Medicinal Cannabis 101

Medicinal cannabis (or medical marijuana) has been a hot topic for quite a while and is red hot here in Australia at the moment. There are a lot of claims around about cannabis, especially on social media cannabis can cure cancer, it relieves pain and nausea in cancer patients, and it helps control spasticity in people with Multiple Sclerosis (MS). It seems as though there is no end to cannabis magical properties. But what s the real deal? What do we really know about the potential of medicinal cannabis?

Cannabis as a form of medicine has been around for a long time. It was used to treat various illnesses and health issues in North America and Europe in the 1800s and centuries before that across Asia. Doctors stopped using cannabis as a medicine at the beginning of the 20th century as it was difficult to control the dose and often led to unwanted (or no) effects. Nowadays, medicinal cannabis is back in the limelight, particularly as some states in the USA have made crude plant cannabis legal for medicinal use. And while we’ve come a long way in how we can prepare cannabis we now have pharmaceutical preparations unfortunately the research hasn t kept up with the pace of citizen initiated changes in policy.

The term medicinal cannabis (or medical marijuana) can be really confusing. Many of us are not sure what the difference is between the drug you get from a dealer down the road, and the medical version that has all the reported healing properties. In addition, when it s reported in the media, sometimes it looks just like a joint, and other times it looks like a capsule, oil or mouth spray. (Check out our handy medical cannabis video that lays out what medical cannabis is, in a way everyone can understand!).

Part of the basis for the confusion is that in some countries (and even in Australia illegally), crude plant cannabis is used for a therapeutic purpose, even though it doesn’t seem like other typical medicines we know. At the other end of the scale, pharmaceutically prepared medicines derived from components of the cannabis plant have also been developed (only legally available to researchers conducting clinical trials or those with authority to use for MS-related spasticity in Australia when other medications aren t working). In essence, when the media reports on medical cannabis, most often they are referring to crude plant cannabis or the oil extracted from it.

Some common terms you will come across when looking at medical cannabis include the following:

THC: Tetrahydrocannabinol. The most common unique chemical found in cannabis, THC causes most of the psychoactive effects of smoking cannabis. It interacts with CB1 and CB2 cannabinoid receptors in our brain and throughout the body.

Cannabinoid: A cannabinoid is any chemical that interacts with the cannabinoid receptor system in our body. These include those from the cannabis plant (phytocannabinoids), our own body (endocannabinoids) and those designed in a lab (synthetic cannabinoids).

Cannabinoids include the following:

• Phytocannabinoids: These are cannabis plant-based cannabinoids. Most commonly refers to either THC or CBD but there are more than 110 cannabinoids so far identified.
• Endocannabinoids: These are found naturally in the human body and include anandamide, and 2-AG
• Synthetic cannabinoids: Designer drugs not found in nature, these man-made chemicals attempt to mimic the effect of phytocannabinoids or endocannabinoids, or may have unique effects of their own.

Cannabinoid receptor: Located throughout the body, cannabinoid receptors are part of the endocannabinoid system, which is involved in a variety of physiological processes including appetite, pain-sensation, mood, and memory. There are two known cannabinoid receptors, CB1 and CB2.

Systemic effect: All organs are affected. Caused if ingested, inhaled or injected.

Topical effect: Not to be confused with topical application where it is absorbed through the skin but acts systemically, the topical effect of cannabis only interacts with a local area, for example eye drops. While this is often desired in medicine, it is difficult to achieve due to drugs passing into blood circulation. Not to be confused with a topical application in which a chemical or drug is absorbed through the skin.

Anti-tumor effect: Preventing or inhibiting the formation or growth of tumors.

Crude plant cannabis: Cannabis in its raw state, not yet refined or processed.

Cannabis oil: Also known as hash oil, it is produced by solvent or other extraction from the cannabis plant. After filtering and evaporating the solvent, a sticky dark liquid with a strong herbal odour is left.

There are some Australians who are desperately in search of treatment options for themselves or loved ones, including children. As seen through tests of cannabis oil purchased online, the reported contents of drugs and other substances purchased on the internet are not always reliable. While some medicinal cannabis suppliers may genuinely want to help people, others are out to make money.

While the dangers, just like the contents, of some of these bottles are unknown, cannabis alone has been linked to long-term side effects such as memory and motivation problems, depression, anxiety, psychosis, schizophrenia and respiratory illnesses. Self-medicating can be dangerous and unpredictable, so always consult a doctor if existing treatments don t seem to be working.

Medicinal cannabis is currently not readily accessible in Australia, although several government authorities are in the process of reviewing its effectiveness and deciding whether to make it available as a treatment for some specific conditions in the future. At the moment, there is a possibility that the Therapeutic Goods Administration (TGA) may grant Australians access to a form of pharmaceutical grade cannabinoids such as nabiximols in exceptional circumstances. For more information please visit the TGA website.