Mythbusters: medical cannabis
MYTH: Medicinal cannabis (medical marijuana) is different from recreational marijuana
This is challenging as the terms medicinal cannabis , medical marijuana and cannabis for medicinal purposes mean different things to different people.
Cannabis is available in a wide range of forms (including plant and pharmaceutical) and all can be referred to as medicinal cannabis.
What is most commonly referred to as medicinal cannabis can be the same part of the plant that is used for recreational purposes (raw, crude, plant or botanical cannabis). Medicinal cannabis might also take the form of a concentrate, such as cannabis oil, which is released from the cannabis plant by separating out the oil with a solvent. This may be prepared from plant stock thought to have higher levels of particular cannabinoids, such as cannabidiol (CBD).
The vast majority of the research into medicinal cannabis has used pharmaceutical prepared synthetic THC (e.g. dronabinol) or pharmaceutical extracts of whole plant cannabis with known levels of THC and CBD (e.g. nabiximols). These products are not smoked, they are taken orally in the form of a tablet or mouth spray.
In some countries, marijuana is grown commercially under semi-secure conditions similar to the way Australia has a secure poppy growing industry but it s the same as recreational marijuana, just said to be used for a different purpose.
Most medical marijuana sold in US dispensaries as medicine is the same quality and carries the same health risks as the pot sold on the street or grown at home. It is not a pharmaceutical product as there is no systematic testing for the cannabinoid levels, what is in it, how much, or whether it is contaminated with bugs or pesticides. In this context, medicinal cannabis is exactly the same drug as home grown or cannabis sold on the street. It is only the stated reason for use that is different.
Pharmaceutical preparations of the plant for research and clinical purposes such as nabiximols (sativex), include components that have been adjusted to assist investigations into which combinations provide the best treatment for various medical conditions. This is critical as it is the psychoactive components (like THC), as well as the balance of the components and the route of administration of the drug that can provide treatment or create the risk of harm (dependence, cognitive impairment, psychological impairment in terms of paranoia, anxiety, depression and impaired judgement when driving or working, hepatic, respiratory and cardiac harms).
In general, raw or plant cannabis isn t a medicine approved by medical and therapeutic goods organisations for use , and dosage can t be controlled. In the USA, it was not approved for use based on evidence, but due to public vote. Despite this, it is a substance that is used for medicinal purposes. In contrast, pharmaceutical preparations are more along the lines of what we usually understand medicine to be, with controlled dosage, potency and form or route of administration. However, in this case, more evidence is needed so side effects are understood and medical professionals can safely prescribe, dispense and monitor the use, and a rigorously regulated recall system can be put in place.
MYTH: Medicinal cannabis is legal in Australia
Cannabis use in any form (and for any purpose) is illegal in Australia.
In Australia, three jurisdictions (NT, ACT & SA) have decriminalised cannabis for personal use and the other jurisdictions have diversion programs or similar approaches. Please refer to our cannabis and the law factsheet.
The NSW Parliament Legislative Council recently conducted an Inquiry into the use of cannabis for medical purposes. More recently, the NSW government has committed to beginning three trials of medical cannabis for children with the most severe form of drug-resistant epilepsy, people with terminal illnesses and chemotherapy-induced nausea.
These trials will seek to enhance available evidence to better understand the appropriate use of cannabis and cannabis-derived products for medical purposes. These trials are expected to start enrolling patients in 2016.
In the meantime, police have been given the power to use discretion when penalising cannabis use by the terminally ill in NSW who have been registered into a specified scheme.
MYTH: Medicinal cannabis (medical marijuana) cures cancer, diabetes, epilepsy, HIV, MS
Almost all of the modern research literature on cannabinoids as a medicine have utilised pharmaceutical preparations of THC and/or CBD. There have been no published human trials employing the accepted gold standard design of a randomised controlled trial using smoked whole plant. The cannabinoid pharmaceutical preparations that have been developed have been used to treat a range of symptoms of conditions such as chronic/acute pain, nausea, HIV and cancer-related wasting and spasticity associated with Multiple Sclerosis but not to cure cancer.
There have been no published clinical trials of smoked cannabis plant as a cure for cancer or any other medical condition. These claims frequently arise from reports of experimental, laboratory studies, where cells from animals are injected with synthetic THC or CBD, or very small experiments with terminally ill humans where THC or CBD is added to other medications.
MYTH: Cannabis oil (hash oil) is a pharmaceutical preparation of cannabis used for medicinal purposes
Cannabis oil (hash oil) is a thick oil derived from hashish, that is often extracted from the heads of plants using butane extraction. Some people (illegally) use cannabis oil as a medicine. It is not a pharmaceutical preparation of cannabis and as such, potency and components may change from batch to batch. Worthy of note is an examination Victorian police conducted on cannabis oil products purchased online as medicine in 2014, which revealed many products contained high levels of THC and low levels of CBD (undesired), with 40% containing no cannabis at all, just alcohol and water.
Pharmaceutical preparations of the plant include Dronabinol (i.e.Marinol); Nabilone (i.e. Cesamet); and Nabiximols (i.e.Sativex) which are swallowed or sprayed in the mouth (nabiximols). See our medicinal cannabis bulletin for more information.
MYTH: All medicinal cannabis products sold in dispensaries in the US are cannabinoid pharmaceutical productsMYTH: All medicinal cannabis products sold in dispensaries in the US are cannabinoid pharmaceutical products
Over the past two decades cannabis has been made available, within various regulatory frameworks (but not the FDA), for medicinal purposes in 22 USA states and Washington DC, with no controls on the quality, dosage or safety of the product or its delivery system.
Most cannabis (marijuana) sold in US dispensaries as medicine is the same quality and carries the same health risks as cannabis sold on the street or grown at home. It is not a pharmaceutical product, in this context medicinal cannabis is exactly the same drug as home grown or cannabis sold on the street, it is only the stated reason for use that is different.
One of the most profitable lines in the medical marijuana dispensaries in the US are so called edibles . These are preparations of cannabis oil in baked goods such as cakes and brownies, pizza, chocolate, soft drinks, milks and ice creams. These are very potent, often up to 100mg THC in a packet, where 10mg is the maximum recommended dose. As they are eaten, the onset is much slower (up to 2 hours) and the effects last much longer. This means people are more likely to take too much and overdose, which is extremely unpleasant, and the resulting hallucinations have been implicated in deaths (for example, people are said to have jumped from buildings). They are also very attractive to animals, leading to deaths, and to children where severe illness has resulted in hospitalisations.
Over the past two decades cannabis has been made available, within various regulatory frameworks (but not the FDA), for medicinal purposes in 22 USA states and Washington DC, with no controls on the quality, dosage or safety of the product or its delivery system.
Most cannabis (marijuana) sold in US dispensaries as medicine is the same quality and carries the same health risks as cannabis sold on the street or grown at home. It is not a pharmaceutical product, in this context medicinal cannabis is exactly the same drug as home grown or cannabis sold on the street, it is only the stated reason for use that is different.
One of the most profitable lines in the medical marijuana dispensaries in the US are so called edibles . These are preparations of cannabis oil in baked goods such as cakes and brownies, pizza, chocolate, soft drinks, milks and ice creams. These are very potent, often up to 100mg THC in a packet, where 10mg is the maximum recommended dose. As they are eaten, the onset is much slower (up to 2 hours) and the effects last much longer. This means people are more likely to take too much and overdose, which is extremely unpleasant, and the resulting hallucinations have been implicated in deaths (for example, people are said to have jumped from buildings). They are also very attractive to animals, leading to deaths, and to children where severe illness has resulted in hospitalisations.
MYTH: Synthetic cannabis (eg K2 or Spice) is the same as pharmaceutical preparations of medicinal cannabis
Though both products are synthetic , meaning they are made in a lab as opposed to naturally occurring, pharmaceutical preparations are made by professional scientists using strict guidelines with a mind to delivering a consistent product with a medicinal purpose.
In contrast, street synthetic cannabis is not cannabis and contains no THC or CBD, but are man-made research chemicals created to mimic the effects of THC on the brain s receptor system where it exerts its effects. The chemical components may differ from batch to batch and little consideration is given to the safety of the user by the manufacturers.