What Is Medical Cannabis?
Medical cannabis, also referred to as medical marijuana, is the use of cannabinoids derived from the cannabis plant to alleviate symptoms associated with various medical conditions.
With more than 100 different cannabinoids present in the plant, the most well-known compounds are THC and CBD, both of which have been identified to possess therapeutic properties beneficial for managing chronic pain, epilepsy, multiple sclerosis, chemotherapy-induced nausea and vomiting, and other health issues (Therapeutic Goods Administration, 2019).
Healthcare professionals often recommend medical marijuana, and it can be administered in diverse forms, including capsules, oils, tinctures, and infused food products. Additionally, it can be inhaled through vaporisation or smoking, although these delivery methods may not be suitable for specific patients due to potential respiratory complications (Therapeutic Goods Administration, 2019).
It is essential to recognise that the use of medical cannabis is subject to strict regulation and can vary depending on the location. Different countries and regions have distinct laws and regulations governing its usage (Therapeutic Goods Administration, 2017). Therefore, it is crucial to adhere strictly to the guidance of a healthcare professional when considering the use of medical cannabis to ensure both the safety and effectiveness of the treatment (Therapeutic Goods Administration, 2017).
Why Use Medical Cannabis?
Medical cannabis is employed to alleviate symptoms associated with various medical conditions, including chronic pain, epilepsy, multiple sclerosis, chemotherapy-induced nausea and vomiting, and specific mental health disorders (Lintzeris et al., 2020).
The cannabinoids found in cannabis, such as THC and CBD, interact with the body's endocannabinoid system, which plays a crucial role in regulating functions like pain, mood, appetite, and memory (Lintzeris et al., 2020). As a result, medical cannabis can offer relief from symptoms that may not adequately respond to conventional treatments (Lintzeris et al., 2020).
In some cases, patients may consider medical cannabis as a more natural alternative to pharmaceutical medications, especially when other treatments have proven ineffective or have resulted in intolerable side effects (Lintzeris et al., 2020).
However, it is vital to emphasise that the decision to use medical cannabis should be made in consultation with a healthcare professional who can provide personalised guidance based on the individual's medical history and needs (Lintzeris et al., 2020).
What Is The Difference Between Medical Cannabis and Marijuana?
The terms "medical cannabis" and "marijuana" are often used interchangeably, but they carry distinct differences in their usage and connotations within the context of Australian health regulations and guidelines (Healthdirect Australia, n.d.).
Medical cannabis refers to the use of cannabis and its cannabinoids, such as THC and CBD, for medicinal purposes under the supervision of healthcare professionals (Therapeutic Goods Administration, 2017). Acquisition is conducted through lawful and regulated channels, adhering to medical laws and regulations (Healthdirect Australia, n.d.). It is governed by strict regulations and oversight by healthcare professionals (Medicinal Cannabis - Alcohol and Drug Foundation, n.d.).
On the other hand, marijuana is commonly associated with recreational consumption for its psychoactive properties, often for non-medical or recreational purposes (Healthdirect Australia, n.d.). It is subject to legal limitations and may not be under the same level of regulatory supervision as medical cannabis (Healthdirect Australia, n.d.).
Is Medical Cannabis Legal In Australia?
Australia's journey into legalising medical cannabis began with a significant announcement by the Federal Government in October 2015, signaling the legalisation of cannabis cultivation for medicinal and scientific purposes. This pivotal move led to amendments in the Narcotic Drugs Act, officially authorising the commercial cultivation of cannabis for medicinal and scientific use, which took effect on November 1, 2016 (Arnold et al., 2020).
This legislative change was influenced by growing interest in the medical use of cannabis and the implementation of similar programs in other countries (Therapeutic Goods Administration, 2017).
In Australia, the Therapeutic Goods Administration (TGA) is responsible for the regulation of medical cannabis. The TGA oversees the supply of medicinal cannabis, which is primarily composed of unregistered drugs. To prescribe these products, healthcare professionals must seek approval from the TGA through specific channels like the Special Access Scheme-B or Authorised Prescriber Scheme (Therapeutic Goods Administration, 2017).
Benefits Of Medical Cannabis
Medical cannabis, also referred to as medical marijuana, has attracted considerable interest due to its potential therapeutic advantages. Numerous medical and health associations have acknowledged the medicinal worth of cannabis, and research suggests its potential benefits for a range of conditions:
1. Pain Management
Medical cannabis has demonstrated promise in relieving persistent pain linked to ailments like multiple sclerosis, arthritis, and cancer. Its potential benefits have been observed in various studies and research (Bridgeman & Abazia, 2017).
2. Nausea and Vomiting Relief
Medical marijuana has proven to be successful in alleviating nausea and vomiting, especially in individuals undergoing chemotherapy or suffering from intense nausea caused by other medical ailments (Mayo Clinic, 2021).
3. Neurological Disorders
Research indicates that there is evidence to support the idea that medical cannabis possesses neuroprotective qualities and may be advantageous for individuals suffering from neurological conditions like epilepsy, Parkinson's disease, and multiple sclerosis (Bridgeman & Abazia, 2017).
4. Anxiety and Depression Relief
According to certain studies, there is evidence suggesting that cannabis could potentially offer relief from symptoms associated with anxiety and depression. This indicates that it may serve as an alternative treatment option for individuals who are dealing with these particular mental health conditions (Bridgeman & Abazia, 2017).
5. Appetite Stimulation
Cannabis has the potential to enhance appetite in individuals suffering from medical conditions that result in a diminished desire to eat or unintentional weight loss, such as HIV/AIDS or cancer (Bridgeman & Abazia, 2017).
6. Anti-inflammatory Properties
Certain substances found in cannabis possess properties that can reduce inflammation, making them potentially advantageous for conditions characterised by inflammation, such as arthritis and inflammatory bowel diseases (Bridgeman & Abazia, 2017).
7. Sleep Aid
Cannabis has the potential to assist certain individuals in enhancing their sleep patterns and relieving symptoms associated with insomnia (Bridgeman & Abazia, 2017).
Drawbacks Of Medical Cannabis
Despite the benefits of medical cannabis, it is crucial to take into account the possible disadvantages of utilising medicinal cannabis, which include:
1. Limited Evidence and Mixed Conclusions
Numerous reviews have presented ambiguous or inconsistent findings regarding the efficacy of medical cannabis for different ailments. Some studies have suggested that cannabis may not be effective or cost-effective when compared to a placebo in treating multiple sclerosis, acute pain, cancer, and injuries (Pratt et al., 2019).
2. Side Effects and Adverse Events
Various reviews have documented adverse events associated with the use of medical cannabis. These events range from minor effects like drowsiness, dizziness, dry mouth, and nausea to more serious ones such as psychotic symptoms, severe dysphoric reactions, seizures, and urinary tract infections. Additionally, a significant number of reviews have reported withdrawals from medical cannabis due to adverse events (Pratt et al., 2019).
3. Neurocognitive Deterioration
Chronic usage of cannabis has been linked to a decline in neurocognitive function, a decrease in brain size and density, and impaired cognitive abilities. This is especially true for individuals who initiate cannabis use at a young age (Suryadevara et al., 2017).
4. Mental Health Risks
Cannabis consumption has been associated with various disorders like depression, anxiety, and episodes of psychosis. Prolonged use of cannabis can potentially elevate the likelihood of cognitive deficiencies, dependency, and deterioration of mental well-being (Suryadevara et al., 2017).
5. Physiological Effects
Chronic utilisation of cannabis can lead to detrimental impacts on physical well-being, such as heightened susceptibility to respiratory ailments and detrimental consequences on both the male and female reproductive systems (Suryadevara et al., 2017).
6. Dependence and Withdrawal
Chronic usage of cannabis has the potential to result in the establishment of dependence and the emergence of withdrawal symptoms, including anxiety, depression, irritability, reduced sleep quality, and abdominal discomfort.
7. Uncertainty and Lack of Monitoring
Plant-based and plant-derived cannabis products are not regulated in the same way as conventional medications, which creates uncertainty regarding potential health risks. The levels of THC and CBD can vary significantly between different cannabis plants and products, resulting in unpredictable effects when consumed (Arkell et al., 2023).
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Who Can Get Medical Cannabis In Australia?
In Australia, the use of medical cannabis is regulated and permitted only under certain conditions. Certain groups are eligible to access medical cannabis in Australia including:
1. Patients with Approval from Registered Medical Practitioners
Only a registered medical practitioner is authorised to prescribe medical cannabis. Patients have the option to obtain medical cannabis if their doctor, who possesses the necessary qualifications and expertise related to the specific medical condition requiring treatment, applies for approval on their behalf to import and supply these products through the Special Access Scheme (SAS Category A or B). Alternatively, the doctor can become an Authorised Prescriber (AP) (Therapeutic Goods Administration, 2017).
2. Clinical Trials and Research
Patients who are involved in clinical trials and research studies that adhere to specific regulatory and ethical guidelines may also have the opportunity to access medical cannabis. These trials and studies aim to investigate the potential advantages, limitations, and safety concerns related to the use of medicinal cannabis for various health conditions and symptoms (Healthdirect Australia, n.d.).
How To Get Medical Cannabis In Australia?
In order to acquire medical cannabis in Australia, patients are required to navigate a prescribed procedure that encompasses multiple pathways and approvals. The subsequent breakdown provides a comprehensive, step-by-step overview of the process:
1. Consultation With A Doctor
In order to begin exploring the potential benefits of medical cannabis, it is essential for patients to engage in a discussion with their healthcare provider. During this conversation, the doctor will carefully evaluate whether medical cannabis is a suitable option for the patient's specific condition. Additionally, the doctor will make an informed decision regarding which specific medicinal cannabis product should be prescribed (Healthdirect Australia, n.d.).
2. Assessment and Medical History
The doctor will evaluate the patient's medical background, family health history, present medications, and any concerns regarding drug addiction and substance misuse. This evaluation is essential for determining whether medical cannabis treatment is suitable for the patient (Therapeutic Goods Administration, 2017).
3. Special Access Scheme (SAS) or Authorised Prescriber Scheme Application
If a doctor concludes that medical cannabis is an appropriate choice for treatment, they must proceed by submitting an application through the Special Access Scheme (SAS) or applying to become an Authorised Prescriber, both overseen by the Therapeutic Goods Administration (TGA). The application procedure involves presenting clinical reasoning, data on safety and effectiveness, as well as information on patient monitoring (Arnold et al., 2020).
4. Approval For Paediatric Patients
If the patient is below the age of 18, extra care and criteria are necessary, particularly when it comes to unapproved medicinal cannabis products that contain THC. The doctor must present evidence of endorsement from a paediatric specialist or a relevant medical expert who supports the usage of the product for the patient's specific medical condition (Therapeutic Goods Administration, 2024).
5. Supply Of Medicinal Cannabis
Once the doctor gives their approval, they will be able to write a prescription for the patient. The patient can then take this prescription to any pharmacy in order to obtain the necessary medicinal cannabis product (Healthdirect Australia, n.d.).
6. Cost Consideration
Patients need to be informed that medicinal cannabis is not covered by the Pharmaceutical Benefits Scheme (PBS). The price of medicinal cannabis may differ based on the specific illness, the type of product, and the dosage, with costs ranging from $50 to $1000 per week (Healthdirect Australia, n.d.).
7. Legal Considerations
Patients should solely acquire legitimate medicinal cannabis products from their doctor, specialist, or by participating in a clinical trial. It is against the law to import cannabis medicines via mail or courier, and patients should refrain from purchasing marijuana products from abroad or using illicitly obtained marijuana to alleviate their symptoms (NSW Health, n.d.)
How Long Does It Take To Obtain Medical Cannabis In Australia?
The duration of getting medical cannabis can be affected by various factors including the thoroughness of the application, the promptness of the sponsor's response, and the specific criteria set by the health department of the state or territory. Nevertheless, when all necessary information is supplied by the medical practitioner, the TGA aims to reach a decision within approximately two working days, establishing a standard timeframe for the review process.
Registered Cannabis Products In Australia
In Australia, there are currently two medicinal cannabis products that have received approval and are listed on the Australian Register of Therapeutic Goods (ARTG). These products have undergone thorough assessment by the Therapeutic Goods Administration (TGA) to ensure their quality, safety, and effectiveness. They are:
Sativex (Nabiximols)
Sativex, also referred to as Nabiximols, is an approved medicinal cannabis product registered with the Therapeutic Goods Administration (TGA) in Australia (Therapeutic Goods Administration, 2017). It is a regulated extract obtained from the cannabis plant and consists of approximately equal quantities of THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol) (Product | Centre for Medicinal Cannabis Research and Innovation, n.d.).
Sativex has received approval for managing moderate to severe spasticity in multiple sclerosis. This encompasses alleviating the symptoms linked to muscle spasticity, which is a prevalent issue among individuals living with multiple sclerosis (Product | Centre for Medicinal Cannabis Research and Innovation, n.d.).
Sativex is given in the form of an oral spray, which makes it a convenient and non-intrusive way of administering the medication. The spray is applied inside the mouth, either on the inner side of the cheek or beneath the tongue, enabling quick absorption into the bloodstream (Therapeutic Goods Administration, 2017).
Sativex is the first registered medicinal cannabis product in Australia for the specified indication, demonstrating its compliance with the rigorous standards of safety, quality, and effectiveness set by the TGA (Product | Centre for Medicinal Cannabis Research and Innovation, n.d.).
Epidyolex (cannabidiol)
Epidyolex (cannabidiol) is a pharmaceutical cannabis medicine that has been included in Australia's Pharmaceutical Benefits Scheme (PBS). This milestone marks the first instance of a medicinal cannabis drug being financially supported by the Australian Government through the PBS (Australian Government Department of Health and Aged Care, 2022).
Epidyolex has been authorised for utilisation alongside a minimum of two other anti-epileptic medications to treat Dravet syndrome, an uncommon genetic epileptic encephalopathy characterised by seizures that are unresponsive to conventional drugs. Typically, this disorder manifests in the initial year of life in otherwise healthy infants. Studies have demonstrated the potential benefits of Epidyolex in managing the symptoms associated with Dravet syndrome, a condition distinguished by a gene mutation that impacts the ion channels in the brain (Australian Government Department of Health and Aged Care, 2022).
Epidyolex is taken by mouth and is the second registered medicinal cannabis medication available in Australia. It is advised to be used alongside other anti-epileptic drugs for the treatment of Dravet syndrome. The inclusion of Epidyolex on the PBS enables eligible patients to obtain the treatment at a considerably lower price, with a prescription costing $41.30 or $6.60 for individuals holding a concession card (Australian Government Department of Health and Aged Care, 2022).
Unregistered Medical Cannabis Products In Australia
Unregistered medical cannabis products in Australia are those that have not been assessed and registered on the Australian Register of Therapeutic Goods (ARTG). These products are considered unregistered because they have not undergone the thorough evaluation process required to guarantee their safety, quality, and effectiveness, as per the stringent standards established by regulatory authorities (NSW Health, n.d.).
To enable patients to obtain unregistered medical cannabis products, certain factors must be taken into account:
1. Prescriber Responsibility
The prescribing practitioner holds the responsibility for the patient's treatment. It is anticipated that prescribers would have taken into account all clinically suitable treatment choices listed in the Australian Register of Therapeutic Goods (ARTG) before contemplating the use of unregistered cannabis medications. Prescribers must thoroughly assess the patient's condition and available treatment alternatives prior to seeking authorisation for unregistered cannabis medicines (NSW Health, n.d.).
2. Regulator Pathways
Accessing unregistered cannabis medications can be pursued through regulatory routes such as the Special Access Scheme (SAS) and the Authorised Prescriber (AP) pathway. These pathways allow for the acquisition of unapproved therapeutic products, like medicinal cannabis, on an individual basis (Therapeutic Goods Administration, 2024).
3. Consideration of Alternatives
Before contemplating the use of unregistered cannabis medications, healthcare professionals are required to thoroughly explore all clinically suitable treatment alternatives listed in the Australian Register of Therapeutic Goods (ARTG) (NSW Health, n.d.).
4. State and Territory Approvals
Depending on the particular situation and the categorisation of the cannabis medication, it may also be necessary to obtain approval from health departments in the respective state or territory. This is particularly important for drugs classified as Schedule 8 controlled substances (Therapeutic Goods Administration, 2024).
5. Patient Informed Consent
Patients are required to give their informed consent before using unregistered cannabis medicines, and healthcare professionals must ensure that patients have a thorough understanding of the treatment, including the fact that the medicine is not registered and the possible risks associated with its use (NSW Health, n.d.).
How Much Is Medical Cannabis?
The expense of medical cannabis in Australia is something that patients need to seriously think about. The price of medicinal cannabis products can be a barrier for numerous people, as patients are left to shoulder the financial load. At present, there is a dependence on imported products, which can amount to approximately $300 per month, rendering it out of reach for many individuals (Castle et al., 2019).
Furthermore, the Pharmaceutical Benefits Scheme (PBS) does not cover medicinal cannabis. The cost of medicinal cannabis can vary depending on the illness, the product, and the dose, ranging from $50 to $1000 per week. This variation in cost further emphasises the financial impact on patients seeking medical cannabis treatment (Graham et al., 2023).
The expensive price of medical marijuana products in Australia can pose a challenge for numerous patients, underscoring the importance of ongoing initiatives to tackle the affordability of medicinal cannabis and enhance accessibility for individuals who could potentially find this type of therapy beneficial (Castle et al., 2019).
Why Is Medical Cannabis Expensive In Australia?
The high cost of medical cannabis in Australia, in comparison to other countries, can be attributed to a variety of factors. These factors include:
1. Legislative Framework and Regulations
In Australia, the regulations and administrative procedures involved in accessing medical cannabis can lead to increased expenses. This is because of the additional burden on prescribers and patients, as well as the costs associated with obtaining the required approvals. These processes include the Special Access Scheme (SAS) or becoming an Authorised Prescriber (Castle et al., 2019).
2. Imported Products
Currently, Australia is dependent on imported medical cannabis products, resulting in increased expenses due to importation fees, taxes, and transportation costs. This reliance on imported goods significantly contributes to the overall cost, rendering it unaffordable for a substantial number of individuals (Castle et al., 2019).
3. Limited Domestic Production
Although Australia has initiated its support for the medicinal cannabis sector, including the establishment of cannabis plantations and the development of extraction technologies, the country's limited domestic production may lead to a restricted supply. Consequently, this could potentially result in higher prices for medical cannabis products (Castle et al., 2019).
4. Cost of Compliance and Quality Assurance
The comprehensive guidelines and safety measures established by regulatory bodies can result in higher expenses for adhering to compliance and ensuring the quality of medical cannabis products in Australia. These additional costs may be passed on to the final consumer, thereby adding to the overall financial burden associated with medical cannabis (Graham et al., 2023).
5. Patient Self-Funding
The existing system places the financial responsibility for medical cannabis products on the patients, who are required to cover the costs themselves. The expensive nature of medical cannabis can create barriers for numerous individuals, possibly leading them to seek illegal sources of cannabis, which presents additional hazards (Castle et al., 2019).
Considerations Before Using Medical Cannabis
Before seeking advice from a healthcare professional regarding the use of medical cannabis, patients should take into account a number of important factors. These factors are crucial for making informed decisions and ensuring the effectiveness of the treatment. Here are the main factors to consider:
1. Medical Condition and Symptoms
Patients are advised to evaluate and record their medical status, symptoms, and treatment background. This entails comprehending the nature and intensity of their condition, along with the particular symptoms they aim to alleviate using medicinal cannabis. Maintaining a journal of symptoms can offer significant insights to healthcare providers.
2. Research and Education
Patients should engage in extensive research regarding medical cannabis, encompassing its possible advantages, hazards, and adverse reactions. It is crucial to gather information from trustworthy sources such as medical publications, governmental health departments, and organisations advocating for patients. Familiarising oneself with the various forms of medical cannabis, such as oils, capsules, or vaporizers, and comprehending their potential impacts holds great significance.
3. Legal and Regulatory Considerations
Patients should take the time to become acquainted with the legal and regulatory structure pertaining to medical cannabis in their area. This involves gaining an understanding of the requirements for accessing medical cannabis, the process of obtaining approval, and any potential expenses involved. Patients should also be knowledgeable about the particular laws and regulations governing medical cannabis in their specific region or territory.
4. Potential Risks and Side Effects
Patients must exercise caution regarding the possible hazards and adverse effects linked to medical cannabis. This entails comprehending its potential interactions with other medications or ongoing treatments. It is imperative for patients to openly communicate any allergies, sensitivities, or unfavourable reactions they may experience with their healthcare provider.
5. Communication with Healthcare Provider
Effective communication with your healthcare provider is crucial when it comes to seeking medical advice. It is important for patients to come prepared with a set of questions and be willing to openly discuss their expectations, worries, and any past encounters with cannabis. Furthermore, patients should be ready to provide information about their general well-being, such as their medical background, current medications, and lifestyle choices. This open and honest dialogue will ensure that your healthcare provider has a comprehensive understanding of your needs and can provide you with the best possible care.
6. Treatment Goals and Expectations
Patients should set specific treatment objectives and anticipate outcomes when considering the use of medicinal cannabis. This entails outlining the desired results, such as pain alleviation, symptom mitigation, or enhanced quality of life. It is crucial to have practical expectations and a comprehensive comprehension of the possible consequences.
7. Accessibility and Affordability
Patients should take into account the accessibility and affordability of medical cannabis. This entails comprehending the potential expenses, availability of products, and the procedure for obtaining prescriptions and accessing treatment. Patients should also be mindful of any potential insurance coverage or financial aid alternatives.
8. Support and Follow-Up Care
Patients should take into account the accessibility of assistance and post-treatment care. This encompasses comprehending the extent of support offered by the healthcare provider, potential monitoring obligations, and the accessibility of resources for continuous education and advice.
Conclusion
In conclusion, embarking on the exploration of medical cannabis availability in Australia can prove to be a challenging yet crucial endeavour for individuals seeking alternative treatment options. This all-encompassing manual has shed light on the legal framework, application procedures, associated expenses, and the wide range of products accessible. By delving into the criteria for eligibility and potential hazards, we have strived to empower readers with the knowledge required to navigate this terrain with confidence.
Whether you are grappling with chronic ailments or are intrigued by the ever-evolving medical cannabis landscape in Australia, this article serves as an invaluable source of information, equipping you to make well-informed choices concerning your healthcare journey. Remember, comprehending the intricacies of accessing medical cannabis can play a pivotal role in shaping your path towards holistic well-being.
Author's Note:
This article provides a general overview of cannabis laws and information in Australia. It is essential for readers to conduct their own research via Australian health government websites and organisations such as Office Of Drug Control, Health Direct and the Therapeutic Goods Administration to obtain the latest up-to-date information about cannabis use and drug detection in the country. This article is not a substitute for professional legal or medical advice and is intended for informational purposes only.
