The team at BudHerd reached out to a specialist medical cannabis doctor in Australia to answer some of the most asked questions they receive. Here is what they found.
As the number of active medical cannabis patients in Australia continues to climb year on year, so does the number of questions patients have surrounding cannabis treatment.
In the current state of prohibition, most medicinal cannabis products are still yet to be listed as an approved item on the Australian Register of Therapeutic Goods. Further to this, the stigma surrounding marijuana and the lack of medicinal cannabis education for doctors can leave many patients’ burning questions unanswered.
We reached out to a general practitioner who was recently approved as an authorised prescriber of cannabis products and forwarded on some of the most frequently asked questions from potential patients seeking cannabis treatment.
Please be mindful the answers below are for informational and educational purposes only. As cannabis can affect individuals in different ways, please consult with your doctor before using any medical cannabis products.
What are the most common conditions medicinal cannabis is prescribed for?
Chronic pain is one of the most common conditions medicinal cannabis is prescribed for. As patients and doctors become more aware of cannabinoid options, more are opting for the former rather than opioid therapy.
Other conditions cannabinoid therapies are known to address include insomnia, anxiety, appetite loss, nausea, neuropathic pain, insomnia, PTSD, inflammatory bowel issues, inflammatory arthritis, palliative care, nausea, and Multiple Sclerosis related muscle spasticity.
Can a patient be prescribed multiple cannabis products at once?
Australian doctors will generally be required to apply for a separate approval for each product from the TGA, but the answer is yes – patients can be prescribed multiple products.
A common scenario may be to use a higher CBD, low THC product during the day and higher THC content products in the evening.
Can cannabis products interfere with other medications? Is it safe to use cannabis products whilst I’m still prescribed opioids or other pain medications?
Patients are advised to seek specific advice from their doctors as there is a chance of cannabis interfering with the metabolism of other medications. As cannabis is metabolised in the liver, it may increase or decrease the metabolism of various other medications.
There are very few pain medications that interact with cannabis. Patients are always recommended to start cannabinoid therapy at very low doses and slowly increment and monitor over time. Other medications should not be immediately ceased, and your doctor should provide you with guidance if they can be slowly reduced over time.
Why don’t most doctors accept medicinal cannabis as a valid treatment?
This is predominantly due to a lack of education. The Endocannabinoid System is not generally taught at medical schools and has only recently become mainstream. There is also a concern in the medical community that cannabis may cause dependence in patients or cause a risk to mental health. In recent years, more research and clinical studies are underway to support the medicinal uses of cannabis. However, as cannabis is still relatively new in the modern medical field, most medical practitioners will still be skeptical until we have strong evidence supporting medicinal cannabis.
If you are not having success with your current GP. It’s best to seek advice from a doctor experienced with medicinal cannabis, or a specialist cannabis clinic.
What are the most common side effects associated with medicinal cannabis?
Every individual reacts to cannabis differently, as every endocannabinoid system is unique. Some of the side effects of cannabis are somewhat conflicting with the actual conditions patients were seeking treatment for. This side effects include nausea, headache, insomnia, racing thoughts, panic, and anxiety. Other more common side effects include drowsiness, increased appetite, dry mouth, red eyes, confusion, memory impairment, dizziness and intoxication or feeling “high”.
The most important factor to take into consideration when dosing medicinal cannabis is to understand the onset of the product, or how long it takes for the effects to kick in. Cannabis consumed in oil form may take up to a few hours to take effect, and patients may be tempted to repeat the dose. Overdosing can cause severe anxiety and panic, rapid heart rate and even vomiting or dizziness.
With that said, overdosing on cannabis generally is not life threatening, and there is no effect on the breathing and cardiac centre of the brain.
Can cannabis help anxiety and depression?
This really depends on the severity of the symptoms. Cannabinoids can be used to relax patients and reduce persistent negative and distressing thoughts. This way it can help anxiety. Cannabis can also be used to help insomnia and improve sleep, which can help improve mood and general wellbeing.
For certain individuals, cannabis may act as a depressant. Like alcohol, cannabis may enhance or dampen the negative moods of users. Patients not used to the effects of THC may also experience anxiety or panic as possible side effects if dosing isn’t administered correctly.
In our experience, cannabis shouldn’t be categorised as an antidepressant and we don’t think it can be a substitute for antidepressants in depressive disorders.
However, medicinal cannabis can support patients with anxiety and depression, given they have found their effective dosage. Cannabis can help alleviate pain, increase their psychical activity levels, sleep, and improve their general wellbeing. With better quality of life, it may help with the patient’s mood and reduce anxiety.
Can I be prescribed cannabis to help with other drug withdrawal symptoms or be used at the same time as other treatments like Opioid Substitution Therapy (OST)?
From a scientific point of view, there is no reason cannabis treatment cannot be combined with OST if the patient has a valid reason to be on cannabinoid therapy. However, some Australian states require patients to be registered as ‘Drug Dependent Persons’ to commend OST and will not be granted Schedule 8 medicines such as THC.
We strongly believe this will need to change over time as medicinal cannabis does not belong in the same category as opiates and amphetamines. There is also strong evidence in cannabis treating dependency on other drugs and acting as a “reverse gateway” drug.