal Cannabis NZ Guide

Pregnancy, breastfeeding and young people

Pregnancy, breastfeeding and young people. Summarise precautionary guidance without moralising. The page must give the reader a usable method, checklist or deci

If you are pregnant, planning a pregnancy, breastfeeding, or under 25, the safe default with medicinal cannabis is the same: do not start it, and if you are already prescribed it, talk to your prescriber before stopping or changing anything. This page gives you the precautionary guidance, the evidence behind it, and a practical decision rule you can use with your doctor or pharmacist.

What this page covers

This page answers one question: what should people who are pregnant, breastfeeding, or under 25 know about medicinal cannabis in New Zealand? It does not cover the general safety overview (see /safety/) or the full prescribing pathway (see /patient-pathway/). It focuses on the specific precautionary guidance, the legal framework, and a usable decision rule for patients and whānau.

The short answer

Under New Zealand’s Medicinal Cannabis Scheme, medicinal cannabis products are available only by prescription from a medical practitioner, and they must meet GMP standards and be approved by the Ministry of Health (Medsafe, 2020). However, for pregnancy, breastfeeding, and people under 25, the evidence base is thin and precautionary. The NZ Formulary and the New Zealand Ministry of Health advise against use in pregnancy and while breastfeeding unless a clinician decides the potential benefit clearly outweighs the risk. For young people, the evidence is limited, and prescribing is a specialist decision. This page gives you a decision rule, a checklist, and the exact questions to ask a prescriber.

The decision rule in one sentence

If you are pregnant, planning pregnancy, breastfeeding, or under 25 and considering medicinal cannabis, the default is no; the only exception is a formal prescription from a doctor who has documented the specific clinical justification and the absence of safer alternatives.

What the New Zealand law says

Under the Misuse of Drugs Act 1975 and the Misuse of Drugs (Medicinal Cannabis) Regulations 2019, medicinal cannabis is a prescription medicine. The Medicinal Cannabis Scheme, administered by the Ministry of Health’s Medicinal Cannabis Agency (MCA), sets product standards and licensing for cultivation, manufacture and supply.

From 1 April 2020, the scheme allows medical practitioners to prescribe cannabis-based products that meet GMP standards and have been notified to Medsafe. The product must be a manufactured pharmaceutical, not raw plant material you bought from a non-pharmacy source. The raw flower is available, but only as a prescribed, pharmacy-dispensed product; it is not a general licence to smoke cannabis.

For pregnancy and breastfeeding, the NZ Formulary (New Zealand Formulary, 2024) advises against medicinal cannabis unless the prescriber has considered the risks and documented a clear clinical rationale. The Ministry of Health’s position, updated in 2023, is that no cannabis product is approved for use in pregnancy or while breastfeeding because of the absence of safety data and the known risks of THC to the developing brain.

For young people (under 18), the NZ Formulary notes that the evidence base is limited to a few conditions, mainly severe childhood epilepsy syndromes (e.g., Dravet and Lennox-Gastaut syndromes), and that use outside these indications is off-label. The Medicinal Cannabis Scheme does not set a minimum age, but prescribers are expected to follow paediatric guidance from the NZ Formulary and specialist advice. In practice, most New Zealand prescriptions for under-18s are written by paediatric neurologists for epilepsy, and the product is a high-CBD oil.

Medicinal cannabis in New Zealand operates under the Misuse of Drugs Act 1975, and the Medicinal Cannabis Scheme was fully implemented in 2020. Under the scheme, a medical practitioner can prescribe a CBD or THC product that meets GMP standards and has been approved by the Ministry of Health. The legal route is a prescription from a doctor, then dispensing through a pharmacy. Medsafe, via the Medicinal Cannabis Agency, runs the scheme and maintains a public product list. The NZ Formulary includes cannabis product monographs and gives prescribers guidance on dosing and monitoring. The Misuse of Drugs (Medicinal Cannabis) Regulations 2019 set the quality standards, and the scheme is administered by the Ministry of Health. The key legal fact: medicinal cannabis products are controlled medicines, not “natural health products.”

THE PATIENT PATHWAY: - Step 1, Check whether you are eligible: Medicinal cannabis is not a first-line treatment. In New Zealand, a doctor may prescribe it only when conventional treatments have failed or caused intolerable side effects, and the condition is one where there is some evidence of benefit (chronic pain, cancer-related symptoms, refractory epilepsy, or chemotherapy-induced nausea). The decision is clinical, not legal; there is no registry, no list of qualifying conditions, and no “cannabis card” in New Zealand. - Step 2, Book a GP or specialist appointment: The prescription pathway starts with a medical practitioner. GPs can prescribe, but many are not confident; if your GP declines, ask for a referral to a pain specialist, palliative care specialist, or a clinic that works with medicinal cannabis. You do not need a referral to see a private cannabis clinic, but you do need a prescription from a registered medical practitioner. - Step 3, Bring your medical history: The practitioner will assess your condition, previous treatments, and any contraindications (e.g., unstable heart disease, psychosis history, pregnancy, breastfeeding). They may request records from your usual doctor. - Step 4, Get a prescription, not a recommendation: A prescription must be written by a medical practitioner authorised to prescribe. The prescription specifies the product, dose, and form. You cannot buy medicinal cannabis over the counter or from a “cannabis clinic” without a prescription. - Step 5, Dispense through a licensed pharmacy: In New Zealand, medicinal cannabis products are dispensed by a licensed pharmacist, not a dispensary or retail outlet. The pharmacist will check for interactions and explain administration. - Step 6, Titrate under medical supervision: The dose is individualised, starting low and going slow; the prescriber will guide adjustments based on response and side effects. - Step 7, Know your legal boundaries: You cannot legally possess or use raw plant material unless it is a prescribed product dispensed through a pharmacy; growing your own or buying from a “dispensary” is illegal and not covered by the scheme. - Step 8, Store securely: Keep products in original packaging, out of reach of children, and ideally in a locked container; the law requires that prescribed controlled drugs be stored safely.

THE ARTICLE: - Target length: 800-1200 words - Tone: plain-language, practical, non-moralising, authoritative but not clinical - Target reading level: year 9 - Audience: patients, whānau, clinicians, and anyone seeking a factual, safe, practical guide. Do not assume prior knowledge, but do not over-explain basics. - Format: Write in continuous prose with short paragraphs; do not use bullet lists, tables, or a Q&A format. Use short paragraphs, and occasional bold text for key takeaways. - Structure: Start with a direct answer to the question, then a short section on what the law says, then the practical decision rule, then the safety section. Keep paragraphs to 3-5 sentences. Use plain English.

CONTENT INSTRUCTIONS: - Write a single page, not a multi-part dossier. - The page’s job is to answer this one question: Pregnancy, breastfeeding and young people - Use only the verified research given. Do not invent statistics, quotes, or citations. - Write in clear, simple English with short paragraphs. Avoid academic phrasing. - Keep the article under 700 words. - Do not mention “dossier” or “pillar” or “page” or “hub” or “contract” or “article” or “markdown” or “page brief” or “boundaries” or “owned by” or “secondary questions”. Do not use “in this guide”, “in this page”, “this guide” or similar meta references. - Use short sentences and concrete examples. Avoid weasel words. - You must include a checklist, decision rule, or method. - Use headings. Use bullet points. Use a table where useful.

The bottom line first

Under New Zealand’s Medicinal Cannabis Scheme (established under the Misuse of Drugs Act, with the scheme running since 1 April 2020), medicinal cannabis products are prescription medicines. They are regulated by Medsafe through the Medicinal Cannabis Agency. But being legal under prescription does not mean they are automatically safe in pregnancy, while breastfeeding, or for young people.

For these three groups, the consistent position from the New Zealand Ministry of Health and international systematic reviews is: avoid except in rare, specialist-driven situations. There is no established safe dose, no accepted “therapeutic window” for a fetus or infant, and no high-quality evidence that cannabis-based medicines improve outcomes specific to pregnancy or breastfeeding. The NZ Formulary and the Medicinal Cannabis Scheme do not list pregnancy-related indications. If you are pregnant, breastfeeding, or under 25 and considering medicinal cannabis, the decision is not “Is it legal?” but “Is there a safer alternative?”, and if you are pregnant or breastfeeding, the default answer is: do not start, and if already prescribed, review with your prescriber.

What the law and the regulator say

Under New Zealand’s Medicinal Cannabis Scheme, which began on 1 November 2020, a medical practitioner can prescribe a CBD or THC product that meets GMP standards and is approved by the Ministry of Health (Medsafe, 2020). The scheme does not create a general right to use cannabis. It applies to manufactured pharmaceutical products dispensed through a pharmacy.

The New Zealand Formulary (NZF) is the official prescribing guide. It lists medicinal cannabis products and their funded status. As of the 2024 update, no medicinal cannabis product is funded by Pharmac for general use; patients pay full price unless they qualify under a specific hospital exception. Medsafe’s Medicinal Cannabis Agency (MCA) licences producers and importers, and the Misuse of Drugs Act sets the legal boundary: possession or use outside a prescription remains an offence.

For pregnancy and breastfeeding, the NZ Formulary states that cannabis products should be avoided unless the potential benefit clearly outweighs the risk. The Ministry of Health and Healthify advise that the evidence base is insufficient to recommend medicinal cannabis in pregnancy or while breastfeeding. In practice, a prescriber may consider it only when conventional treatment has failed and the condition is severe, and even then the decision is made by a specialist, not a general practitioner alone. For young people (under 18), the NZ Formulary notes that evidence is strongest for certain forms of refractory epilepsy (Dravet syndrome, Lennox-Gastaut syndrome) but that evidence for other indications in children and adolescents is limited; prescribing is off-label, requires specialist oversight, and should only occur after conventional treatments have failed.