medical cannabis From Taboo to Treatment: Understanding Australia's Medical Cannabis Journey

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Historical Context: Australia's Shifting Perspective on Cannabis

From societal reservations to medical intrigue, Australia's perspective on cannabis has evolved, influenced both by global narratives and domestic priorities.

Cannabis has had a tumultuous history across the globe, and Australia has been no exception. In earlier decades, perceptions around cannabis were largely negative, heavily influenced by international anti-drug campaigns, and societal concerns. However, as the global conversation around cannabis began to shift in the late 20th century, so did Australia's. With the worldwide acceptance of cannabis for its therapeutic potential and the wave of decriminalisation and legalisation in various countries, Australia found itself re-evaluating its stance.

The Australian government, researchers, and healthcare professionals started looking into the possible benefits of cannabis, not just relying on international findings but also instigating local studies and discussions. This blend of global influence and domestic research laid the foundation for the more accepting and regulated view of cannabis that Australia holds today.

The Science of Healing: Medical Benefits of Cannabis Down Under

With insights derived from global collaborations and Australia's unique research initiatives, the therapeutic potential of cannabis begins to shine through.

While international studies offer foundational knowledge, Australia has cultivated its own research initiatives to delve deeper into the therapeutic nuances of cannabis. Over the years, Australian universities, medical institutions, and research bodies have embarked on extensive studies, trials, and investigations. These endeavours aim to understand the various compounds in cannabis, like CBD and THC, and how they interact with the human body. The studies also sought to identify any distinct therapeutic applications especially pertinent to the Australian populace, such as specific strains best suited to Australia's environment or unique formulations addressing prevalent health issues in the country.

These domestic scientific explorations, combined with global findings, have helped paint a comprehensive picture of cannabis's therapeutic potential. They've provided compelling evidence to support its use in treating a myriad of conditions, from chronic pain to epilepsy, and have been crucial in breaking down the barriers of scepticism and hesitation around the plant.

Navigating Australia's Medical Cannabis Landscape: Regulatory Milestones and Emerging Trends

In the evolving world of medicinal cannabis, Australia is taking leaps with stringent regulations, tailored patient access schemes, and the burgeoning role of pharmacists. Led by the Therapeutic Goods Administration (TGA) under the Therapeutic Goods Act 1989, the country places a significant emphasis on medicines included in the Australian Register of Therapeutic Goods (ARTG) due to their thorough assessment of safety, quality, and effectiveness.

However, understanding Australia's cannabis domain goes beyond just regulatory frameworks. Special mechanisms, like the Special Access Scheme (SAS) and Authorised Prescriber (AP) pathway, have been established for 'unapproved' therapeutic goods like medicinal cannabis. These schemes, while ensuring that registered health practitioners have considered ARTG-listed treatments, also embed a level of trust. Notably, the TGA doesn't provide guarantees for these unapproved products' safety or efficacy, placing the onus on prescribers and patients.

Recent data from the Lambert Initiative for Cannabinoid Therapeutics at The University of Sydney sheds light on contemporary prescribing practices, especially within the psychiatric realm. Between 1st November 2016 and 30th September 2022, findings included:

• A significant 300,000 SAS-B approvals, with 33.9% focusing on psychiatric conditions.
• The dominance of prescriptions for anxiety disorders, followed by sleep-wake and trauma-related disorders.
• The prevalent use of oil-based products, with CBD-dominant products emerging as a key choice, especially for autism spectrum disorder treatments.

Yet, a cautionary note arises from these findings. The growth in prescriptions for conditions like ADHD and depression appears exploratory due to limited clinical evidence of medicinal cannabis efficacy. Furthermore, the increased prescription of THC products poses concerns, given the known psychiatric issues linked to THC, highlighting a need for robust clinical guidelines.

The TGA, in its bid for transparency, publishes data concerning SAS approvals, and AP notifications, offering a lens into the nuances of medicinal cannabis access in Australia. Moreover, to simplify administrative processes, the TGA introduced the SAS/AP Online System, creating a unified application point for medicinal cannabis products across federal and state territories.

Pharmacy's Emerging Role in the Cannabis Realm:

Recent regulatory shifts have placed Australian pharmacists at the forefront of dispensing prescription-only cannabis-based medicines. Moreover, these changes have paved the way for specific low-dose cannabidiol products to be available over-the-counter in pharmacies, aligning Australia with several other nations where such products are more accessible.

In a cross-sectional study conducted between May and December 2021, the experience, knowledge, and attitudes of Australian pharmacists towards medicinal cannabis were explored. A few key findings include:

• Experience: A significant 60% of the pharmacists had dispensed at least one medicinal cannabis prescription during their careers. Moreover, a similar percentage had received at least one medicinal cannabis-related query in the past two weeks.
• Comfort & Confidence: Approximately 54% felt comfortable supplying medicinal cannabis products, but fewer (around 39%) felt confident discussing related queries.
• Support for Over-The-Counter Availability: Over half of the participants supported the idea of supplying low-dose cannabidiol products over-the-counter in pharmacies.
• Knowledge Gaps: Despite the support and some experience in the field, two-thirds of the respondents scored below 60% in the knowledge segment of the survey. This finding underscores the evident need for enhanced training, with an overwhelming 94.2% acknowledging this requirement.

Conclusions from this study suggest that while Australian pharmacists are generally in favour of medicinal cannabis availability and easier access to low-dose cannabidiol products, there's a clear need for bolstered training and education around cannabis-based medicines. Such initiatives could ultimately boost pharmacists' confidence and competency, potentially enhancing patient outcomes.

References:

• Medicinal cannabis access pathways and patient access data
• Medicinal cannabis for psychiatry-related conditions: an overview of current Australian prescribing
• A cross-sectional survey exploring the knowledge, experiences and attitudes of Australian pharmacists toward medicinal cannabis