TMR podcast: So you’re thinking about prescribing cannabis…

2 minute read

Chronic Disease Pain Palliative

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Staff Writers

In this week’s ''potcast" we’re weeding out the myths around medical cannabis

For this week’s ‘potcast’ we’re weeding out the myths around medical cannabis.

Patients in Australia are just starting to get their hands on medical cannabis and, for some, it’s made a huge difference to their ability to cope with chronic pain.

This field is moving rapidly so in this episode we’ll look at what the experts are saying right now about the scientific evidence.

And we’ll look at what barriers are still holding GPs back from prescribing.

This week’s episode also includes a sponsored interview with Professor Liz Reymond, a palliative care specialist.

In this interview, she refers to these useful resources for GPs:

– The ‘End-of-Life Care Framework’ designed to assist GPs to deliver proactive palliative care

– The Caring@home package which can assist health care professionals to support and train the voluntary carers of people dying at home

– The ‘Advanced Care Planning’ online resource which can assist in the documentation of a person’s medical treatment preferences

– The PalliMEDS app developed by NPS Medicinewise to assist in the appropriate prescribing of end-of-life medications

You can subscribe to The Medical Republic podcast on iTunes, Spotify via the RSS feed or wherever you get your podcasts by searching for ‘The Medical Republic”.

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igor.jakubowicz@gmail.com
igor.jakubowicz@gmail.com
4 years ago

There are several inaccuracies in this podcast about medicinal cannabis. Dr Nespolen as president of the RACGP has demonstrated his near total ignorance of this new product. Having had a lot of experience with medicinal cannabis in its use for pain and palliative care, and reviewed much of the evidence (and there’s lot of it), there are significant advantages in cannabis, provided patients, or their families, can afford it.

As for driving, consider how many people drive with (illicit) cannabis in their systems already, or with methadone or other strong opioids which are far more dangerous. If someone feels impaired or takes strong medications, they should not drive. I believe there have been test cases already in NSW & SA.

Cannabis is much safer, with fewer side-effects, than opioids. It can help the “opioid crisis.” I already receive referrals from specialists (rheumatologists, palliative care and even pain specialists) who have found that medicinal cannabis is very effective in some people. Like any medication, it needs to be appropriately chosen as it is a combination of TWO compounds (THC & CBD) in different ratios, and appropriately titrated.

There are MANY studies, and even the TGA website, in its guidance pages, lists over 200 trials categorised according to there quality level. Prof Liz Reymond had some good information, although her experience may be somewhat limited. One of her guests was not up to date. Medicinal cannabis is not a panacea. It doesn’t actually cure a single condition but treats a whole lot of symptoms.

Cancer pain is well treated by cannabis, although opioids are freely accepted for this purpose. As for psychosis, I avoid THC but have found CBD very effective in a few patients who absolutely refused traditional antipsychotics! CBD is herbal.

There is at least one Australian grower (in WA). Medicinal cannabis is not addictive (less than caffeine!) except perhaps in adolescents. The “gateway drug” hypothesis of my younger years may have been due to dealers lacing their marijuana with heroin. I had a patient recently tell me her recreational joint had a strong effect. Urine drug screen showed illicit opioids. Medicinal cannabis is indeed an exit drug as patients are able to reduce opioids (typically by 30-50%), pregabalin (typically stop), and studies suggest that over 40% of patients are able to stop benzodiazepines.

There are numerous opportunities to learn to use this exciting medication. Pity about the bureaucratic paperwork though….

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