What is plant-based medicine?
Cannabis medicines refer to cannabis-derived products used for therapeutic purposes. The two main cannabinoids (a group of over 200 active chemical compounds found in cannabis) found to have therapeutic benefits are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These are also the most studied cannabinoids. There is also research underway exploring the therapeutic potential of other cannabinoids, such as cannabidivarin.
Cannabis medicines can be a combination of both THC and CBD or only THC or CBD, depending on the health condition for which they are prescribed. There are a range of routes of administration, including vaporising, oral administration, oro-mucosal sprays, topical and smoking. As it is difficult to estimate the amount of THC an individual patient is receiving through smoking cannabis products, and due to the well-documented evidence that smoking in general is harmful, smoking of cannabis products is not supported.
How is plant medicine taken?
There are many ways to use plant medicine these include raw cannabis flower, which for medicinal purposes should be vaporised but not smoked, cannabis extracts in oils, and solvent extracts such as tinctures, and oro-mucosal sprays. Some products for trans-dermal application (patches or topical application of gel or cream) have also been developed.
What health conditions can be treated by plant medicine?
There is no predetermined list of conditions for which cannabis medicine can be prescribed. Each application to prescribe is considered on its merits and assessed on a case-by-case basis.When making an application to the Australian Government’s Therapeutic Goods Administration (TGA) to prescribe a cannabis medicine, a doctor must provide clinical evidence about use of the product to enable an assessment of potential benefits and harms. It is expected that all registered conventional medicines or non-medicinal treatments will have already been explored.
Currently, there are trials investigating the safety and efficacy of cannabis medicines in:
-reducing seizures in children with severe treatment-resistant epilepsy,
-preventing nausea and vomiting in chemotherapy patients,
-enhancing the appetite and appetite-related symptoms of palliative care patients with advanced cancer,
improving the control of symptoms, including pain, nausea and lack of appetite, in advanced cancer patients, and
-reducing chronic pain in patients with spinal cord injury.
What are the side effects of medicinal cannabis treatment?
Like all prescription medicines, medicinal cannabis products can have side effects. The extent of effects of these can vary with the type of medicinal cannabis product and between individuals. In general, the side effects of CBD-rich products are less than those for high-THC products, but because the required doses for CBD can be quite high in conditions such as paediatric epilepsies, a proportion of patients encounter side-effects with these CBD doses.
The known side-effects from medicinal cannabis treatment (both CBD and THC) include fatigue and sedation, vertigo, nausea and vomiting, fever, decreased or increased appetite, dry mouth, and diarrhoea.
THC (and products high in THC) have been associated with convulsions, feeling high or feeling dissatisfied, depression, confusion, hallucinations, paranoid delusions, psychosis, and cognitive distortion (having thoughts that are not true).
Can I drive while using plant-based medications?
Cannabis medicines are pharmaceutical-grade products containing active cannabinoids, which can cause impairment and affect fitness to drive. Whether it is illegal or appropriate for a person to drive after taking a cannabis medicine will depend on the type of medication prescribed.
It is illegal for patients taking cannabis medicines which contain delta-9-tetrahydrocannabinol (THC) to drive. This is because THC can affect the cognitive and motor skills necessary for safe driving, such as attention, judgment, memory, vision and coordination.
Patients taking cannabidiol(CBD)-only medicines can lawfully drive if they are not impaired. As CBD can cause drowsiness, fatigue and lowered blood pressure, patients should discuss usage and risk of impairment with their treating doctor.
Roadside drug testing in Australia tests for THC in saliva. In NSW, it is an offence to drive (a) with the presence of THC in oral fluid, blood or urine; or (b) under the influence of THC. There is no medical defence to these offences specified in the Road Transport Act 2013 (NSW) for using a prescribed cannabis medicine. There may also be insurance implications for patients who are convicted of these offences.
How do I access medicinal cannabis ?
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Medicinal cannabis products are highly regulated and the process of getting access to the medication is not generally as simple as asking your doctor for a prescription.
As most cannabis products in Australia are unregistered, your doctor will need to follow a special process give you access to medicinal cannabis. Generally, the following steps are involved:
Have a consultation with your doctor or specialist.
If deemed suitable for treatment, your doctor will send an application to the TGA and possibly to the NSW Health Department to get an approval. Please note, your doctor will select a particular class of medicinal cannabis product at this time which can only be changed with a new approval.
The approval process usually take 1-5 days if you are a suitable patient and all of the correct information is provided to the TGA.
Once approved, the TGA will forward the approval letter to your doctor. This letter will set out the approved indication, how long you have been approved for and what product and dosage you have received approval for.
Your doctor will then be able to provide you with a prescription and copy of the approval letter which will be needed in order for your pharmacy to order the specific medicinal product that has been approved.
Once the pharmacy receives the product from the supplier, they will be able to fill your prescription. Please note, most medicinal cannabis products are not subsidised on the PBS or Medicare.
You will be required to undergo regular reviews by your doctor to ensure you are not experiencing side effects and the treatment is safe and effective.
Do we have a catalogue?
As medicinal cannabis is an unregistered medicine in Australia, we cannot advertise lists or products publicly or online. Please speak to your prescribing doctor for further information.
The full list of brands and formulations available in Australia can be found on the TGA website. Please contact our pharmacists on 9569 4396 or firstname.lastname@example.org if you have any enquiries regarding plant-based medications.