By Dr. Sud Agarwal
It’s been over two years since medicinal cannabis became available on prescription in Australia. Since March 2018, more than 3,100 prescriptions were approved by the Therapeutic Goods Administration. But amongst the media hype, there is also a lot of misinformation, so it’s essential to separate the myths from the facts.
Myth #1: There is no scientific evidence to support medicinal cannabis.
The legal status of cannabis has made it challenging to conduct research and clinical trials until recent decades. Cannabis research is, therefore, still in its early days, but a mounting body of scientific evidence suggests that it could be an effective treatment for a wide variety of medical conditions.
Medicinal cannabis has been shown to reduce the number of seizures in children with epilepsy – or even stop them entirely. Research also shows that medicinal cannabis may be effective in treating chronic pain, particularly in patients with cancer or multiple sclerosis, as well as anxiety, insomnia, and bowel conditions such as Crohn’s disease. It may also help prevent nausea and vomiting and stimulate appetite in cancer patients.
Major universities around the world now have research departments dedicated to the study of medicinal cannabis. In Australia, Cannvalate has partnered with Swinburne University to create the Cannvalate-Swinburne Medical Cannabis Research Collaboration (MCRC) – the first university clinical research department focusing exclusively on medicinal cannabis research in the country.
Myth #2: Medicinal cannabis gets you high.
Because of its association with recreational cannabis (or marijuana), many people assume that medicinal cannabis has the same psychoactive effects.
The feeling of relaxation and euphoria, or being ‘high’, that comes from smoking marijuana is a product of the chemical compound delta-9-tetrahydrocannibinol – otherwise known as THC. However, the main compound used in a medicinal context is cannabidiol or CBD.
While THC has some therapeutic benefits, it has been genetically engineered out of many medicinal strains of cannabis. The vast majority of medicinal cannabis products currently prescribed in Australia mainly contain CBD and therefore, don’t usually make patients have any psychotropic effects or intoxicated.
Myth #3: Medicinal cannabis is highly addictive.
Many people are concerned that medicinal cannabis could be addictive. The fact is, cannabis is not very physically addictive.
If you take any drug repeatedly, your body will gradually become more efficient at processing it and you will build up a tolerance. This means that, over time, you will need a higher dose to get the same effect. This is a common issue for people who regularly take painkillers such as codeine for chronic pain, who need a higher and higher dose to relieve the same pain after months and years of taking these drugs.
Cannabis does develop tolerance, but it’s essential to realise that this is not the same as addiction. In addiction, your body will go into withdrawal if you suddenly stop taking the drug. Withdrawal symptoms include cravings, aches, sweating, and heart palpitations. Cannabis withdrawal doesn’t cause any of these physiological symptoms, so while patients may build a tolerance to the dosage, it is not considered addictive.
Myth #4: Medicinal cannabis needs to be smoked to have an effect.
Smoking is the most common way for recreational cannabis users to take the drug, and images of hand-rolled joints often accompany articles about medicinal cannabis.
The reality of medicinal cannabis is that it is most commonly administered as an oil that is taken sublingually (under the tongue), which helps it enter the bloodstream and start taking effect quickly. In some cases, such as treating arthritis, an ointment may be prescribed that can be applied directly to the skin.
Pop culture may have popularised the image of someone picking up a ziplock bag of ‘legal weed’ from their pharmacist, but in reality medicinal cannabis looks a lot like, well, medicine.
Myth #5: It’s easy to get a medicinal cannabis prescription.
In Australia, the use of medicinal cannabis was decriminalised in 2016. In the past year, the number of prescriptions has grown by 800%. With usage on the rise and so much hype in the media, getting a prescription from your doctor must be easy, right?
Wrong. Obtaining a prescription for medicinal cannabis in Australia is a complex and time-consuming process, for both GPs and their patients.
To prescribe medicinal cannabis to a patient, GPs must first make an application to the Therapeutic Goods Administration outlining the patient’s situation and why they are recommending this course of treatment. Then they have to find a product that meets the patient’s needs, and a pharmacist in the area that has an account with the manufacturer and the correct license to supply it.
The patient then has to collect the prescription from the pharmacist and take it back to their GP for instructions on how to use it. The GP then has to monitor the patient to find the right dose over time. Some GPs reported that the paperwork alone required to prescribe medicinal cannabis can take over ten hours of their time.
Patients and medical practitioners both urgently need this process to be streamlined, which is why my cofounders and I started Cannvalate. Our company manages the process of applying for TGA approval, finding a suitable pharmacist, and creating a shared-care plan to monitor treatment.
Our mission is to simplify, accelerate, and demystify medicinal cannabis prescribing in a safe, clinical manner. Setting the facts straight on medicinal cannabis is the first step.