Access to medicinal cannabis
With the exception of one product (Nabiximols), medicinal cannabis products are not registered medicines in Australia, and none are subsidized through the Pharmaceutical Benefits Scheme (PBS), so they can only be accessed through special pathways available for unapproved medicines.
A variety of products are currently available through these pathways, via import from Canada or Europe. These include raw (botanical) cannabis which may be vaporized for medicinal purposes, as well as oils, liquids and oral sprays. Some products have also been developed for direct application to the skin (gels).
Similar products made from locally grown medicinal cannabis are expected to become available during 2018. Medicinal cannabis can only be prescribed by a registered medical practitioner after a thorough assessment to decide if the treatment is appropriate for the patient condition and individual circumstances.
If a doctor decides that a medicinal cannabis product is suitable for the patient, they must apply for approval to prescribe it under the applicable state or territory laws. Rules relating to medicinal cannabis products vary between states and territories and could affect whether or not medicinal cannabis can be prescribed.
Individual patients cannot apply to the TGA for access to medicinal cannabis products.
Like all prescription medicines, medicinal cannabis products can have side effects. These may include:
- fatigue and sedation
- nausea and vomiting
- appetite increase or decrease
- dry mouth
- feelings of euphoria (intense happiness) or depression
- hallucinations or paranoid delusions
- psychosis or cognitive distortion (having untrue thoughts)
The extent of side effects can vary with the type of medicinal cannabis product and between individuals.
Patients using any medicinal cannabis products should seek their doctors advice before driving or operating machinery due to the risk of experiencing drowsiness. While drowsiness is not a known side effect of CBD alone, it may occur if the CBD interacts with other medications. Some medicinal cannabis products may also include tetrahydrocannabinol (THC), in which case there is a strict ban on driving and operating machinery.
Patients with conditions of the nervous system may be more likely to experience negative effects from medicinal cannabis.
Although medicinal cannabis treatment may help one condition or symptom, this does not mean it will have benefits for other conditions or individuals, even with the same product and the same dose.
There is also very limited evidence about how medicinal cannabis reacts with other approved medications.
More research is needed
There is a significant need for larger, high-quality studies to explore the potential benefits, limitations and safety issues associated with medicinal cannabis treatment across a range of health conditions and symptoms.
If more studies support medicinal cannabis use and provide evidence for particular forms, dosages and administration methods, it is more likely that doctors will feel confident in prescribing medicinal cannabis over other approved options.
Further research will also compare medicinal cannabis with standard medication options and build knowledge on how medicinal cannabis interacts with other drug treatments.
For more resources and further information about medicinal cannabis go to the TGA Website https://www.tga.gov.au.