What is medicinal cannabis?
The main cannabinoids studied and currently thought to be the most important for medical use are THC and cannabidiol (CBD). Many other cannabinoids exist and a number are being researched for possible medical use.
The term ‘medicinal cannabis products’ covers a range of approved, quality assured cannabis preparations intended for human therapeutic use, including pharmaceutical cannabis preparations such as tablets, oils, tinctures and other extracts.
Crude cannabis is difficult for doctors to prescribe because the specific components (chemicals known as cannabinoids), the dose and potency in each plant is not tested or known.
Pharmaceutical preparations of cannabis contain specific active components in known amounts and mixtures, which optimise the therapeutic benefit and minimise side effects. The dose and strength of the preparation can be controlled and standardised, making it safer for patients to use.
What are the benefits of medicinal cannabis?
There is little high quality research on the benefits of medicinal cannabis and the clinical evidence for its role is still under discussion and being investigated.
Medicinal cannabis preparations have been used with some reported success to relieve symptoms in some specific conditions, such as reducing spasticity and muscle pain in people with multiple sclerosis.
There is also some evidence that medicinal cannabis may be useful in treating seizures, nausea and vomiting due to chemotherapy, and also as an appetite stimulant for people living with human immunodeficiency virus (HIV) infection or cancer.
What are the side effects of medicinal cannabis?
It is important that medicinal cannabis is only used under medical supervision because it may interact with other medicines a patient is taking or cause adverse reactions.
The known side-effects from medicinal cannabis treatment (both CBD and THC) include fatigue and sedation, vertigo, nausea and vomiting, fever, decreased or increased appetite, dry mouth, and diarrhoea.
THC (and products high in THC) have been associated with feeling high or feeling dissatisfied, depression, confusion, hallucinations, paranoid delusions, psychosis, and cognitive distortion (having thoughts that are not true).
What is the current legal status of medicinal cannabis?
Amendments to the Narcotics Drugs Act 1967 to allow the controlled cultivation of cannabis for medicinal or scientific purposes under a national licensing scheme came into operation on 30 October 2016. The Commonwealth Government is responsible for issuing licences and permits under this scheme.
These amendments do not legalise the growing or use of cannabis for non-medical purposes nor do they legalise the cultivation of cannabis or its use outside of regulated medicinal purposes. They also do not make cannabis products available over the counter without a prescription from an authorised specialist medical practitioner.
South Australia adopts the Commonwealth scheduling and from 1 November 2016, medical practitioners in South Australia can legally prescribe medicinal cannabis products with Commonwealth approval and relevant State approval for purposes of South Australian Controlled Substances legislation.
The State Government released a patient access pathway to clarify access in South Australia.
Medicinal cannabis is lawful when the cultivation, manufacture, prescribing, and supply complies with all applicable Commonwealth and State laws (opens in a new window).
All other types of cannabis remain prohibited.
What about cannabidiol?
One cannabis derivative, cannabidiol (also known as CBD), in products for therapeutic use containing 2% or less of other cannabinoids found in cannabis, is a Schedule 4 medicine. The total cannabinoids in the product must be at least 98% cannabidiol to be in Schedule 4.
There are no registered cannabidiol medicines in Australia. Supply of unregistered Schedule 4 cannabidiol medicines requires a prescription from a medical practitioner and Commonwealth approval or notification.
Does legislation that deals with medicinal cannabis mean that it is now legal to smoke cannabis?
No, cannabis remains a highly regulated drug in Australia and its use and supply is controlled by a number of Commonwealth, State and Territory laws. Patients will not be able to access medicinal cannabis products for smoking.
Do the legislative changes mean I can now grow my own medicinal cannabis legally?
No, people cannot legally grow their own cannabis for medicinal use; even it has been prescribed for them by an authorised medical practitioner.
Throughout Australia, it remains illegal to cultivate cannabis or manufacture cannabis products. The only exception will be where cultivation and manufacture is done under a licence and a permit granted under the Commonwealth licensing scheme for medicinal use.
Who can prescribe medicinal cannabis?
The conditions for which medicinal cannabis might be considered will likely be complex medical conditions and as such, prescribing of medicinal cannabis is restricted in South Australia to specialist medical practitioners with expertise in the management of the disease being treated. In certain circumstances, authority may be granted to a general practitioner where written support for treatment is provided by the patient’s treating specialist.
What approvals or notifications are required to prescribe medicinal cannabis?
To prescribe or supply an unregistered medicinal cannabis product requires Commonwealth approval or notification under the applicable Commonwealth schemes. These are the TGA Special Access Scheme, Authorised Prescriber Scheme or Clinical Trials Schemes. (opens in a new window)
Approval under South Australian Controlled Substances legislation is also required to prescribe a Schedule 8 medicinal cannabis product where it is being prescribed for longer than 2 months, or to patient already prescribed a Schedule 8 drug for a period exceeding 2 months, and for any person the medical practitioner reasonably believes to be dependent on drugs.
Exemptions apply in South Australia for patients aged over 70 years of age, and terminally ill patients whose doctors have notified the Drugs of Dependence Unit (Notified Palliative Care Patients).
Is there a list of doctors who can prescribe medicinal cannabis?
Australia doctors are not allowed to advertise to the public that they are able to prescribe a particular medicine. This is related to the Therapeutic Goods legislation, and to the standards upheld by the Australian Health Practitioner Regulation Agency and the Medical Board of Australia and goes to matters of medical ethics and good medical practice. Furthermore, for privacy reasons we do not publish or provide the names of doctors who prescribe medicinal cannabis products.
Can I drive while being treated with medicinal cannabis?
Patients should not drive or operate machinery while being treated with medicinal cannabis. In addition measurable concentrations of THC (tetrahydrocannabinol – the main psychoactive substance in cannabis) can be detected in urine many days after the last dose. It may take up to five days for 80 to 90 per cent of the dose to be excreted. Drug-driving is a criminal offence, and patients should discuss the implications for safe and legal driving with their doctor.