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In Australia, medicinal cannabis refers to a range of quality assured, pharmaceutical cannabis preparations intended for therapeutic use.

Medicinal cannabis products must be prescribed by a doctor to treat the symptoms of a medical condition or, the side effects of a medical treatment (e.g. chemotherapy). Medicinal cannabis preparations include tablets, oils, tinctures and other extracts.

The words cannabis and marijuana are used interchangeably. Marijuana is often, although not always used in an illicit context. Cannabis, named after the plant genus, is the internationally recognised term so experts prefer to use cannabis when referring to the plant.

Cannabinoids are a diverse set of chemical compounds which bind to the CB1 and CB2 receptors in the endocannabinoid system (ECS) to regulate homeostasis. Depending on which receptor a particular cannabinoid binds to, different effects may occur.

There are three general types of cannabinoids;

  • endogenous cannabinoids, known as endocannabinoids, which are produced naturally in the body;
  • Phytocannabinoids, such as those present in the cannabis plant; and
  • Synthetic cannabinoids, which are man-made chemicals synthesized to mimic the activities of a particular natural cannabinoid.

Phytocannabinoids, such as THC and CBD – the primary active cannabinoids in the cannabis plant – have been shown to imitate cannabinoids that are naturally produced in the body (called endocannabinoids), leading to a therapeutic effect in patients with certain medical conditions. More than 100 cannabinoids have been identified in the cannabis plant, many of which have been shown to have medical value.

In addition to cannabinoids, the cannabis plant can contain up to 400+ additional chemical compounds, including terpenes – oils secreted in the same glands that produce cannabinoids, which are responsible for the aroma and colour of cannabis plants.

Over 100 different terpenes have been identified in the cannabis plant, and every individual plant has a unique profile of terpenes and cannabinoids.

The following infographic outlines the most commonly studied cannabinoids and terpenes in the cannabis plant.

Medicinal cannabis is legal in many countries, including Australia, when produced under strict regulatory guidelines and prescribed and administered by an approved registered medical practitioner.

 

Medicinal cannabis is legal in many countries, including Australia, when produced under strict regulatory guidelines and prescribed and administered by an approved registered medical practitioner.

The cannabis plant produces over 400 chemical compounds, more than 65 of which are unique to the cannabis plant (called cannabinoids, or phytocannabinoids). Phytocannabinoids are compounds which hold medicinal value and the most well-known are THC and CBD.

  • delta-9-tetrahydrocannabinol (THC) and
  • cannabidiol (CBD).

CBD and THC have different chemical properties, and they affect the body differently.

CBD has a very wide range of pharmacological actions but no intoxicating effects. CBD does not bind to CB1 receptors, so it does not have the same psychoactive effect as THC.

In many countries, CBD is readily available in over-the-counter nutraceutical ‘wellness’ products. Over-the-counter access to CBD is not yet available in Australia, although the Therapeutic Goods Administration (TGA) is currently examining the possibility of such simplified access.

THC is responsible for the intoxicating effects of cannabis due to its action on CB1 cannabinoid receptors.

Despite intoxicating effects at higher doses, clinical trial evidence generally supports the efficacy of THC in treating conditions such as chronic pain, spasticity in multiple sclerosis, anorexia and cachexia, Tourette syndrome and chemotherapy-induced nausea and vomiting.

Medicinal cannabis is be administered via a variety of pathways, including but not limited to vaporisation, sublingual and topical absorption.

  • Oils
  • Vaporisation/Inhalation (flower)
  • Tablets
  • Capsules
  • Wafers
  • Sprays

 

Cannabis, THC and CBD are generally well tolerated by patients with few serious adverse effects.

In some individuals, medicinal cannabis may cause undesirable side effects, which may increase with higher doses. Patients should speak with their medical professional about their treatment and any take note of any side effects.

Possible side effects may include:

  • fatigue and drowsiness
  • increased or decreased appetite
  • dry mouth
  • vertigo
  • diarrhoea
  • nausea and vomiting

Medications containing THC can potentially cause psychotropic effects – feeling ‘high’

The costs of medicinal cannabis will vary considerably dependent on the dosage required and the product prescribed.

No cannabis products currently have a subsidy on the Pharmaceutical Benefits Scheme, so patients will generally need to cover the costs of filling the prescription out of pocket.

On average, medicinal cannabis patients can expect to spend around $5-$15 per day, although costs can be substantially higher for patients with conditions such as epilepsy that require very high doses of CBD.

Some medical insusrers may partially fund medications – please check with your insurer to see if they cover medicinal cannabis medications.

Medications prescribed by doctors in Australia are legal.

Cannabis that is not prescribed by a doctor is less reliable than a medicinal product, as it has not undergone the extensive safety and quality testing required of medicinal products, and the active ingredients contained within it (cannabinoids such as THC) are inconsistent.

Medicinal products in Australia allow doctors to rely on the stated concentrations and therefore manage dosing and make accurate adjustments to better match treatments to your symptoms.

Using cannabis that has not been prescribed by a doctor – in any form – remains illegal in most States and Territories in Australia.

Many cannabis medicines have little to no delta 9 tetrahydrocannabinol (THC), the primary cannabinoid responsible for cannabis’ pshyoactive effects. These products are often high in cannabidiol (CBD) and very low in delta 9 tetrahydrocannabinol (THC), significantly reducing or eliminating psychoactivity.

Please discuss this during your consultation with your prescribing doctor.

Patients using medications containing THC should not drive or operate machinery.

Mobile Drug Testing is used all states in Australia. Testing for the presence of THC, drivers will be penalised if they test positive.

THC may be detected by roadside drug testing devices up to 12 hours, or for some, even days after use.

Some CBD medications may contain THC or cause symptoms of impairment. Patients are advised to check with their state government about their suitability to drive.

The Endocannabinoid system (ECS) is an endogenous (internal) homeostatic regulating system found in all vertebrates. The ECS is a complex system responsible for multiple physiological processes, which includes modulation of pain, seizure threshold, appetite, digestion, cognition and mood. Scientists believe that the main role of the ECS is to help the body maintain homeostasis or balance.

The suitability of medicinal cannabis treatments needs to be assessed for each individual by a registered doctor.

There are some scenarios where cannabinoid traetments are contraindicated and will need you to discuss further with a Novel Health Co doctor:

  • Women who are pregnant, breastfeeding or planning to become pregnant
  • Have a history of substance abuse, addiction or drug dependency
  • A personal or family history of schizophrenia or psychotic illness
  • A history of active bipolar disorder
  • A history of severe anxiety disorder or mood disorder
  • Severe or unstable cardio-pulmonary disease
Consultations are either conducted in person or online using a Telehealth system (similar to Zoom or Facetime). If on Telehealth, treat it just like a face to face consultation.

The doctor will.

  • Discuss your medical history
  • Try to understand your expectations and health goals
  • Answer any questions or address any concerns you might have
  • Discuss treatment options with you and talk through what to expect when using these medications

CBD: The literature today and observational analysis indicate there are no cases of physical addiction or abuse.