The conversation around cannabis is evolving rapidly now that it’s been legalised for medical use in Australia and many other parts of the world. After decades of stigma and demonisation, we’re finally seeing increased attention being paid to the medical benefits of cannabis.
What Is Medical Cannabis?
Medical cannabis is, in short, cannabis prescribed by doctors to treat various conditions. Doctors in Australia have written over 390,000 medical cannabis prescriptions since its legalisation in 2016. Emerging research suggests that the two primary compounds in cannabis – tetrahydrocannabinol (THC) and cannabidiol (CBD) – may play a role in managing several chronic conditions, ranging from multiple sclerosis to chronic pain, PTSD, anxiety and more.
You probably have a lot of questions about medical cannabis. This post will try and answer some of those questions and introduce to you the potential benefits of medical cannabis and how you can access it, as well as looking at the possible risks and side effects.
Could I Benefit From Medical Cannabis?
Hundreds of thousands of Australians are already being treated with medical cannabis, but whether you might be eligible depends on your condition and medical history. Speak with your doctor about medical cannabis if you haven’t found relief with conventional treatments and experience a chronic condition such as:
- Chronic pain
- Multiple sclerosis
- Anxiety
- Depression
- Epilepsy
- Fibromyalgia
- PTSD
- Insomnia
While the research for using medical cannabis to manage many of these conditions is still in its infancy, medical professionals are beginning to see its exciting potential.
In Australia, doctors have prescribed medical cannabis to more than 390,000 people for over 130 different conditions.
How Can I Access Medical Cannabis?
Getting a medical cannabis prescription is a relatively straightforward process, provided you are eligible for one and your doctor thinks you could benefit. To be eligible for a medical cannabis prescription, you need to have a chronic condition (i.e. one that has lasted for 3+ months) and to have tried other conventional treatments first and found them to be ineffective or that they caused unwanted side effects.
If you think you’re eligible and would benefit from medical cannabis, you can either see your regular GP or you can book a consultation with a dedicated medical cannabis clinic. All doctors in Australia can prescribe medical cannabis, but your regular healthcare provider may not be willing to do so.
This can be due to many factors. They may not understand the uses or research behind medical cannabis. Or they may not have systems in place to process medical cannabis prescriptions.
Dedicated medical cannabis clinics tend to have automated the process for prescribing medical cannabis. Cannabis clinics also offer confidential telehealth appointments with doctors who know the benefits and risks of medical cannabis.
The Process For Prescribing Medical Cannabis
As an emerging pharmaceutical, all medical cannabis prescriptions need to go through one of two schemes devised by the Therapeutic Goods Administration (TGA):
- Special Access Scheme: the SAS allows doctors to apply for a medical cannabis prescription on behalf of their patient if the doctor believes it will help their condition.
- Authorised Prescriber Scheme: doctors can apply to the TGA to become authorised prescribers of unapproved medications for a particular class of patients.
Almost all the medical cannabis prescriptions in Australia occur through the SAS and approvals usually take 24-48 hours.
Doctors need to go through this process because the vast majority of medical cannabis products are unapproved by the TGA. This doesn’t mean medical cannabis is unsafe or ineffective, it just means that most medical cannabis products haven’t gone through the TGA’s strict approval process.
Only two medical cannabis products have so far been TGA approved:
- Sativex: an oral mouth spray containing THC and CBD for helping manage multiple sclerosis symptoms.
- Epidyolex: a CBD oil for helping manage seizures associated with the two rare forms of childhood epilepsy Lennox-Gastaut syndrome and Dravet syndrome.
What’s The Difference Between Medical Cannabis and Marijuana?
Cannabis goes by many names – you’re probably most familiar with “marijuana”, but this term has specific connotations. Marijuana typically refers to cannabis obtained via the black market. It’s often difficult or impossible to tell exactly what’s in street weed and there’s no reliable way to measure your dose when smoking, which is the most common way illicit cannabis is consumed.
Medical cannabis, by contrast, is carefully grown and held to a strict safety standard to ensure it’s not contaminated by pesticides, microbes, heavy metals and other harmful substances. Medical cannabis is also grown with certain techniques and conditions in mind to create specific balances of cannabinoids, terpenes and other medicinal compounds. This careful process is designed to produce high-quality cannabis strains tailored to treat particular conditions.
Doctors don’t recommend smoking medical cannabis, so the most common way it’s consumed is through vaporisation of the dried flower, or through concentrated oils, capsules, topical creams and lotions. These methods of cannabis consumption allow you to carefully dose your medical cannabis and avoid the harmful effects of smoke inhalation.
How Medical Cannabis Works
Medical cannabis works by affecting what’s known as the body’s endocannabinoid system. There are two main receptors in the endocannabinoid system: CB1 receptors, which are mostly in the central nervous system, and CB2 receptors, found in the peripheral nervous system and particularly in immune cells. The body’s natural endocannabinoids bind to these receptors, causing various effects on bodily systems.
Medical cannabis contains ‘phytocannabinoids,’ which are usually just referred to as ‘cannabinoids.’ The two main cannabinoids in medical cannabis are THC and CBD, but there are more than 100 others. These cannabinoids bind to the CB1 and CB2 receptors much like our natural endocannabinoids, prompting changes in our mood, appetite, pain sensation, sleep and other bodily functions.
What’s The Difference Between CBD & THC?
THC is the cannabinoid responsible for the ‘high’ many people associate with cannabis, while CBD has no psychoactive properties but may hold a variety of health benefits. THC causes its psychotropic effects through binding to the CB1 receptors, while CBD primarily interacts with CB2 receptors, acting as a modulator and producing various therapeutic effects.
THC and CBD are thought to work together along with other minor cannabinoids and compounds to produce what’s known as the entourage effect. The entourage effect may increase the therapeutic benefits of medical cannabis.
Some medical cannabis products contain only THC, only CBD or a mixture of the two and other compounds. Which medical cannabinoids a doctor prescribes you depends on your condition and comfort level. Some people also can’t or prefer not to experience THC’s psychoactive effects, meaning they may prefer isolate CBD oil, which has no psychoactive properties.
Is Medical Cannabis Legal In Australia?
Medical cannabis has been legal in Australia since 2016, but it requires a prescription to use.
As it stands, this includes pure CBD oil, which is technically legal to buy over the counter. The reason you can’t freely purchase CBD oil is because pharmaceutical companies have yet to go through the long and expensive approval process required by the Australian Register of Therapeutic Goods (ARTG).
This process involves large amounts of research to certify a product's safety, efficacy and overall quality. However, you can still get CBD oil through a doctor’s prescription if you’re eligible for medical cannabis treatment.
How Much Does Medical Cannabis Cost?
Since most medical cannabis products are yet to receive approval from the TGA, they generally aren’t covered by the Pharmaceutical Benefits Scheme (PBS). This means that you’ll probably have to pay out of pocket for medical cannabis, which costs on average $250 to $300 per month depending on your dosage and the form you've been prescribed. An appointment with a prescribing doctor also tends to be between $80 and $150.
Many private health providers will cover medical cannabis under their General Treatment or Extras plan. If your private health insurance does cover medical cannabis, it will need to have been prescribed through the Special Access Scheme or the Authorised Prescriber Scheme.
Private health insurers offer different coverage for medical cannabis, but typically they’ll cover up to a certain maximum each year and will likely have a limit on the cost per script as well. This means that you might not be covered for a full 12 months if you have an ongoing medical cannabis prescription.
Does Medical Cannabis Have Any Side Effects?
Like all medications, medical cannabis can have side effects. The extent of these side effects will depend on what type of medical cannabis you’ve been prescribed, your dose and how your body reacts to the medication. CBD-dominant products such as isolate CBD oils generally have fewer side effects than THC products.
Side effects associated with either CBD or THC may include fatigue, vertigo, nausea, vomiting, fever, decreased or increased appetite, dry mouth and diarrhoea. However, most of these side effects are rare – medical cannabis is usually well-tolerated.
In some vulnerable people, THC may cause paranoia, delusions, hallucinations and possibly psychosis. Medical cannabis is not prescribed to people with a history of psychosis for this reason.
Keep in mind that it’s illegal in all Australian states except Tasmania to drive with any amount of THC in your system, because of these potential side effects. THC can take a long time to leave your system depending on how frequent and heavy your use is. If you drive or use heavy machinery regularly, speak to your doctor about how you can safely plan your medical cannabis use around this.
The Exciting Future Of Medical Cannabis
In the coming years, we’re likely to see more and more research into medical cannabis and its benefits. We’re already seeing some promising results with using medical cannabis to help manage a variety of chronic conditions.
Book an appointment with your GP or a medical cannabis clinic if you’re living with a condition that you think might benefit from medical cannabis. Thousands of Australians have joined the medical cannabis community since 2016 and the number is only going to grow as more people begin to see its exciting potential.
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