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Medicinal cannabis is any product that contains cannabis, or components derived from cannabis, that is prescribed by a doctor to treat the symptoms of a medical condition.

The term ‘medicinal cannabis’ describes a range of cannabis preparations intended for therapeutic use, including:

• pharmaceutical cannabis preparations, such as oil, tinctures and other extracts
• untreated cannabis (raw and dried cannabis)
• cannabis resin (hashish), natural and synthetic cannabinoids

All medicines imported into, supplied in and exported from Australia must be entered in the ARTG, unless special conditions apply. Any medicine not on the ARTG is considered an ‘unapproved therapeutic good’. Unapproved therapeutic goods can potentially be accessed using one of the access schemes administered by the TGA, including the SAS.

The Endocannabinoid System is a complex regulatory system made up of receptors, molecules called endocannabinoids, and enzymes that either synthesize or metabolize those endocannabinoids. The main function of the endocannabinoid system is to regulate the human body by maintaining homeostasis.

The cannabis plant produces more than 500 different chemical compounds, including over 120 phytocannabinoids (like THC and CBD), 30 (known) terpenes (like linalool and myrcene), flavonoids and hundreds of other compounds; but fewer than 50 of these compounds are produced in significant amounts.

CB1 receptors are found primarily in the nervous system while CB2 receptors are found predominately the immune system, however both receptors can be found in various organs throughout the body. The mapping of these receptors fits well with the diverse range of symptoms and conditions that are found to respond positively to medicinal cannabis, and the synergistic effect (known as the Entourage Effect) of these different compounds working together in each unique strain/medicine is what causes such diverse effects.

The cannabis plant contains up to 545 chemical compounds including 114 different cannabinoids, many of which have been clinically demonstrated to interact with the endocannabinoid system in the human body. To date, the most researched cannabinoids have been Δ 9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is a cannabinoid in the cannabis plant that is frequently associated with the treatment of chronic pain, inflammation, spasticity, and nausea. It also has intoxicating effects. These are also typically the most abundant cannabinoids in the cannabis plant.

CBD is a non-intoxicating cannabinoid typically prescribed for seizures, pain, anxiety and inflammation. CBD is non-addictive and less potent than THC with very low toxicity.

THC and CBD may work synergistically, while CBD is understood to antagonise the adverse side effects associated with THC, so when used in combination, patients are less likely to feel euphoria or ‘high’.

In order for the government to approve an authorisation for medicinal cannabis, there must be enough evidence supporting the benefits of treatment.

Currently, there are no restrictions imposed by the TGA on the indications/conditions for which a medical practitioner may apply for medical cannabis for their patient.  The body of clinical evidence continues to grow daily, meaning a variety of other conditions may be recognised to have positive associated outcomes with cannabinoid medications.

There is some evidence that cannabis can function as a substitute for prescription drugs or can be added to an existing treatment regime. However, more knowledge is needed on the motives of substitution users, their patterns of use, and perceived effects of substitution use.

Your doctor will determine what is the best treatment option for you based on your individual circumstances.

To be eligible for medicinal cannabis, you must:

• Be over 18
• Be an Australian resident
• Have had a chronic condition for at least three months
• Have exhausted all conventional treatment options, or experienced adverse unacceptable side effects from these treatments

The process to get TGA approval and receive your prescription is:

1. Discuss your health, needs and options with your doctor
2. If your doctor thinks medicinal cannabis is appropriate for you, they will apply to the TGA on your behalf
3. If your application is approved, this usually happens within 48 hours
4. The doctor writes your prescription, which goes to a pharmacy

The cost of medicinal cannabis in Australia can vary greatly and depends on a number of considerations such as a patient’s condition and the product being prescribed.

A helpful guide to the average costs of medicinal cannabis products can be found in an independent report conducted by Freshleaf Analytics ‘Australian Medicinal Cannabis Market Patient, Product and Pricing Analysis – Q1 2020’. The report advised that the average patient taking prescribed medicinal cannabis is spending less than $10 per day.

Please note, this cost does not take into consideration the private insurance benefit which eligible patients can receive from some health insurance companies.

Medicare generally covers in-person cannabis clinic consultations. PBS does not provide rebates for medicinal cannabis products like CBD or THC oil. A few select Health Funds cover medical cannabis products as a non-PBSprescription.

Medicinal cannabis is available in various delivery forms, as well as a range of strengths and varieties. In Australia your doctor can prescribe you medicinal cannabis in oil form, tablets/pills, sublingual spray or flower for vaping. The dose and strength of the medicinal cannabis will depend on your condition and the recommendation from your prescribing doctor.

In many cases, the answer to this is: only if you want to, unless the dosage you need is quite high. The doses needed for medical purposes are often significantly lower than what is used recreationally.

Most experts agree that cannabis is generally not physically addictive. This means it doesn’t have medically verified properties that can establish a physical dependence in the average body, unlike other drugs such as opioids.

Laws about driving with tetrahydrocannabinol (THC) from medicinal cannabis in your system vary across states and territories. It is best to check your state’s or territory’s laws carefully.

It is important to discuss potential side effects with your doctor. The risks and potential side effects of medicinal cannabis depend on the type of product, and the individual. Cannabidiol (CBD) generally has minimal side effects. However, tetrahydrocannabinol (THC) is known for making people feel ‘high’. Common side effects for both include:

• Tiredness or drowsiness
• Nausea and vomiting
• Changes in appetite
• Dry mouth
• Low blood pressure
• Dizziness
• Anxiety
• Euphoria
• Cognitive effects

Balnce also advises against smoking or vaping cannabis, as this poses risks to lung health.

Medicinal cannabis can interact with some other medications. It is important to tell your doctor about all prescription and over-the-counter medications and supplements you use or plan to use.

It is important to discuss potential risks of medicinal cannabis with your doctor. In general, you should avoid using medicinal cannabis if you:

• Have allergies or hypersensitivity to cannabis or carrier oil.
• Are pregnant, breastfeeding, or hope to become pregnant during the treatment period.
• Have a psychiatric condition
• Have certain heart or lung conditions

Yes. Medicinal cannabis is legal in Australia if an authorised prescriber (doctor) decides the treatment appropriate for you, you receive approval for use from Therapeutic Goods Administration (TGA), and you obtain the medicinal cannabis with a valid prescription.