Article by Dr Aparna Hegde
The use of cannabis for medicinal reasons is not new and written evidence dates back to 2700BC when Chinese Emperor Chen Nung drew up the first pharmacopeia. It was legally and widely used until the early 20th century when it became demonised as part of prohibition policies in the US and then internationally when it became illegal as it was included in the Single Convention of Narcotic Drugs in the 60s.
Is Cannabis Treatment Legalised in Australia?
Medicinal use of Cannabis initially became legal in Israel, then the US and Canada.
In Australia, it has been federally legalised since 2016 with patient availability in 2017. Much has changed in this time to make it more accessible to patients. There is more awareness in the general public, less stigma, more GP Authorised Prescribers such as myself, expanded criteria of indications for use and plethora of different products including a couple that are registered in Australia, which has made the price point more affordable.
All the choice has made the process for a patient quite overwhelming and it is important to consult a practitioner who is experienced and knowledgeable.
What Cannabis Products Can Be Prescribed?
Schedule 4 medicinal cannabis products contain cannabidiol (CBD) as the active and do not contain tetrahydrocannabinol THC, which is the psychoactive component that is more stringently regulated. CBD preparations do not cause cognitive impairment. They are commonly used to manage pain, anxiety, spasticity and movement disorders and modify inflammation in the body. CBD can be used safely in quite high doses as the side effects are minimal and there is no issue with safety critical work or driving. CBD use does not result in a positive drug test.
Schedule 8 products contain THC and CBD in varying concentrations. The THC component is very useful to manage chronic pain, insomnia, anxiety and palliative care patients. It can cause some undesirable side effects on balance, cognition and precludes any safety critical tasks and driving. The great benefit for THC is that there is no tolerance, which means once we get to a dose that gives good pain relief without side effects, this is the therapeutic dose long term.
There is now uniformity in the approach throughout Australia with Schedule 4 products, however every State still has different regulations for the Schedule 8 products.
How Can Medical Cannabis Help Me?
Clinical indications for Dr Hegde’s approval as TGA Authorised Prescriber:
- Chronic Non-Cancer Pain (CNCP)
- Neuropathic pain
- Arthropathic pain
- Cancer Pain and/or Palliation
- Anxiety (including PTSD)
- Autism Spectrum Disorder (ASD)
- Movement disorders
- Parkinson’s Disease
- Multiple Sclerosis (MS)
What Are the Risks and Costs of Medical Cannabis?
There are always risks and downsides with these medications and in my experience, this is where the “art of medicine” becomes important.
Cost is the main deterrent for most patients as none of these products are on the PBS. DVA is the only organisation that will cover the cost in some cases if there is specialist support.
I have been so convinced of the benefits of medicinal cannabis that I have been a TGA approved Authorised Prescriber for medicinal cannabis products for the past 5 years. In my view, these products are a game changer in patients where conventional medicines have either failed or caused too many undesirable effects. Why use opioids for chronic pain when we know they simply do not work long term, can cause terrible effects on physical and mental health and result in overdose fatalities when we have an option with an effective medication that does not cause tolerance effects or fatalities.
Optimise Your Health with Alternative Treatments at Cellf Wellness and GP Clinic.
If you want to book in for an appointment to discuss the use of medicinal cannabis with Dr Aparna Hegde at Cellf Wellness and GP Clinic, please note the first appointment should be for 45 minutes and will not be bulk billed.