Is the Hype About Cannabis Nothing but Hype?

Both Federal and State Governments have been very active recently in facilitating the use of cannabis in Australia, however, doctors do not appear to be showing the same level of interest.

The first two commercial shipments of medicinal cannabis products to be legally imported to Australia arrived in Melbourne and Perth on 3 May 2017, following action taken by the Federal Government.

On a State level, the NSW Government is rapidly expanding the number of hospitals involved in a medicinal cannabis trial for the prevention of chemotherapy-induced nausea and vomiting using new generation anti-emetics alongside cannabis products.

However, at a doctor level, there does not appear to be the same level of interest. Officials from the Federal Ministry of Health told the Community Affairs Legislation Committee on 29 May 2017 that there were only 25 authorised prescribers of medicinal cannabis products. All but one of the 25 authorised prescribers are paediatric neurologists treating epilepsy in children. There are a further 66 doctors who have been allowed to prescribe through the Special Access Scheme (for a single patient).

The low number of authorised prescribers could be explained by the incomplete evidence base for the medical use of cannabis.

The October 2016 RACGP position paper reported that there remains much to be learned, particularly relating to treatment efficacy and the longer term side-effects of cannabis-based drugs. The RACGP concluded that there is very little high quality evidence for the medical use of cannabis.

The current Queensland guidelines stress that medicinal cannabis is not considered first line therapy for any indication, and should be considered only where conventional treatments have been tried and proven unsuccessful in managing the patient’s symptoms.

A study published in JAMA on 25 May 2017 by Australian researchers revealed that among patients with Dravet syndrome (a complex childhood epilepsy disorder associated with drug-resistant seizures and a high mortality rate) cannabidiol resulted in a greater reduction in convulsive-seizure frequency than placebo and was associated with higher rates of adverse events.

There is a complex regulatory process for doctors to navigate if they plan to prescribe medicinal cannabis.

This blog contains general information only. We recommend you contact your medical defence organisation or insurer when you require specific advice in relation to medico-legal matters.