In recent years, medicinal cannabis has gained significant attention as an alternative therapeutic option for a variety of health conditions. For Australian healthcare providers, understanding the potential health benefits of medicinal cannabis is essential for informed patient care. In this blog, we explore the clinical applications and health benefits of prescribing medicinal cannabis, supported by the latest research.

Chronic Pain Management

One of the most well-documented benefits of medicinal cannabis is its effectiveness in managing chronic pain:

1. Neuropathic Pain:

      Studies indicate that cannabinoids, particularly Tetrahydrocannabinol (THC), can significantly reduce neuropathic pain, which is often resistant to conventional painkillers (Ware., et al., 2010, Canadian Medical Association Journal).

      2. Arthritis and Inflammatory Pain:

        Medicinal cannabis has anti-inflammatory properties, making it a viable option for treating arthritis and other inflammatory conditions.

        Neurological and Psychiatric Conditions

        Medicinal cannabis offers promising benefits for various neurological and psychiatric disorders:

        1. Epilepsy:

          Cannabidiol (CBD) has demonstrated efficacy in reducing the frequency and severity of seizures in epilepsy patients, especially in treatment-resistant forms such as Dravet syndrome and Lennox-Gastaut syndrome. The TGA has approved several CBD-based medications for this purpose (Devinsky., et al., 2017).

          2. Multiple Sclerosis (MS):

            Cannabis can alleviate symptoms such as muscle spasticity and pain in MS patients. Sativex, a cannabis-based medication, has been approved in Australia for treating MS-related spasticity (MS Australia).

            3. Anxiety and PTSD:

            Medicinal cannabis, particularly CBD, has anxiolytic properties and can be beneficial for patients with anxiety disorders and post-traumatic stress disorder (PTSD). It helps in reducing anxiety levels without the psychoactive effects of THC (Blessing., et al., 2015).

            Oncology Support

            Cancer patients can derive multiple benefits from medicinal cannabis:

            1. Nausea and Vomiting:

              Cannabis is effective in controlling chemotherapy-induced nausea and vomiting (CINV). THC-based medications such as dronabinol have been used successfully for this purpose (Bathula PP, Maciver MB, 2024).

              2. Pain Management:

              Cancer-related pain, which is often multifaceted, can be managed effectively with medicinal cannabis, offering a complementary option alongside opioids and other pain relievers (MUHC, Medical Cannabis).

              3. Appetite Stimulation:

              THC can stimulate appetite, helping patients combat cancer-related cachexia (wasting syndrome) and improve their nutritional intake (Strasser., et al., 2006).

              Palliative Care

              In palliative care settings, medicinal cannabis can improve the quality of life for terminally ill patients by addressing multiple symptoms:

              1. Pain and Symptom Relief:

                Medicinal cannabis provides broad-spectrum symptom relief, including pain, nausea, and anxiety, enhancing overall patient comfort (The Health Effects of Cannabis and Cannabinoids., 2017).

                2. Sleep Improvement:

                Cannabis can improve sleep quality, which is often disrupted in palliative care patients due to pain and other symptoms (Shannon., et al., 2019).

                Gastrointestinal Disorders

                Medicinal cannabis can be beneficial for several gastrointestinal conditions:

                1. Inflammatory Bowel Disease (IBD):

                  Patients with Crohn’s disease and ulcerative colitis have reported symptom relief with the use of medicinal cannabis, including reductions in abdominal pain and improvement in overall quality of life (Naftali., et al., 2013).

                  2. Irritable Bowel Syndrome (IBS):

                  Cannabis can help in managing IBS symptoms through its effects on the endocannabinoid system, which plays a role in gut motility and pain sensation (Samiksha Pandey., et al.,2019).

                  Skin Conditions

                  Emerging research suggests that medicinal cannabis may offer benefits for dermatological conditions:

                  1. Psoriasis and Eczema:

                    Topical CBD has anti-inflammatory and anti-proliferative properties, which can help in managing conditions like psoriasis and eczema Palmieri., et al., 2019).

                    2. Acne:

                    CBD’s anti-inflammatory and sebum-regulating effects can make it a useful adjunct in the treatment of acne (Oláh., et al., 2014).

                    Clinical Integration and Best Practice

                    For Australian healthcare providers, integrating medicinal cannabis into clinical practice involves:

                    1. Educating Patients:

                      Provide comprehensive information about the potential cost, benefits and risks of medicinal cannabis. Address common concerns and misconceptions to ensure informed decision-making.

                      2. Personalised Treatment Plans:

                      Develop individualised treatment plans based on the patient’s medical history, medications, current symptoms, and therapeutic goals. Consider the most appropriate formulation of medicinal cannabis for your patient. Start with low doses and adjust based on patient response and tolerability.

                      3. Monitoring and Follow-up:

                      Conduct regular follow-ups to monitor patient outcomes and adjust treatment as necessary. Encourage patients to report any side effects or changes in symptoms.

                      4. Interdisciplinary Collaboration:

                      Work with subspecialist doctors, pharmacists, and other healthcare providers to ensure a holistic approach to patient care.

                      The health benefits of medicinal cannabis are diverse and well-supported by emerging research. For Australian healthcare providers, understanding these benefits and integrating medicinal cannabis into practice can enhance patient outcomes across a spectrum of conditions. Through careful patient assessment, personalised treatment plans, and ongoing monitoring, practitioners can effectively harness the therapeutic potential of medicinal cannabis, contributing to improved quality of life and overall patient health.

                      Upcoming Educational Opportunities

                      To support health professionals in mastering the intricacies of medicinal cannabis, GPEx is offering two valuable webinars:

                      References

                      Bathula PP, Maciver MB., 2024 Cannabinoids in Treating Chemotherapy-Induced Nausea and Vomiting, Cancer-Associated Pain, and Tumor Growth: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10779013/

                      Collin, C., Davies, P., Mutiboko, I. K., & Ratcliffe, S., 2007, European Journal of Neurology: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-1331.2007.02064.x

                      Devinsky, O., Cross, H. J., & Laux, L., et al., 2017, The New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMoa1611618   

                      MUHC, Medical Cannabis: A Valuable Option for Cancer Pain Relief: https://muhc.ca/news-and-patient-stories/news/medical-cannabis-valuable-option-cancer-pain-relief

                      MS Australia, Medicinal Cannabis and MS: https://www.msaustralia.org.au/medicinal-cannabis-ms/

                      Naftali, T., Bar-Lev Schleider, L., Dotan, I., et al., 2013, Clinical Gastroenterology and Hepatology: https://pubmed.ncbi.nlm.nih.gov/23648372/    

                      Oláh, A., Markovics, A., Szabó-Papp, J., et al., 2014, Journal of Clinical Investigation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151231/

                      Palmieri, B., Laurino, C., & Vadalà, M., 2019, A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars: https://www.semanticscholar.org/paper/A-therapeutic-effect-of-cbd-enriched-ointment-in-Palmieri-Laurino/161d96bf8ccf0769084ac0c20d9906b5f89dba16

                      Samiksha Pandey, Saima Kashif, Mina Youssef, Somia Sarwal, Hala Zraik, Ripudaman Singh, Ian H. Rutkofsky,Endocannabinoid system in irritable bowel syndrome and cannabis as a therapy, Complementary Therapies in Medicine, Volume 48, 2020: https://doi.org/10.1016/j.ctim.2019.102242   

                      Shannon, S., Lewis, N., Lee, H., & Hughes, S., 2019, The Permanente Journal: https://pubmed.ncbi.nlm.nih.gov/30624194/

                      Strasser, F., Luftner, D., Possinger, K., et al., 2006, Journal of Clinical Oncology: https://ascopubs.org/doi/10.1200/JCO.2005.05.1847

                      The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington (DC)., 2017: https://www.ncbi.nlm.nih.gov/books/NBK425767/

                      Ware, M. A., Wang, T., Shapiro, S., et al., 2010, Canadian Medical Association Journal: https://www.cmaj.ca/content/182/14/E694