About medicinal cannabis
How cannabis compounds interact with the body
Cannabis comes from a plant called the cannabis sativa plant, and humans have been using the plant for probably thousands of years for all sorts of medicinal and recreational purposes. The active ingredients in the plant are known as cannabinoids, which are present in the buds and leaves which are used in making cannabis.
There are around 80-100 of these cannabinoids, which can interact with the body’s endocannabinoid system, understood to be involved in the regulation of cognitive and physiological processes.
Two of these cannabinoids in particular have effects on the human body: cannabidiol (‘CBD’) and delta-9-tetrahydrocannabinol (‘THC’). THC induces psychoactive effects, that is it produces the ‘high’ associated with recreational cannabis. CBD on the other hand acts in a way that reduces these psychoactive effects.
While there is a significant body of research suggesting that there are reasons to be optimistic about the therapeutic benefit of cannabis compounds, we feel that the necessary high quality research studies confirming that cannabis products are unequivocally beneficial are lacking, and we therefore as a general rule support the position taken by the Faculty of Pain Medicine that cannabis compounds generally should not be freely offered to most patients unless there are certain very narrowly defined pain syndromes, and that no other treatment modalities have been successful.
Most medicinal cannabis does not contain THC, but does contain CBD and other cannabinoids.
Medicinal cannabis access in Australia
Prescribing and access requirements
The use of recreational cannabis is highly regulated in Australia, however in recent years the law has changed to allow the use of medicinal cannabis in very specific circumstances.
The Therapeutic Goods Administration (TGA) has approved a range of products including nabiximols and some synthetic cannabinoids for medical use specifically for treating some symptoms of multiple sclerosis.
Doctors are now able to apply to the TGA for authority to prescribe medicinal cannabis to patients through two schemes called the Authorised Prescriber Scheme and the Special Access Scheme. There is no facility for individuals to apply, all applications must be through either a GP, a medical specialist or via a clinical trial.
The TGA has listed a range of over 40 medical conditions where medicinal cannabis may be effective, although this is not an exclusive list and medicinal cannabis may also be approved as treatment for conditions and symptoms that do not appear on the list.
Recreational cannabis and self-medication risks
Why recreational cannabis is not recommended for pain management
Although these cannabis-based medications are approved for certain medical treatments, current medical advice is strongly against using recreational cannabis for self-medication.
This is primarily for two reasons:
- Much like cigarettes, smoking cannabis involves the inhalation of smoke, which is implicated in a wide range of medical conditions, from lung cancer to other pulmonary conditions and a degradation of the blood circulatory system.
- Recreational cannabis is totally unregulated, so it is impossible to know what strength or ‘dose’ you are receiving; there may also be other compounds or substances present which may counter the effect of the active components.
The Faculty of Pain Medicine Australian and New Zealand College of statement which covers the use of Medicinal Cannabis (published April 2015), with particular reference to its use in the management of patients with chronic non-cancer pain.
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