News and Education for health professionals

Advertisement

Going green without the high

An ancient remedy causing present-day debates, Dr Joe Kosterich explores the use of medicinal cannabis throughout history, and examines it's place in modern medicine.

  Every year a number of new drugs come onto the market. There is an assessment process to bring pharmaceuticals to market to show that they are safe, that they work and that side effects are acceptable. To get a listing on the Pharmaceutical benefits scheme (PBS) and thus attract a government subsidy, the manufacturer needs to show that the costs justify the benefits.

  You might think that a very old product, which is not particularity expensive, has an excellent safety profile, a reasonable side effect profile and demonstrated usefulness in specified conditions would sail though easily. You might think doctors, patients and governments would welcome such a product.

  It would, except for one tiny problem - the name of the product. Medicinal cannabis.

 Let’s get three things clear. Medicinal cannabis is not a cure for all conditions as some of the more zealous supporters claim; it is not a dangerous addictive drug as the zealous opponents claim; there is scientific research to support its use in childhood epilepsy, spasticity in MS, chronic pain and chemotherapy induced nausea. There is also some evidence for a role when combatting anxiety, PTSD and fibromyalgia.

 Cannabis is an ancient plant. Historically, it was prescribed legally for medicinal purposes until 1936 in the USA and 1938 in Australia. Interestingly, fore runners to three of today’s biggest pharmaceutical companies sold medicinal cannabis products.

 Currently many Australians self-medicate, illegally, with inhaled cannabis because they get medical benefit. Some of them are the strongest advocates for medicinal cannabis.

 Medicinal cannabis is taken orally rather than smoked. Dose (like all medications) is controlled. The ratio of cannabinoids, which are the medically active component to tetrahydrocannabinol (THC) - the part that gives you the high - is minimised.

 International experience (namely Canadas near 20 year experience) shows us that when used medicinally, people do not form addictions (as can occur when smoked) mainly due to lower concentrations of THC and differing absorption profile when taken orally rather than inhaled.

 There are also no cannabinoid receptors in the brainstem making it is almost impossible to overdose and die with oral cannabis through suppression of the breathing centre. Contrast this with opiates, for example, which are responsible for more deaths each year than illicit drugs.

 In simplest terms medicinal cannabis, administered orally at a known dose can provide a clinical benefit without creating a “high”.

 There is evidence to support the use of medicinal cannabis in certain people for certain conditions. Much like we don’t use a blood pressure medication for asthma, we wouldn’t use medicinal cannabis to treat blood pressure. Like all medications there are potential side effects but currently we use medications, potentially far more harmful than medicinal cannabis with far fewer hoops (federal and state) to jump through.

 Ultimately it would be good to have a level playing field where it is no harder or easier to prescribe medicinal cannabis than any other medicinal product. At that point, those who can benefit from medicinal cannabis can have it legally prescribed in the same way as any other pharmaceutical agent.

Declaration- Dr Kosterich is medical advisor to Medicinal Cannabis company Little Green Pharma

Jow KosterichDr Joe Kosterich MBBS
Doctor, speaker, author of three books, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.He is a regular on Channel 9 and radio, writes for various medical and mainstream publications, as well as maintaining a website and blog providing health information. He is the health ambassador for locally grown fresh potatoes. Dr Joe also gives practical motivational health talks for the general public and organizations.