MEDICINAL CANNABIS FAQ

What is cannabis?


Cannabis is a plant species that includes three varieties: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. Cannabis has a long history of human use for medicinal, recreational, and industrial purposes, with various parts of the plant used for paper, clothing, fuel, food, and medicine. 


It is widely known for its psychoactive properties due to the presence of compounds called cannabinoids, most notably delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the compound responsible for the "high" associated with recreational use of cannabis, while CBD is non-psychoactive and has been studied for its potential therapeutic benefits.


 CBD and THC, two of the 113 cannabinoids identified in the plant, can interact with the endocannabinoid system in the human body, which regulates various physiological and cognitive processes through endocannabinoids, receptors, and enzymes. Their chemical similarity to endocannabinoids allows these cannabinoids to bind to cannabinoid receptors and influence bodily processes, potentially offering therapeutic benefits for conditions like pain management, anxiety, and neurological disorders.


What is the endocannabinoid system?


The endocannabinoid system (ECS) is a complex signaling network within the human body that regulates many physiological processes. It consists of three main components: endocannabinoids, cannabinoid receptors, and metabolic enzymes. Endocannabinoids are molecules produced by the body that bind to cannabinoid receptors located throughout the central nervous system and peripheral tissues. These receptors, known as CB1 and CB2, are responsible for modulating many bodily functions such as mood, appetite, pain, and inflammation. Metabolic enzymes break down endocannabinoids once they have fulfilled their functions. The ECS plays a critical role in maintaining overall health and balance in the body, and it can be influenced by cannabinoids from external sources, such as those found in cannabis.


What is THC? 


THC, or delta-9-tetrahydrocannabinol, is a psychoactive compound found in the cannabis plant. THC, or delta-9-tetrahydrocannabinol, is primarily used to treat symptoms such as pain, nausea, and vomiting. It has also been shown to stimulate appetite and reduce muscle spasms. THC works by binding to CB1 receptors in the brain and nervous system, which are involved in regulating pain, mood, and other bodily functions. 


What is CBD? 


CBD, short for cannabidiol, is a non-intoxicating compound found in the cannabis plant. It is one of over 100 cannabinoids, which are unique chemical compounds found in the plant. CBD has gained popularity for its potential therapeutic properties, and is thought to have anti-inflammatory, analgesic, and anxiolytic effects. Unlike THC, CBD does not cause psychoactive effects or the feeling of being "high". It interacts with the body's endocannabinoid system, which helps regulate various physiological processes such as mood, appetite, and pain sensation.


What is CBD-1?


The CB1 receptor is a type of protein molecule found on the surface of certain cells in the body, particularly in the brain and central nervous system. It is a key component of the endocannabinoid system, which plays a role in regulating various physiological processes, such as appetite, pain, mood, and memory. When activated by endocannabinoids or cannabinoids from external sources, the CB1 receptor can modulate the release of neurotransmitters in the brain, leading to various effects. Some of the most well-known effects of CB1 activation include euphoria, sedation, and changes in perception and mood. 


What is CBD2? 


The CB2 receptor is a type of cannabinoid receptor found in the human body that is primarily located in the immune system and peripheral tissues. It plays a role in modulating the immune response, inflammation, and pain sensation. Activation of the CB2 receptor has been shown to have anti-inflammatory and analgesic effects, making it a potential therapeutic target for a variety of conditions such as chronic pain, multiple sclerosis, and inflammatory bowel disease. Unlike the CB1 receptor, which is primarily found in the brain and central nervous system, activation of the CB2 receptor does not produce the psychoactive effects associated with cannabis use.


How does the human body interact with medicinal cannabis?


Medicinal cannabis works by interacting with the endocannabinoid system (ECS) in the human body. The ECS is a complex signaling system that regulates many physiological processes, including pain, mood, appetite, and sleep. It consists of endocannabinoids (cannabinoids produced by the body), cannabinoid receptors (proteins found on the surface of cells that bind to cannabinoids), and enzymes that synthesize and break down cannabinoids.


Cannabis contains many cannabinoids, including tetrahydrocannabinol (THC) and cannabidiol (CBD), which can bind to cannabinoid receptors in the body. THC is the main psychoactive compound in cannabis and is responsible for its euphoric and intoxicating effects. It binds primarily to the CB1 receptor in the brain and central nervous system, producing a range of effects, including pain relief, relaxation, and altered perception.


CBD, on the other hand, has no psychoactive effects and does not bind strongly to either the CB1 or CB2 receptors. Instead, it appears to modulate the effects of THC and interact with other receptors and ion channels in the body, producing a range of potential therapeutic effects, including reducing inflammation, anxiety, and seizures.


Put simply, this process occurs through the following steps: 


1. The body naturally produces endocannabinoids, which are the body's own version of cannabis compounds. The two key endocannabinoids are anandamide (AEA) and 2-arachidonoylglycerol (2-AG).


2. Endocannabinoids are synthesized and released by neurons in response to certain stimuli.


3. Endocannabinoids bind to and activate the cannabinoid receptors CB1 and CB2, which are found throughout the body. CB1 is mainly found in the central nervous system, while CB2 is mainly found in the immune system.


4. Once activated, the cannabinoid receptors transmit signals to different parts of the body, resulting in various effects.


5. Enzymes, such as fatty acid amide hydrolase and monoacylglycerol acid lipase, break down endocannabinoids after they have completed their function.


6. The endocannabinoid system helps regulate a wide range of bodily functions, including sleep, appetite, reproduction, memory, inflammation, mood, and many other functions.


When using medicinal cannabis, the phytocannabinoids THC and CBD can also activate the endocannabinoid system. THC is known for its psychoactive effects and can activate the CB1 receptor, while CBD has been shown to have various therapeutic effects and can indirectly modulate the endocannabinoid system.


Eligibility - Patients


 In Australia, medicinal cannabis products are not approved medicines and can only be obtained through pathways for unapproved medicines. To access medicinal cannabis, patients must meet specific eligibility criteria and be prescribed by a doctor. The doctor must provide justification to the Therapeutic Goods Administration (TGA) on why the patient requires medicinal cannabis. Eligibility for TGA approval is subject to various criteria under the Department of Health's TGA approval framework, which includes having the condition for at least three months and having tried conventional medical treatment with no success or unbearable side effects. 


Eligibility – Prescribers 


In Australia, any medical practitioner is authorized to prescribe medicinal cannabis, but they must seek approval from the Department of Health’s Therapeutic Goods Administration (TGA) and state or territory health departments if required. To prescribe medicinal cannabis, doctors must provide clinical evidence and justification for treatment, dosing regimen, and treatment duration in the Special Access Scheme (SAS) application submitted on the patient's behalf. The TGA considers each patient's case on a case-by-case basis. Other pathways to access medical cannabis include the Authorised Prescriber Scheme (APS) and Clinical Trials. For the latest and most accurate information on medicinal cannabis and its prescription in Australia, visit https://www.tga.gov.au/medicinal-cannabis-guidance-documents.


Insomnia


Insomnia is a sleep disorder that can be diagnosed when a person has difficulty getting to sleep, staying asleep, waking too early, or experiencing non-restorative sleep. The disorder must persist for at least three months, and symptoms must occur at least three times per week, causing significant distress or impairing daily activity. Insomnia can cause fatigue, mood swings, anxiety, impaired memory, and performance at school or work, and lack of motivation. 


While traditional sleep medications are available, medicinal cannabis may provide an alternative option for treating insomnia. Research has shown that cannabidiol (CBD) may be effective in treating insomnia, excessive daytime sleepiness, and REM sleep behavior disorder, and may improve sleep adequacy in patients with neuropathic pain. However, further research is needed to determine the long-term effects and safety of medicinal cannabis use in treating insomnia.


Multiple Sclerosis


Multiple sclerosis (MS) is a chronic condition that affects the central nervous system, causing scars to develop and interfere with nerve impulses in the brain, spinal cord, and optic nerves. This can lead to a wide range of symptoms, including memory problems, slurred speech, visual disturbances, fatigue, dizziness, chronic pain, muscle weakness, and difficulty walking or maintaining balance. Patients with MS may experience a significant impact on their quality of life, with estimates suggesting a 31% lower quality of life than the average population.


One of the approved medicinal cannabis treatments in Australia is a product called Nabiximols, which is commonly prescribed to treat muscle spasticity when other treatments have failed. However, preliminary research suggests that medicinal cannabis may hold further promise for MS patients. Studies have shown that some formulations containing both tetrahydrocannabinol (THC) and cannabidiol (CBD) can effectively treat neuropathic pain associated with MS, with no evidence of tolerance buildup over two years of treatment. 


Additionally, whole plant cannabis-based medicine was found to be effective in reducing pain and sleep disturbance in patients with MS, with mild adverse effects. While more research is needed, these findings suggest that medicinal cannabis could offer new options for MS treatment.


Epilepsy


Epilepsy is a neurological disorder that causes recurrent seizures due to sudden uncontrolled rush of electrical or chemical activity in the brain, resulting in symptoms such as muscle spasms and loss of consciousness. Although seizures are common, they become known as "epilepsy" when they keep occurring repeatedly, making it a disorder. The causes of epilepsy are not entirely understood, but genetics, injuries, and serious illnesses play a role. Several factors trigger seizures, including flashing lights, stress, lack of sleep, illness, and certain medications. Studies have found that cannabidiol (CBD) in medicinal cannabis may help reduce seizures in children with drug-resistant epilepsy, Dravet syndrome, and Lennox-Gastaut syndrome. CBD may also improve quality of sleep, reduce visits to the emergency room, and improve quality of life. 


PTSD


Post-traumatic stress disorder (PTSD) is a mental health condition that affects individuals who have experienced or witnessed a traumatic event involving serious harm or the threat of serious harm. PTSD can be triggered by various experiences, including war, sexual assault, natural disasters, accidents, and traumatic professions like firefighting or policing. Symptoms of PTSD can include flashbacks, nightmares, anxiety, feelings of disconnection, difficulty concentrating, and avoidance of certain triggers. While there are various treatments available, including psychotherapy and medication, medicinal cannabis has shown potential as a treatment for PTSD. Studies have shown that synthetic and natural cannabis compounds can significantly improve symptoms of PTSD, such as reducing nightmares, improving sleep quality, and decreasing hyperarousal symptoms. Many users of medicinal cannabis with anxiety conditions report that it improves their symptoms and reduces the need for prescribed medication. Patients who use medicinal cannabis to treat PTSD have reported experiencing therapeutic effects such as improved sleep, reduced anger, and a decrease in taking other medications.


Pain Management


Palliative care refers to a range of treatments provided to patients suffering from a life-limiting illness, for which there is no cure and which could lead to death. Palliative care can be delivered in various settings, including hospitals, care facilities, or at home, depending on the patient's needs. The treatment does not belong to one particular medical discipline and usually involves a team of healthcare professionals, including nurses, social workers, dieticians, physiotherapists, and occupational therapists. Palliative Care Australia is the leading organization in Australia that provides assistance in finding the right treatment and service providers for patients undergoing palliative care.


Common symptoms among palliative care patients include chronic pain, movement difficulties, eating and digestive issues, fatigue, and mental health struggles such as depression or anxiety. Recent studies suggest that medicinal cannabis may help alleviate some of these symptoms, although further research is needed. Preliminary evidence shows that medicinal cannabis may have positive effects on patients in palliative care, providing an alternative treatment option for these individuals.


Endometriosis


Endometriosis is a painful condition caused by the growth of tissue similar to the uterus lining in other parts of the body, such as the pelvis, lungs, bladder, and brain. Women in their reproductive years, including teenagers, may experience symptoms such as painful periods, stomach and digestive problems, painful intercourse, fatigue, and subfertility. Due to its difficulty in detection, it may take multiple visits to the doctor and minor surgeries to diagnose the condition, and diagnosis may take up to eight years from the onset of symptoms. Medicinal cannabis has been used to alleviate pain and discomfort for thousands of years and recent research suggests that it could also have benefits in the treatment of endometriosis.


Chronic Pain


Chronic pain is a debilitating condition that affects a significant number of people worldwide. It is characterized by persistent pain that lasts longer than three to six months, and can be caused by a variety of underlying problems such as injury, surgery, musculoskeletal conditions, advanced cancer, endometriosis, and migraines, to name a few. Unlike acute pain, which usually comes on fast and goes away once the underlying cause is treated, chronic pain can be difficult to manage and can significantly impact a person's quality of life.


While traditional pain medications can be effective, many people experience unwanted side effects, or they may not work as well as needed. That is why researchers have been exploring the use of medicinal cannabis as a potential treatment for chronic pain. Studies have shown that medicinal cannabis can be effective in reducing the frequency and intensity of migraines, as well as improving sleep quality in patients with neuropathic pain. While more research is needed, the early results suggest that medicinal cannabis may be a promising option for those struggling with chronic pain.


Fibromyalgia


Fibromyalgia is a complex and chronic condition that causes widespread musculoskeletal pain, fatigue, and cognitive issues. Although its cause is not fully understood, it is believed to involve abnormalities in the way the brain and spinal cord process pain signals. The condition affects more women than men, and it is often difficult to diagnose.


Research has suggested that medicinal cannabis may have potential benefits in treating fibromyalgia symptoms. Although more research is needed, these findings suggest that cannabis could be a promising treatment option for fibromyalgia, particularly in cases where traditional treatments have been ineffective.


Cancer

Cannabis has been used by some cancer patients to manage their symptoms and improve their quality of life. While cannabis is not a cure for cancer, it has been suggested that it may have some potential in treating cancer-related symptoms such as nausea, pain, and poor appetite.


Cannabis contains compounds called cannabinoids, which interact with the body's endocannabinoid system. These compounds can have both analgesic and anti-inflammatory properties, which may help reduce pain and inflammation associated with cancer and its treatments.


Additionally, there is some evidence to suggest that cannabinoids may have anti-tumor properties, and may be able to slow or inhibit the growth of certain types of cancer cells. However, more research is needed to determine the safety and efficacy of using cannabis as a cancer treatment, and it should not be used as a substitute for traditional cancer treatments such as chemotherapy and radiation.


It is important for cancer patients considering using cannabis to discuss this with their healthcare provider and obtain medical-grade cannabis products from a reputable source.


Anxiety

Anxiety is characterized by feelings of worry, unease, and physical changes in the body. While it's a normal part of life, persistent or intense anxiety can be debilitating and require treatment. 


Medicinal cannabis has long been used to help with a variety of mental and physical ailments, including anxiety. While modern medicine is still exploring the benefits of cannabis for anxiety disorders, preliminary evidence suggests that it can be of real help to alleviate anxiety symptoms, including increased heart rate, restlessness, and uncontrollable thoughts.


While research is still ongoing, preliminary evidence suggests that cannabis can be a useful tool in treating anxiety. It's important to note that the effects of cannabis can vary from person to person and can depend on the strain, dosage, and method of consumption. As with any treatment, it's crucial to consult with a healthcare professional to determine if medicinal cannabis is the right choice for you.



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