Cannabis is a flowering plant that has been used by humans for thousands of years, including as a:
Cannabis is also permitted for use as a recreational drug in some jurisdictions and may also be used for animal therapeutic use at the discretion of a vetereniarian.
Medicinal cannabis is any cannabis derived product which is prescribed by a doctor to treat a medical condition. These products include pharmaceutical cannabis preparations such as oils, tinctures, dosed capsules, and other extracts; as well as untreated cannabis, such as raw and dried cannabis flower.
Medicinal cannabis works when cannabinoids interact with our bodies through a biological system known as the endocannabinoid system (ECS). The ECS is involved in many physiological functions including pain, inflammation, sleep, memory, digestion, immune function, neuroprotection, and more.
Cannabinoids occur naturally in our bodies and are known as endocannabinoids. Phytocannabinoids are cannabinoids that are found in plants that interact with our ECS. There are over 100 known phytocannabinoids found in cannabis. The two most commonly known cannabinoids are THC and CBD.
THC (Tetrahydrocannabinol) is a compound in cannabis that has psychoactive properties; the part of the cannabis plant that produces euphoric effects or gets you ‘high’. Research shows that THC can reduce symptoms of nausea, vomiting, pain and muscle spasticity, and can also improve sleep and appetite.
Cannabidiol (CBD) is a non-psychoactive compound in cannabis that does not produce euphoric effects. CBD can help to reduce inflammation, seizures, anxiety, and to improve sleep. It can also reduce the unwanted side effects of THC, such as nervousness.
Marijuana is the term given to recreational cannabis, which has psychoactive and physiological effects when consumed. These effects include a feeling of relaxation, euphoria (the ‘high’ or ‘stoned’ feeling), a general alteration of conscious perception and increased awareness of sensations, amongst others. Marijuana is typically unregulated, which means that quality, efficacy and safety is not guaranteed, and in some cases may produce unwanted side effects.
Hemp is a variety of cannabis containing very low levels of THC and/or higher concentrations of CBD. It is grown primarily for industrial purposes, such as to produce textiles, food, and building materials.
If you’re interested in accessing medicinal cannabis you should first speak to your doctor about whether it is appropriate for your health needs. In many cases doctors will only prescribe medicinal cannabis if other ‘first line’ therapies have not sufficiently managed patients’ symptoms. If your doctor considers that medicinal cannabis would be an appropriate treatment for you, they will need approval from the Therapeutic Goods Administration (TGA) to prescribe it, and will be responsible for monitoring your treatment. The pathway to accessing medicinal cannabis is outlined below.
Your doctor will conduct a thorough assessment, including a full medical and mental health history. They will make a list of all other treatments you have tried without success or that have produced unwanted side effects. If your doctor is uncomfortable or unfamiliar with prescribing medicinal cannabis treatments, they may choose to refer you to another doctor with expertise in medicinal cannabis. Please contact us if you would like further information about doctors with expertise in the field of medicinal cannabis.
Your doctor will research the use of medicinal cannabis for your condition. Practitioners must only prescribe medicinal cannabis based on evidence and your risk factors. If medicinal cannabis is suitable for your condition, your doctor will need to apply for approval, which may take several days. More information about the approval process is available here.
If approved, your doctor will write a prescription for your medicinal cannabis treatment (e.g. 30mg CBD oil in a capsule). Your doctor will then be able to send your approval and prescription to a pharmacy that holds your prescribed product.
It is important to check in regularly with your doctor to discuss whether medicinal cannabis is working for you, or if you are experiencing any side effects.
Medicinal cannabis products can be taken in several ways, including:
The concentration of THC and/or CBD in cannabis oil is measured in milligrams per millilitre (mg/ml) of oil. Medicinal cannabis is prescribed in various dosages depending on the patient’s medical condition. Always speak to your doctor for advice about how much and how often you should be taking your prescribed medicine.
All medicines, including medicinal cannabis can have side effects. Side effects can vary between individuals based on their body, and the type and dose of medicinal cannabis product prescribed.
There are other side effects that may occur in some people whilst taking medicinal cannabis. Side effects are commonly dose-dependent, so it’s important to follow your doctor’s dosing recommendation and to tell your doctor as soon as possible if you do not feel well while taking medicinal cannabis.
If you have experienced a medicine-related side effect or adverse event, you must contact your doctor. If the side effect or event is serious, call 000 for emergency services.
Medicinal cannabis can be legally prescribed by doctors in all States and Territories in Australia. There are slight variations on legislation from state to state.
Recreational cannabis remains illegal in most States and Territories, however, in late 2019 the ACT passed laws which allow residents aged 18 years and older to grow cannabis plants at home. There is a limit of two plants per person and four per household, and each person is allowed to be in possession of no more than 50 grams of dried cannabis.
Medicinal cannabis prescribed by a doctor in Australia is legal. Cannabis ordered online or without a prescription is illegal.
CBD oil is cannabis oil with a substantial proportion of Cannabidiol. Unlike hemp oil, CBD oil is produced from the flowers, leaves and stalks of the cannabis plant and not from seeds. Although both oils derive from the same plant, CBD oil is created from the flowers produced by the plant, and contains higher amounts of cannabinoids, terpenes and flavonoids.
Not all CBD oils are the same. CBD oils may be differentiated by the amount and ratio of THC and CBD (mg/ml) as well as the presence of other cannabinoids and/or terpenes and flavonoids. The cannabinoid spectrum range contained within a CBD oil product is what determines whether the product is full spectrum, broad spectrum, or CBD isolate.
CBD isolate oil only contains one active ingredient (CBD) in the oil. In scientific terms, CBD isolate is the purest form of the compound. It is produced by extracting and isolating CBD from all other compounds found in the cannabis plant, including fibrous plant material, terpenes, flavonoids and other cannabinoids. As a comparison, this is equivalent to isolating ethanol from an alcoholic beverage such as wine or beer.
CBD isolate is usually added to a carrier oil, such as olive oil, sesame oil or MCT oil in preparation for human consumption. The benefits of CBD isolate oil over other types of CBD oils are that it’s generally cheaper, it does not contain THC, and patients may still be able to drive while being treated. The disadvantage of CBD Isolate oil is that other cannabinoids, terpenes and flavonoids are excluded from the oil, which removes the potential synergistic effects that may exist in a full spectrum oil.
Full spectrum CBD oil is an extract that contains all the compounds found naturally occurring in a cannabis plant. This includes all terpenes, flavonoids, and other cannabinoids inherent to the plant. Research suggests that these compounds work together to create an enhanced therapeutic outcome known as ‘the entourage effect.’
Not all full spectrum CBD oils are the same. The genetics or strains of cannabis from which CBD oil is extracted can vary significantly. Full spectrum CBD oils each have a unique chemical composition of different cannabinoid, terpene and flavonoid profiles, which may produce a range of effects or results for patients. As the entourage effect is influenced by the presence of different cannabinoid, terpene and flavonoid profiles, the genetics of the plant source(s) from which a particular CBD oil is extracted will affect this synergy.
Broad spectrum CBD oil is similar to full spectrum CBD oil in that the compounds found within the cannabis plant are preserved in the extract. However, in broad spectrum CBD oil the THC component is removed. As broad spectrum CBD oil contains a range of cannabinoids, terpenes and flavonoids, it may still influence the ‘entourage effect’ without the risk of any psychoactive effects associated with THC.
Additionally, given it is currently illegal to drive with detectable amounts of THC in your body, some doctors and patients consider broad spectrum CBD oil to be a more convenient product than full spectrum CBD oil.
Terpenes are aromatic compounds (similar to essential oils) found in cannabis which are considered to be important active components of the plant. These compounds are thought to play a key role in differentiating cannabis strains and similar to cannabinoids, terpenes are primarily found in the resin produced by the flowers of female cannabis plants.
Flavonoids are compounds found in cannabis plants that affect the colour, odour and flavour of a given cannabis strain. Research has shown that flavonoids have a variety of beneficial properties (anti-inflammatory, anti-fungal, etc) and may also be involved in ‘the entourage effect.’
Scientists have identified thousands of flavonoids in other plant life, fruits and vegetables. Flavonoids that are exclusively found in cannabis are known as ‘cannaflavins,’ and similar to terpenes, these compounds affect the smell, taste and effects that cannabis products have on their user(s).
Both terpenes and flavonoids are thought to be involved in the ‘entourage effect.’
The ‘entourage effect’ is a theory that describes the potential synergy that forms between cannabinoids, terpenes, flavonoids and other plant constituents found in cannabis. Interactions between terpenes and cannabinoids may be responsible for particular experiences associated with particular strains of cannabis, such as those that make individuals feel sleepy after consumption or those that stimulate and encourage creativity (Russo 2011).
There are more than 100 cannabinoids which have been found in cannabis. Whilst THC and CBD remain the most well-known cannabinoids, research has shown that other cannabinoids potentially present in full spectrum CBD oil may have a therapeutic application.
Each of these cannabinoids plays a different role in the human body. Early research suggests that these cannabinoids may provide consumers with greater sedation, anticonvulsant (anti-seizure), anti-inflammatory and antibiotic properties.
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