Medical cannabis is one of the unregistered drugs in Australia. Doctors seeking to prescribe marijuana to patients first seek the approval of the Therapeutic Goods Administration Special Access Scheme-B or Authorised Prescriber Scheme. Although many doctors in the country are cautious about prescribing cannabis, the number of prescriptions has increased since 2016 when Australia legalized medicinal cannabis.
Patients’ inquiries about medical cannabis have become common as well. Access to information about cannabis and its health or treatment benefits have made patients more open to consulting their doctors about the possibility of cannabis prescription.
Although higher or uncontrolled cannabis doses may cause intoxicating effects to users, clinical evidence supports efficacy of marijuana in treating different conditions and drug side effects. Cannabinoids such as cannabidiol (CBD) have become readily available over-the-counter nutraceutical ‘wellness’ products to Australians and in many other countries such as the United States.
Therapeutic doses of medicinal cannabis are prescribed to patients in Australia due to various reasons.
Why doctors in Australia prescribe medicinal cannabis to patients
In 2016, the Australian federal government passed a law legalizing prescription of various cannabis products to patients by registered healthcare professionals. Before the legislation, many Australians reported using cannabis products for self-identified therapeutic reasons. The law made it possible for doctors to seek approval to prescribe medicinal cannabis to patients with specific conditions or experiencing certain drug side effects.
The use of cannabis for medical purposes is supported by robust evidence from clinical trials around the world. Medicinal cannabis products contain the cannabinoids cannabidiol (CBD) and tetrahydrocannabinol (THC) that can be used to effectively treat symptoms of various conditions such as epilepsy, chronic pain and nausea.
Medicinal cannabis products are highly standardized medicines derived from cannabis plants. Although medical cannabis-based products are prescribed as unregistered medicines, they’re provided by government-approved manufacturers and distributors who are regulated to ensure high quality and minimal adverse effects on patients.
As researchers continue to study the medical benefits of cannabis, preliminary evidence shows it can be effective in treating non-cancer chronic pain, nausea and vomiting, muscle spasms, sleep issues, epilepsy and palliative care.
Medicinal cannabis may also be used to help treat other conditions and diseases such as AIDS, anorexia, arthritis, migraines, chronic pain, glaucoma, and cancer.
Unregistered cannabis-based medicines in Australia can be accessed via the TGA Special Access Scheme Category B (SAS-B) and the Authorised Prescriber Scheme. Authorised Prescriber Scheme provides doctors with approval to prescribe medical cannabis products to a group of patients. For instance, pediatric neurologists may get approval to prescribe CBD products for children with refractory epilepsy.
Medicinal cannabis products are dispensed in pharmacies. The pharmacist dispensing medical cannabis products is required to have clear understanding and communication with the prescriber and the patient. Therefore, doctors are aware that if they prescribe cannabis, patients will have access to the prescription from registered pharmacies across the country.
Although the Australian medicinal cannabis industry is quite young in development, the majority of cannabis products are available through import. Once your doctor assesses your needs, they can make a decision on whether an appropriate cannabis-based medicine is available in the country.
Medicinal cannabis products vary. They depend on the conditions or symptoms they are designed to treat. How they are administered to the patient also varies. There are orals, vapors, sprays, capsules, injections and other diverse products that the doctor can prescribe.
Medicinal cannabis is tightly regulated in Australia. Products approved for use in the country include nabiximols and synthetic cannabinoids. The government also regulates cannabis-based medicine manufacturers and distributors to ensure only registered manufacturers and distributors operate within the Australian territory.
Unlike in some other countries where crude cannabis or raw cannabis plant material and cannabis oil are used for therapies, these kinds of products are illegal in Australia.
Prescribers must be mindful of meeting the Schedule 8 (controlled drugs) authorization requirements of the state or location where the cannabis-based medicines are dispensed.
Prescriptions require the approval of the respective state or territory health department.
It is recommended that health practitioners discuss with the patient the benefits and risks involved when prescribing medicinal cannabis. Providing adequate information on positives and negatives of the unregistered drugs help the patient to make an informed decision and provide an informed consent to the cannabis therapeutic pathway.
Cannabis, THC and CBD have few serious adverse effects. If consumed in higher doses CBD can cause sedative effects. THC commonly causes appetite stimulation effects. Careful titration of THC reduces intoxication symptoms such as paranoia, severe anxiety and psychotic reactions.
According to the Queensland Government website, cannabis-based medicine prescribers must adhere to several conditions detailed by TGA and state health departments, such as obtaining informed consent in writing from the patient in relation to the specific use of cannabis medicine.
Doctors must also report any adverse events, adverse reactions, serious adverse reactions and unexpected reactions to the TGA.
Doctors are aware of all the compliance procedures they need to follow to prescribe medicinal cannabis.
Although medical cannabis is used to relieve symptoms and not to treat or cure diseases, it makes patients feel better, alleviate their discomfort, pain or other symptoms and improve their quality of life.
Doctors prescribe cannabis-based medicine when they believe that the patient’s life will become much better after using the drugs. It relieves adverse symptoms of diseases or the side effects of their treatments.
Facts about cannabis prescription in Australia
Medicinal cannabis has become a common prescription in Australia. In 2019 alone, Australia issued over 28,000 cannabis prescribing approvals. More than 1400 doctors prescribed cannabis-based medicine to their patients in 2019. The number of prescriptions is projected to continue rising in the coming years.
Medicinal cannabis is still under research to establish evidence supporting its effectiveness.
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