Medicinal cannabis is cannabis that is used to help treat or relieve symptoms of an expanding list of medical conditions. Medicinal cannabis should be thought of as a class of drugs rather than an individual drug because the active constituents can vary between products and, in lower quality medicines, between batches. Medicinal cannabis includes pharmaceutical preparations that can contain a broad spectrum of the bioactive chemical constituents of the cannabis plant (i.e. ‘whole-plant’ or ‘full-spectrum’ products), only individual chemical constituents of the plant (isolates) or in a varied combination of constituents.
What are the different types of medicinal cannabis available?
Medicinal cannabis products exist in various forms with oils being the dominant and preferred method of delivery. Medicinal cannabis products can also be found as capsules, dry flower, oromucosal spray, lozenges and creams – with new methods of delivery continually being developed.
What are the active ingredients of medicinal cannabis?
The cannabis plant contains more than 400 plant constituents with approximately 100 that are specific to the cannabis plant and referred to as cannabinoids and primarily responsible for therapeutic activity.
More detailed information on the active constituents of the cannabis plant can be found here.
What can medicinal cannabis be used for?
There are numerous conditions and indications that medicinal cannabis is being prescribed for, including epilepsy, chronic pain, spasticity and anxiety. More detailed information on approved indications, including supporting clinical evidence can be found here.
Who is medicinal cannabis appropriate for?
Medicinal cannabis can be prescribed for any chronic indication where there is supporting clinical evidence for its use and after all clinically appropriate treatment options have been considered.
Is medicinal cannabis legal?
In Australia, medical Cannabis was legalised in 2016 and can be prescribed by any Australia registered medical doctor. Based on the active constituent profile, the medicinal cannabis products will be either scheduled as a Schedule 4 (S4) Prescription Only Drug or Schedule 8 (S8) Controlled Drug.
In the UK, medicinal cannabis was legalised in 2018 but is classified as a Schedule 2 Controlled Drug. Medicinal cannabis products are considered ‘unlicensed’ medications in the UK.
Who can prescribe medicinal cannabis?
Any registered medical doctor in Australia can prescribe medicinal cannabis, while only a specialist doctor can prescribe medicinal cannabis in the UK.
Please refer to our guidance information on the prescription pathways for Australia and the UK.
There are many different types of medicinal cannabis. Each can vary in the active constituents, consistency of plant constituents and also the quality. Medicines can also vary in the safety and tolerability studies conducted.
The most common medicinal cannabis product is provided in an oil. Medicinal cannabis products can be ‘full-spectrum’, ‘broad-spectrum’ or cannabinoid isolates.
Whole cannabis extracts provide a ‘full-spectrum’ or ‘broad-spectrum’ range of plant material. An ethanol extraction process ensures the greatest spectrum of constituents, including terpenes and flavonoids.
‘Full-spectrum’ medicinal cannabis provides the whole range of cannabinoids and other plant constituents, such as terpenes.
‘Broad-spectrum’ medicinal cannabis does not contain the full range of constituents naturally present in the starting plant material. Instead the extract is manipulated to remove or add specific plant constituents and has been produced in a strict environment from cloned plants that allows for predictable cannabinoid content.
Cannabinoid isolates contain one or more specific cannabinoids. The cannabinoids can be plant-derived or synthetically produced.
These varying types medicinal cannabis products would elicit different physiological actions in the body and may serve different therapeutic applications. They may also differ in the way they interact with other medications.
Speak to your doctor about whether any of these types of medicinal cannabis would be appropriate for you.
The entourage effect describes the greater pharmacological effects seen with the whole extract compared to the individual chemical components of cannabis. It appears a synergistic relationship exists between the cannabinoids and the accompanying terpenoids, flavonoids and fatty acids.
Medicinal cannabis may be prescribed for a broad range of conditions due to its action on the endocannabinoid system. Research continues to grow for the potential benefits of medicinal cannabis. Many conditions require careful medical management. For more information speak to your doctor or go to: https://sydney.edu.au/lambert/medicinal-cannabis.html
Pharmaceutical GMP is the system that applies to medicines. “Good Manufacturing Practice (GMP) describes a set of principles and procedures that when followed helps ensure that therapeutic goods are of high quality.” https://www.tga.gov.au/good-manufacturing-practice-overview. For more information go to: https://www.tga.gov.au/publication/manufacturing-principles-medicinal-products