An Australian Resource to Learn About Alternative Medicine with a Focus on Medicinal CBD Oil
Medicinal CBD Oil Treatments
AltMed Podcast EP.03 Featuring Josh Savage
AltMed Podcast EP.02 Access to Cannabis
AltMed Podcast EP.01 Intro to Cannabis
Frequently Asked CBD Oil Questions
Cannabis is a flowering plant that has been used by humans for thousands of years. Cannabis has many applications and can be used as a:
- medicinal therapy
- food source such as hemp juice, seeds and oils
- fibre used to produce clothing, industrial textiles and building materials.
Cannabis is also permitted for use as a recreational drug in some jurisdictions.
Medicinal cannabis is any cannabis derived product which is prescribed by a doctor to treat a medical condition. Medicinal cannabis 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.
How does medicinal cannabis work?
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. Cannabinoids that interact with our ECS can be also found in cannabis plants and are known as phytocannabinoids. 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.
CBD (Cannabidiol) 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.
Discuss medicinal cannabis with your doctor
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.
Get your doctor’s recommendation
Your doctor will research the use of medicinal cannabis for your condition. Doctors 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.
Accessing medicinal cannabis
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.
Monitoring your progress
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.
The TGA has approved applications for the use of medicinal cannabis to treat the following medical conditions (please note this list is not exhaustive):
- AIDS nausea/vomiting
- Anorexia and wasting associated with chronic illness (such as cancer)
- Cancer pain
- Chemotherapy-induced nausea and vomiting
- Crohn’s Disease
- Immune Disorders
- Inflammatory bowel disease
- Multiple Sclerosis
- Neuropathic pain
- Palliative care
- Parkinson’s Disease
- Psychological conditions (eg. Schizophrenia)
- Refractory epilepsy
- Rheumatological conditions
- Tourette’s syndrome
Medicinal cannabis products can be taken in several ways, including:
- swallowing oils, liquid capsules or tablets
- spraying into the mouth or under the tongue
- heating the cannabis and inhaling the vapour (vaporising).
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.
Known side effects from medicinal cannabis treatment include:
- fatigue and sedation
- nausea and vomiting
- decreased or increased appetite
- dry mouth
Products containing THC have been associated with:
- feeling ‘high’
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.
What should I do if I experience side effects?
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.
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. Medicinal cannabis ordered online or without a prescription is illegal.
Accessing illegal medicinal cannabis carries a number of risks including:
- buyers are at risk of being scammed
- products may contain too little or too much THC or CBD which can be either harmful or ineffective
- products may be contaminated and contain undisclosed or dangerous ingredients
- products may be past their use-by date.
Medicinal cannabis products accessed legally in Australia:
- are regulated to ensure Australian quality and safety standards
- must contain known quantities of the cannabinoids THC and CBD
- must not contain any moulds, fungi, bacteria, pesticides, heavy metals or other potentially harmful substances
- are prescribed by a doctor who is responsible for monitoring the patient’s progress.
CBD oil is cannabis oil with a substantial proportion of cannabidiol. CBD oil is produced from the flowers, leaves and stalks of the cannabis plant and not from seeds like hemp oil. 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
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
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
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 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 including:
- CBG (Cannabigerol)
- CBC (Cannabichromene)
- CBN (Cannabinol)
- CBGV (Cannabigerivarin)
- THCV (Tetrahydrocannabivarin)
- CBDV (Cannabidivarin)
- CBCV (Cannabichromevarin)
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.