In 2016, The Therapeutic Goods Administration (TGA) reclassified medicinal cannabis products containing tetrahydrocannabinols (THC) from Schedule 9 (prohibited) to schedule 8 (controlled) of the Poisons Standard, making the prescription of medicinal cannabis containing THC legal in Australia. Cannabidiol (CBD) products (which have less than 2% of any other active component) remain at Schedule 4, and have much less restriction than Schedule 8 products.

A patient must receive an approval from the TGA and/or State Health Authority, and a prescription from a medical practitioner to legally possess and consume medicinal cannabis.

Recreational use remains illegal across all federal, state, and territories in Australia.

The Endocannabinoid System is a complex regulatory system made up of receptors, molecules called endocannabinoids, and enzymes that either synthesize or metabolize those endocannabinoids. The main function of the endocannabinoid system is to regulate the human body by maintaining homeostasis.

The cannabis plant produces more than 500 different chemical compounds, including over 120 phytocannabinoids (like THC and CBD), 30 (known) terpenes (like linalool and myrcene), flavonoids and hundreds of other compounds; but fewer than 50 of these compounds are produced in significant amounts.

CB1 receptors are found primarily in the nervous system while CB2 receptors are found predominately the immune system, however both receptors can be found in various organs throughout the body. The mapping of these receptors fits well with the diverse range of symptoms and conditions that are found to respond positively to medicinal cannabis, and the synergistic effect (known as the Entourage Effect) of these different compounds working together in each unique strain/medicine is what causes such diverse effects.

Currently, medical cannabis products are quite costly in Australia. The high cost of product is largely because a number of medicines available in Australia are being imported. As more companies produce medicinal cannabis locally in Australia, we hope to see lower products become available.

The current cost of cannabis medication per patient varies greatly. Cost is dependant on the type of medicine that is prescribed (e.g. oil, flower, capsule), dosage and the indication being treated.  A patient could expect to pay at least $200 per month.

In addition to the above variables, numerous studies have shown the enormous range of effects occurring when cannabis medicines are administered to different patients. This variance depends on several factors: cannabis use pattern, additional drugs being taken, genetic variations and how the cannabis is administered, etc. When administered orally, for example, the amount of THC that will make it into the bloodstream will vary between 4 and 20 percent.

There have been no recorded deaths attributed directly to cannabis use, however, cannabis can still produce notable side effects, especially in cannabis naive patients.

Side effects are very much dose-dependant, stemming from large doses of the cannabinoid, delta 9 Tetrahydrocannabinol (THC). Some users, especially novice ones, could experience psychoactive and other side effects associated with THC consumption:

• Tachycardia (rapid heartbeat) is common among novice users;
• Dry mouth (cottonmouth);
• Dizziness or light-headedness;
• Red, irritated eyes;
• Coughing caused by inhaled cannabis (combustion), or vaporized cannabis.

In many instances, the above side effects are short-term and more prevalent in novice users. CBD neuro-modulates THC at the CB1 receptor level, interfering with THC’s ability to activate the CB1 receptor. This causes CBD to eliminate some of THC’s negative side effects such as sedation, anxiety, and rapid heartbeat caused by THC. Though some early clinical data, it has been found that the combination of CBD and THC is a much more powerful application than THC just on its own; leading to the concept of the “Entourage Effect”.

Patients who are pregnant or breastfeeding, have liver disease, heart disease, lung disease, a family or personal history of mental health disorders such as bi-polar disease, schizophrenia, psychosis or substance use disorder are at greater risk for experiencing negative side effects, and should take further precautions and always consult with their doctor before using cannabis.