"I can understand GPs' hesitation, especially because of the issues that we've had regarding opioid prescribing," Dr Kotsirilos said. "Even though the evidence is not strong, there is some evidence … when it's a last resort and the patient has failed to obtain relief from the usual medication, or they've had side effects." The role of GPsīecause of the limited evidence base, many GPs remain cautious when it comes to prescribing medicinal cannabis. "I've had some really good success with patients who have got fibromyalgia, anxiety, difficulty sleeping and other behavioural problems," she said. "The data shows that might be better for some people than placebo - so doing nothing - but they don't really show any benefit over our existing drugs," she said.ĭr Kotsirilos agreed that there was a lack of high-quality evidence for the use of cannabis products, but noted that "there is a growing body of research trying to backfill that absence of evidence".
She added there was also some evidence for its use in people with "existential" distress or pain, which has been described as suffering with no clear connection to physical pain.īut Professor Martin said the data so far suggested that in most cases, medicinal cannabis was "no better" than existing pharmacological treatments. "There is evidence for some types of chronic pain, such as neuropathic pain … which people can get with diabetes and sometimes after chemotherapy," Professor Martin said. While the amount of scientific literature on medicinal cannabis has increased in recent years, the evidence for its use remains limited overall. "If they have less pain, they may sleep better and therefore wake up feeling better, and they are quite happy to accept that." Evidence for cannabis still limited overall "But what it can potentially do is bring some quality of life. "It's more symptomatic control, so not all of them will attain 100 per cent relief. She said she took a similar approach for patients with chronic pain, and if medicinal cannabis was suitable, always followed a method of "start low and go slow". "If they've explored everything, including lifestyle changes and seeing a psychologist … medicinal cannabis might be my last resort treatment." "A lot of times, patients may have already tried anti-anxiety or other medication and found it limiting - they might have had side effects, weight gain, loss of appetite, or they were ineffective, and they are not interested in pursuing that," Dr Kotsirilos said. She said if pharmacological treatment was required, it was important to first try registered medicines such as analgesics or anti-anxiety drugs (which have been assessed for safety, quality and consistency) before considering medicinal cannabis. The federal government legalised access to medicinal cannabis in 2016. These products, of which there are more than 250, contain CBD or THC (or both), and come in the form of oils, capsules or dried flowers to be vaporised.ĭata shows most prescriptions are for chronic pain, anxiety, cancer-related symptoms, and insomnia. The vast majority of cannabis products are unregistered drugs, which require approval under the TGA's Special Access Scheme (or via its Authorised Prescriber Scheme). One is prescribed to treat rare, drug-resistant forms of epilepsy that begin in childhood, the other as a muscle relaxant for people with multiple sclerosis. In Australia, there are only two cannabis-based prescription medicines on the Australian Register of Therapeutic Goods. It doesn't get you high, but has anti-psychotic and anti-inflammatory effects. More than 100 different cannabinoids have been found, including tetrahydrocannabinol, or THC, the chemical that gets you highĬannabidiol, also known as CBD, is another cannabinoid. One group of cannabis compounds are cannabinoids. The cannabis plant ( Cannabis satvia) produces hundreds of different compounds in its leaves and flowers In other words, a GP can prescribe a product if it's based on an approved category of cannabinoid content (eg. CBD-only treatment) for that patient, rather than having to get approval for each new product. "In the past, we also had to get a permit for every single product … now, it's generically prescribed." "Since the end of 2018, the TGA introduced an online permit system, and extended the duration from three to six months to one year, and now even up to two years. I was not able to get very many permits," said Dr Kotsirilos, an associate professor at Western Sydney University. "It was exceptionally hard in the beginning. Dr Vicki Kotsirilos says medicinal cannabis isn't a "cure", but can improve quality of life.
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