Medicinal cannabis explained
Medicinal cannabis (also referred to as medical marijuana) is any product that contains cannabis or components derived from the cannabis plant that is prescribed by a doctor to relieve the symptoms of a medical condition.
Medicinal cannabis products generally include one or both of two major components: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC and CBD are the two main cannabinoids responsible for most of the medicinal benefits of cannabis. There are other components of cannabis being researched for possible therapeutic use.
Is medicinal cannabis legal in Australia?
In recent years, the Federal Government has regulated and legislated the cannabis industry allowing approved cannabis companies under license to cultivate and manufacture medicinal cannabis for medical or scientific purposes.
Buying and using medicinal cannabis is legal and available for patients in Australia who meet specific eligibility criteria, under certain circumstances, and if prescribed by a registered medical practitioner who follows the correct process. This includes the prescribing doctor or general practitioner needing to justify to the Department of Health’s Therapeutic Goods Administration (TGA) why the person needs medicinal cannabis.
Medicinal cannabis products are regulated in Australia by the Commonwealth Department of Health’s Therapeutic Goods Administration (TGA) and the Office of Drug Control (ODC).
How to access legal medicinal cannabis in Australia?
In Australia, all registered medical practitioners are eligible to prescribe medicinal cannabis but approval is required by the Department of Health’s Therapeutic Goods Administration (TGA). Doctors can prescribe medicinal cannabis for patients who have had the condition for at least three months and have not responded to conventional medicine or if their current treatment has intolerable side effects.
Through the TGA framework, the TGA considers each patient’s prescription of medicinal cannabis via the TGA Special Access Scheme (SAS) application. The SAS application is submitted on the patient’s behalf by the prescribing doctor. This application includes clinical evidence and reasons for treatment, dosing routine, and length of treatment. Other access pathways within the TGA framework is the Authorised Prescriber Scheme (APS) which allows doctors to prescribe medicinal cannabis for a specific condition or patient participation in Clinical Trials.
Even though prescriptions are required to access medicinal cannabis products in Australia, on 15 December 2020, the TGA announced that low-dose CBD products, up to a maximum of 150mg/day in adults, can be supplied without prescription by pharmacists to patients over-the-counter. The products supplied are TGA approved and included on the Australian Register of Therapeutic Goods (ARTG). For more information about this update on low-dose CBD preparation, please visit the NPS Medicinewise website.
For the most current and accurate information on cannabis medicine and prescribing medicinal cannabis in Australia, please visit https://www.tga.gov.au/medicinal-cannabis-guidance-documents
Types of Medicinal Cannabis
Medicinal cannabis products are derived from the cannabis plant but depending on the health condition being treated, products will vary in terms of concentration, cannabinoid type, formulation, and method of administration.
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two major cannabinoids used for medicinal purposes. THC is the main psychoactive compound in the cannabis plant while CBD causes no psychoactive effects.
Medicinal cannabis products will vary in their ratios of cannabinoids. Formulations will generally contain mostly CBD or mostly THC, or a specified ratio of both.
The entourage effect is where some cannabis products retain the same ratio of cannabinoids and other active ingredients and minor cannabinoids together with CBD and/or THC compounds exactly the same as the cannabis strain. This modulates the effects of the THC and CBD and is thought to produce better health outcomes than cannabis products with a single isolated compound.
Does medicinal cannabis contain THC?
Some medicinal cannabis products contain THC. In Australia, most medicinal cannabis products are classified as Schedule 8 (S8) medicines (controlled drugs). This includes medicinal cannabis products containing THC.
Some medicinal cannabis products only contain CBD (cannabidiol; CBD cannabis oil), which are classified as Schedule 4 (S4) prescription-only medicines. The Poisons Standard allows ‘cannabidiol (CBD) only’ cannabis medicines to also contain up to 2 per cent of THC.
In Australia, prescribing and supply of medical cannabis must comply with the Medicines and Poisons legislation, similar to all other S4 and S8 medicines.
Who may benefit from medicinal cannabis?
Medicinal cannabis is an alternative treatment option for various health conditions if conventional medicine is ineffective or has unbearable side effects. To qualify for the use of medicinal cannabis, patient eligibility is not limited to a specific list of conditions or symptoms but the patient must have had the condition for at least three months.
Conditions treated in Australia
Medicinal cannabis as a plant-based therapy may be a valid treatment option for a number of health conditions which include sleep and insomnia, multiple sclerosis, epilepsy, PTSD, palliative care, endometriosis, chronic pain, cancer pain and anxiety.
Who can prescribe medicinal cannabis in Australia?
All registered medical practitioners can prescribe medical cannabis in Australia but every prescription is subject to TGA approval.
Who qualifies for medicinal cannabis in Australia?
Medicinal cannabis is legally available to buy and use in Australia for patients who meet specific eligibility criteria and if the correct process is followed by the prescribing doctor, which includes TGA approval. Access to medicinal cannabis by way of TGA approval is not limited to a specific list of conditions or symptoms but the person must have had the condition for at least three months and tried conventional medical treatment which was ineffective or resulted in intolerable side effects.
Getting the correct dosage
After completing the application process and receiving your medicinal cannabis, it is important to continually monitor your experience throughout your treatment with your healthcare specialist. Each patient’s experience may be different so if you experience any side effects or adverse reaction it is important to consult your doctor. Common issues to be aware of through treatment includes:
Efficacy – If your pain management medication doesn’t seem to be working it may be due to dosage, formulation, titration, or product compatibility.
Side effects – Medical cannabis can present with side effects in some instances for some patients, which may depend on dosage, mode of administration, formulation or titration. Side effects may include dry mouth, red eyes, increased appetite, reduced alertness, impairment of concentration, increased heart rate, lower blood pressure, and/or dizziness.
How much does medicinal cannabis cost in Australia?
The Australian government does not fund medicinal cannabis products under the Pharmaceutical Benefits Scheme (PBS). This means that patients need to pay the full cost of products themselves. The cost of cannabis medicines varies depending on the type of product prescribed and dosage. Patients also need to pay for related medical costs and review appointments with medical professionals.
Even though most medicinal cannabis products are unregistered medicines with no government funding under the PBS, from May 2021, Australians living with Dravet syndrome, a rare form of epilepsy, have access to Epidyolex® (CBD). This is the first medicinal cannabis drug to be subsidised by the Australian government under the PBS. Epidyolex® as well as Sativex® (nabiximols; THC and CBD), which treats moderate to severe spasticity in multiple sclerosis, are two cannabis medicines which have been registered on the Australian Register of Therapeutic Goods (ARTG).
To make pain management treatments more accessible and affordable for Australian patients, Cannatrek has a number of initiatives in place with doctors, medical practitioners and pharmacists. For a small number of patients, Cannatrek may be able to reduce costs through clinical trials or concession-based discounts. Although this is often not the case, to find out more, speak to a health professional or make contact with the Cannatrek team.
Have more questions? Contact one of our consultants at Cannatrek today.
Cannatrek is a technology-driven Australian company specialising in the research, cultivation, manufacturing and delivery of medical cannabis, committed to enhancing Australian patients’ quality of life.
To learn more about medicinal cannabis and for the latest news about accessing medicinal cannabis products in NSW, ACT, Victoria, South Australia, Queensland, Northern Territory, Western Australia and Tasmania, please speak to a doctor or contact Cannatrek directly on 1300 122 662. For general enquiries email firstname.lastname@example.org or for access-related enquiries email email@example.com.