Patient Queries Regarding Medicinal Cannabis
At CBD Doctors Melbourne our general practitioner’s often get asked questions about prescribing medicinal cannabis.
An increase in medicinal cannabis legalisation in many countries (subject to their own regulations) has resulted in an increased interest in Australia.
Differentiating Between Medicinal and Street Cannabis
It is important to clearly differentiate between cannabis medicines (also known as medicinal cannabis) and street cannabis.
Medicinal cannabis is standardised medical grade cannabis plant derived, semi-synthetic or synthetically produced cannabinoid products developed in a controlled environment for medicinal use. They have been approved by Australian Therapeutic Goods Administration (TGA) for medical use in Australia.
Street cannabis (also known as cannabis), on the other hand, comes from an unregulated source and is illicit. The composition of THC and CBD quantities in the street cannabis products is unknown, and may contain harmful substances (pesticides, fungi and heavy metals).
There is limited data on the effects, side effects and success rates in using medicinal cannabis for medical purposes.
Today’s science relies on randomised (double blind) controlled multicentre trials.
Lack of Randomised Controlled Trails (RCT) is the main reason why we, doctors, either don’t believe in the benefits of medicinal cannabis or don’t want to prescribe it to patients.
Suggested Benefits of Treatment
Current evidence suggests that there are some benefits of treatment with medicinal cannabis of the following conditions:
- Multiple sclerosis
- Palliative care
- Nausea and vomiting
- Chronic non cancer pain
There are also some indications that there may be some benefit from medicinal cannabis in the treatment of:
- PTSD (post-traumatic stress disorder)
However, more new studies are needed in which both patients and doctors may be required to participate in.
Lots of people have tried different treatments in different situations and would like to try medicinal cannabis as “more natural” way of treatment.
During COVID-19 there has been an increased interest in prescribing medicinal cannabis due to the increased uncertainties, symptoms of fear, anxiety and depression COVID-19 may be contributing to.
There are certain things to consider before asking a doctor to prescribe you medicinal cannabis:
- There is not enough scientific evidence and we, doctors, are learning from all the different sources, current studies and our patients.
- Strict regulations with the TGA and the Special Access Scheme (SAS) make it time consuming for doctors to apply, process, comply and re-apply (and maintain) their permit to prescribe.
- For prescribing doctors, it is important to carefully monitor patients on medicinal cannabis.
- Patients have a responsibility to report all improvements of symptoms, all side effects and all changes in their symptoms to the prescribing doctor.
- Patients need to know that the recommendation is not to drive while using medicinal cannabis (all products may contain at least a trace of THC).
- Ideally, all practitioners involved in care would be aware of the treatment with medicinal cannabis.
- Please take into consideration the costs involved both for consultations and medicines as there is no subsidy from the PBS.
Dr Jelena Radosavljevic, MBBS FRACGP
CBD Doctors Melbourne