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Physicians search for medicinal cannabis knowledge – Australia and SA

Tens of thousands of people in Australia are turning to medicinal cannabis to treat a range of conditions – but the evidence is patchy and costs can be high, reports The Guardian. Locally, doctors have been reminded of medicinal cannabis course, with 20 CPD points, accredited by the Health Professions Council of South Africa (HPCSA) and in several American states.

On 31 October 2021, The Citizen reported on a two-day Medical Cannabis Roadshow that will be held in Johannesburg, Durban and Cape Town during November, hosted by the Cheeba Cannabis Academy and Carol’s Oil. The South African organisations run the course in collaboration with United States online medical cannabis training company Medical Marijuana 411.

 

‘It’s mind-boggling’: the complex, and growing, use of medicinal cannabis in Australia

Medicinal cannabis has become popular among many Australians for treating pain and mental health conditions, wrote Manuela Callari for The Guardian on 30 October 2021. Tens of thousands of people are turning to the drug to treat a range of conditions.

When Helen was diagnosed with fibromyalgia in her early 40s, her doctor prescribed her a range of opioids. She tried morphine, meperidine and a few others, but none helped ease the constant pain her chronic condition caused.

Long before medicinal cannabis was legal in Australia, while Helen was travelling across North America, a doctor at a dispensary suggested she try cannabidiol oil. “He gave me this bottle of tincture and taught me to use one or two drops under my tongue,” Helen says. “My pain decreased dramatically. I was stunned.”

But once she returned from her trip, her only option was the black market.

Helen is one of hundreds of thousands of Australians who have turned to medicinal cannabis to treat numerous conditions, which they feel have not been helped by traditional therapies. But as the industry grows after its legalisation in 2017, the evidence remains inconclusive and the costs, for many, prohibitive, reports The Guardian.

Today in Australia, medicinal cannabis products are only available on prescription. Data from the Therapeutic Goods Administration reveals that more than 172,000 people have been approved access to medicinal cannabis through its special access scheme.

Only two products have received approval from the TGA and are registered on the Australian Register of Therapeutic Goods. One is Epidyolex, prescribed for rare but severe, drug-resistant forms of epilepsy in children. The other one is Sativex, approved in 2012 to treat muscle spasticity associated with multiple sclerosis.

Doctors can request access to 224 different unregistered medical cannabis products through the TGA scheme or as an authorised prescriber. These products can be capsules, oils, nasal and oral sprays containing either THC (delta-9-tetrahydrocannabinol) or CBD (cannabidiol) or a combination of the two. Some of these are plant-derived. Others are synthetically produced.

Alongside skyrocketing demand for medicinal cannabis, there has been growing research interest around its use, with many clinical trials trying to demonstrate its efficacy for a number of medical conditions.

Yet, strong evidence is often lacking and many products remain unregistered, making prescribing with confidence difficult for many GPs, writes The Guardian.

Associate Professor Vicki Kotsirilos, a GP and Australia’s first authorised medicinal cannabis prescriber, says the process for prescribing medicinal cannabis is “much easier” than it was four years ago.

The major challenge GPs face is to pick the right product among more than 200 unregistered ones, for which clinical evidence is unavailable. “Choosing the right product is a real challenge,” Kotsirilos says.

Professor Iain McGregor heads the Lambert Initiative for Cannabinoid Therapeutics, a Sydney University research centre. “It’s quite mind-boggling to try and match a patient’s condition to the right product and dosage because often that clinical trial evidence isn’t there,” McGregor says.

Yet the number of medicinal cannabis users has escalated over the past five years. This year alone more than 86,000 applications have been lodged, with the number forecast to surpass 100,000 next year.

Like Helen, The Guardian continues, the vast majority of patients resort to prescription medicinal cannabis to manage chronic pain. Yet last March the faculty of pain medicine at the Australian and New Zealand College of Anaesthetists released a statement recommending health practitioners not to prescribe the available medicinal cannabis products to treat chronic non-cancer pain unless they are part of a registered clinical trial.

“There is not one clinical trial yet that shows that CBD does anything useful for chronic pain,” McGregor says. “The prescribing continues nonetheless, and that’s not evidence-based prescribing.”

Common uses for medicinal cannabis include treating cancer pain, and sleep and mood disorders. Anxiety is now the second most common condition for which patients request medicinal cannabis.

Link below to the full story in The Guardian.

 

SA to host first cannabis roadshow 

As government moves to capitalise on the untapped cannabis industry, doctors are being invited to get accredited to prescribe medicinal marijuana, reports The Citizen.

The Cheeba Cannabis Academy has partnered with Carol’s Oil to launch a “first in Africa” two-day Medical Cannabis Roadshow that will be presented in Johannesburg, Durban and Cape Town during the course of next month.

Last year, the academy launched the country’s first medical professional cannabis training course with the global leader in online medical cannabis training, United States-based Medical Marijuana 411.

The course is accredited for 20 continuing professional development (CPD) points by the Health Professions Council of South Africa and is also accredited in several US states.

According to The Citizen, the two-day roadshow comprises the online medical professional cannabis course and a two-day in-person seminar which is accredited for 14 CPD points by the HPSCA.

Cheeba Africa CEO and cofounder Trenton Birch said the training roadshow provided an opportunity for doctors to learn from and engage with leaders in the medical cannabis field.

“We are proud to have partnered with the incredible team from Carol’s Oil to put together a compelling introduction and overview presented by top experts who are at the front lines of the specialised field of medical cannabis,” said Birch.

Birch said there is a growing curiosity around marijuana-based medication among patients who are keen to include the herb in their treatment plans.

“This is an opportunity for GPs, psychologists, dietitians and other healthcare providers to increase their knowledge so that they are equipped to meet this new demand,” said Birch.

In recent months, medical cannabis activist and Cheeba Academy lecturer Kwanda Mtetwa became the first South African to receive a legal prescription for medical cannabis. Mtetwa uses a medical cannabis-based treatment for pain management for injuries from a car accident, The Citizen story continues.

He receives prescriptions through the medical cannabis cultivator CBD Full Spectrum, which uses the Section 21 provision set up by the South African Health Products Regulatory Authority (SAHPRA).

Cannabis pharmaceutical products that are not yet registered by SAHPRA may be obtained under Section 21 of the Medicines Act by authorised medical practitioners for their patients.

 

The Guardian story – “It’s mind-boggling’: the complex, and growing, use of medicinal cannabis in Australia (Open access)

 

The Citizen story – SA to host first cannabis roadshow (Open access)

 

See also from the MedicalBrief archives

 

BMJ: New clinical guidelines for medical cannabis in pain relief

 

Medical cannabis – SA’s high hopes of a cash cow that blunts pain

 

Patients hopeful for France's medical cannabis experiment

 

Doctors still reluctant to prescribe medical cannabis – Canadian study

 

 

 

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