The government has no intention of legalising the use of cannabis for recreational (non-medical) use.
You cannot get cannabis-based medicine from a GP – it can only be prescribed by a specialist hospital doctor.
It would only be considered when other treatments were not suitable or had not helped.
Will the laws on cannabis be relaxed?
If the above does not apply to you, do not ask a GP for a referral for medical cannabis.
The risks of using cannabis products containing THC (the chemical that gets you high) are not currently clear. That’s why clinical trials are needed before they can be used.
Nabiximols (Sativex) is a cannabis-based medicine that is sprayed into the mouth.
It’s expected this would only apply to a very small number of people in England.
In a statement to Hack, the AMA said it isn’t confident pharmacists have the education to properly advise patients, and that side effects could go unchecked.
Firstly, these products won’t get you high. This is only low-dose CBD oil we’re talking about and products won’t be allowed to have more than 1 per cent THC (which is the psychoactive part of the plant).
“Sometimes those products say they have something in them and that’s not in there, so you can’t really rely on the fact that you’re getting a good product.”
Medical Association “surprised” by down-scheduling
She says it’s not clear what info the TGA wants, but if it’s expecting companies to run clinical trials then it could be a five-year wait for products.
“Previously, they’ve had to go to a GP and they’ve had to talk to the GP about what they’re trying to treat, and then the GP has had to get special permission in order for them to be able to access a prescription.”
“In order for companies to get these products registered or available over-the-counter in pharmacies, they have to be registered as an S3 medicine,” she said.
Cassandra from Fresh Leaf Analytics admits evidence of how well these products work is hard to come by but agrees they’re not harmful.
CBD oil or Epidiolex?
Are CBD oil and Epidiolex really the same drug? They are both CBD, short for cannabidiol, but where they differ is in their purity and regulatory status. Epidiolex is a Schedule V prescription drug, the lowest level of regulation for a controlled substance. CBD oil is an over-the-counter supplement. It is legal in all states as long as it’s extracted from the hemp plant, a variety of cannabis that contains little THC and produces no high.
Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC.
While we sort out these dilemmas, patients will no doubt experiment with the readily available CBD oil, so what should we do in the interim? We recommend the following commonsense approach.
In addition to psychosis, there are a couple of small, placebo-controlled trials of CBD in social anxiety disorder. These looked at the drug’s acute effects when taken before a stressful social situation in 34 subjects. Compared to placebo, CBD had a significant effect, bringing anxiety down to the same levels reported by healthy controls (Blessing EM et al, Neurotherapeutics 2015;12(4):825–836).
Table: Cannabinoids From CBD to THC
CBD in psychiatric disorders
In one of the most paradoxical clinical findings in recent memory, it turns out that CBD, far from causing psychosis, may actually be an effective treatment for psychosis. So far, 5 out of 7 controlled trials of CBD’s antipsychotic effects have been positive, and the latest of these is reviewed in this issue (Epidemiol Psychiatr Sci 2018;27(4):327–335). Another prescription CBD product, Arvisol, is undergoing phase I clinical trials in schizophrenia.
Side effects and drug interactions
The World Health Organization concluded that CBD has “a good safety profile” (WHO, 2018). Somnolence is its main side effect, and the PDR warns of elevated liver enzymes. On drug screens, CBD can cause a false positive for THC.