Medicinal cannabis, typically manufactured from the flowering head of the plant, refers to a cannabis product which is administered with the aim of treating the symptoms of a disease, ailment or injury. This may be in the form of a regulated or non-regulated pharmaceutical product.
There are three main species of cannabis:
Each species has distinct physical attributes, growth patterns and contains varying amounts of Phytocannabinoids, or compounds. There are over a hundred different phytocannabinoids yet the two most studied are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).
CBD is typically prescribed for convulsions, pain and inflammatory disease. CBD is non-intoxicating and less potent than THC.
THC is frequently used to manage or alleviate severe pain, tremors, sleep disorders, spasticity and nausea. It is also more intoxicating than CBD.
Medicinal cannabis primarily involves the use of Cannabis sativa and Cannabis indica (or a hybrid of these two). Cannabis indica tends to contain a little more CBD than THC, whereas Cannabis sativa plants are higher in THC.
How does medicinal cannabis work?
Phytocannabinoids, commonly referred to as ‘cannabinoids’ are chemical compounds that act on cannabinoid receptors by mimicking naturally occurring cannabinoids (called ‘endocannabinoids’).
Cannabinoid receptors are found throughout the human body – in the nervous system, internal organs, connective tissues, glands and immune cells, and are collectively referred to as the endocannabinoid (ECS) system.
The ECS system has a homeostatic role, having been characterised as “eat, sleep, relax, forget, and protect.” It is known that the ECS plays a role in the pathology of many disorders while also serving a protective function in certain medical conditions. The ECS system is involved in the regulation of many physiological processes including pain, mood and appetite.
Unapproved medicinal cannabis therapeutics have been legal in Australia via prescription since early 2016. The industry has faced the usual cost and efficiency challenges of a new industry yet more recently many of the barriers to access have been streamlined, through:
There are several pathways for accessing medicinal cannabis:
- the SAS;
- Authorised Prescriber Scheme;
- Clinical Trials, or
- the newly introduced, low-dose over-the-counter CBD.
Information regarding access can be found on the Australian Therapeutic Goods Administration (TGA) website.
The SAS is the most common pathway; applications are submitted on a per patient basis and must be lodged by a medical practitioner. Applications need to include the patient diagnosis and clinical justification for the proposed prescription, including commentary regarding the seriousness of the relevant condition, justifying the supply of medicinal cannabis products and the way in which the medical practitioner will monitor the safety and efficacy of that product. The application must also identify the proposed medicinal cannabis product and any safety and efficacy relevant to the proposed product.
Medicinal cannabis costThe price of medicinal cannabis products is not regulated by Government, nor are they generally subsidised under the Pharmaceutical Benefits Scheme (PBS) so patients will need to pay the full cost of the medicine.
Research and use
Australia’s TGA provides guidance for the use of medicinal cannabis in the treatment of various diseases and conditions on its website.
There is continued strong growth in medicinal cannabis use in Australia through the Government’s SAS as can be seen by the statistics released from the TGA showing over 210,000 SAS Category B applications and approvals for unapproved medicinal cannabis products, up until the 31 January 2022.
More information about medicinal cannabis and application approvals can be found on the TGA website.