Getting stoned could get easier
AUSTRALIA has already approved medicinal cannabis to provide relief for those suffering from six types of chronic illnesses, and it may soon be legalised as a recreational drug.
Experts claim it is only a matter of time before it becomes available as an over the counter purchase, but first, a few things need to happen.
In the two years since medicinal cannabis was legalised in Australia, 1059 patients have received approval for treatment, and while it does seem like a low figure, Australia is finally catching up to the rest of the world, where in some countries it has been legal for decades.
Bloomberg predicts that by 2028, the vast majority of European countries will legalise medical cannabis programs and recreational cannabis, valued at $A182 billion.
Pharmacist and owner of Health House International Paul Mavor, who brought the first shipment of medicinal cannabis to Australia earlier this year, said patient numbers were above where other countries had been at the same time.
"In the first year of introducing it, Canada, which has a slightly bigger population to us, only had 150 patients, Australia had 300. Canada is now up 300,000 medical patients since legalising it 18 years ago and now they're just about to go legal for recreational (adult use) in a few months."
Mr Mavor said before becoming legal for recreational use in Australia "it is important we get the medical system right first".
Cannabis comes in many forms such as smokeables and also edibles.
Most medical forms come in concentrated forms such as capsules, tablets, sublingual sprays and topicals.
OVER THE COUNTER
Currently, nine US states have legalised cannabis and Spain and Uruguay have done the same. Canada announced reforms recently that will legalise cannabis use and New Zealand is set to put the issue to a referendum.
On April 16, Greens leader Richard Di Natale announced the Greens plan to legalise cannabis for adult use in Australia, as recreational use is still illegal across the country. They've proposed an "Australian Cannabis Agency" (ACA), which would allow experts, regulators and state and territory governments to issue licenses to produce and sell the drug, monitor and enforce those licences and conduct ongoing reviews.
At the Future of Cannabis seminar at Advertising Week APAC in Sydney on Wednesday, Sharlene Mavor, medical scientist and director of Medical Cannabis Research Australia told news.com.au that she anticipates recreational cannabis to become available in about five to 10 years time, once medicinal cannabis becomes fully implemented in Australia.
"We need to have doctors on board first who see it as a legitimate pharmaceutical product before we legalise it for adult use," she said.
"Otherwise we will just become muddied and doctors will lose respect for the product, but in itself I do believe cannabis is safe and low on the addiction scale - coffee is more addictive."
She anticipates a timescale similar to Canada.
"Canada legalised it recreationally once authorities realised the sky didn't fall in and there were no major social issues."
Mr Mavor said from a harm minimisation point of view, "there's a very good argument to legalise it recreationally," however he is not lobbying for it to happen.
"That way patients who are going to use it anyway are getting safe cannabis. It's impossible to overdose unless you eat a tonne of it. I personally don't have a problem with it. If it's controlled and tested it could be a good thing for our economy."
The seminar revealed that 35 per cent of Australians support the legalisation of adult use cannabis while a whopping 91 per cent supported medicinal.
NOT ABOUT LIGHTING UP AND SMOKING BONGS
More education is needed for doctors and patients to destigmatise cannabis as it's not a case of "people smoking bongs" whenever they want, say experts.
Patients who use the drug take it as an oil or vaporiser form and experts advise that it shouldn't be smoked as that can increase bronchial irritations and reduce the potency.
According to a survey of 640 Australian GPs, more than half the doctors said they supported medicinal cannabis, with more than two thirds of their patients asking about it.
But researchers from The Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney who conducted the study revealed that doctors felt their knowledge of the drug was inadequate and they were not comfortable discussing it with patients.
Drake Sutton-Shearer, CEO and founder of PRØHBTD Media, a company which creates, builds and markets cannabis brands to global audiences, said education is key, especially to destigmatising cannabis.
"Doctors need to know when cannabis has the potential to help and the protocols for delivering the maximum amount of benefit with the minimum amount of risk," Mr Sutton-Shearer told news.com.au at the Future of Cannabis seminar.
"Ironically, many medical professionals also need to be retrained to undo whatever misinformation they were fed in years past that rarely came from sound clinical research."
"Health minister Greg Hunt said he wants Australia to become the world's leading supplier of medical cannabis, which would necessitate more training across a wide spectrum of professions, including medical."
With the majority of doctors already on board, Mr Sutton-Shearer said they now need to be more outspoken about medical cannabis as a viable treatment option.
"Doctors can truly help destigmatise cannabis by using their credibility to explain the potential benefits and dispel the many untruths that originally gave cannabis a bad name."
"This expansion of knowledge helps remove the stigma that limits how doctors can best treat their patients."
DOES IT ACTUALLY ALLEVIATE PAIN FOR SERIOUSLY ILL PATIENTS?
A recent study conducted by the National Drug and Alcohol Research Centre (NDARC) found that while most people "perceived it to help", in reality, cannabis didn't really change the level of pain for those suffering from chronic illnesses.
The report published in Lancet Public Health in July was slammed by the experts who claim that the 1500 people it followed over four years were not medically supervised.
"We believe it was floored because it was based on a phone study where people were self medicating and probably smoking it, with no professional supervision," Ms Mavor said.
"It was done before the adoption of medical cannabis and people were probably dosing whatever they felt like, so it just wasn't a good study."
As a pharmacist, Mr Mavor said there has never been more of a need for the medical industry to jump on board.
"There's good clinical evidence for about six chronic illness conditions which the Australian government has been approving prescriptions for, that are helping suffering patients," he said. "Chronic pain is the biggest one, about 70 per cent of patients accessing medical cannabis are using it for their chronic pain which works above other drug treatments. Some of these patients have tried 10 or so other different types of drugs with no relief."
He said no one has ever died from cannabis but the results of deaths from pharmaceutical opioids which are largely used for pain are responsible for killing more than 30000 patients each year in the US and 577 in Australia in 2012.
The biggest cohort of patients is chronic pain. Mr Mavor said it is estimated that one in five Australians suffer from some form of chronic pain.
"There is also an estimated 100,000 Australian patients currently using medical cannabis from underground sources."
"Most of this product is untested and of unknown purity and potency and is being given to patients that have in some cases chronical illnesses with serious health conditions."
He said it is far better their healthcare is managed under the existing healthcare system in a timely manner.
"There are also an estimated 250,000 Australian patients with epilepsy and it is estimated 35-40 per cent of them have uncontrolled epilepsy. A recent study using cannabis showed it may be of benefit in about 40 per cent of these patients."
HOW DO YOU GET IT?
Patients have to undergo a rigorous assessment to obtain it. The six conditions are: chronic pain, multiple sclerosis, nausea in cancer related chemotherapy, drug resistant epilepsy, palliative care and post traumatic stress disorder.
Currently doctors write a prescription with a dose specifically aligned to a patient's illness which then must get Government approval.
Admittedly, Mr Mavor said more needs to be done to make the process easier for GP's who have to sift through a lot of paperwork just to get their patients access to medical cannabis.
"They need approval at the federal and at the state level. Most of the hold ups have been at the state health departments who I believe have set the bar too high," Mr Mavor said.
Only recently, NSW adopted a one page online form which Mr Mavor said allows for faster approvals within a 48 hour period.
"I understand Queensland, South Australia and Victoria have just adopted this system which will make a big difference to waiting times which has been up to two months."
He said the excess paperwork up until now has prevented many GPs accessing it for their patients.
"It has taken hours to fill in paperwork and there have been long waits."
Western Australia have committed to a streamlined system but have not yet adopted it.
CHEMOTHERAPY AND CANNABIS BREAKTHROUGH
Pancreatic cancer is particularly aggressive and has one of the lowest survival rates of all cancers.
A study that was led by Queen Mary University of London and Curtin University, Australia revealed that mice with pancreatic cancer that were treated with medicinal cannabis alongside chemotherapy, survived almost three times longer than those treated with chemotherapy alone.
It tested the impact of the cannabinoid Cannabidiol (CBD) on the use of the commonly used chemotherapy medication Gemcitabine as a treatment for pancreatic cancer in mice.
Lead researcher Professor Marco Falasca from Curtin University labelled the result as "remarkable."
"We found that mice with pancreatic cancer survived nearly three times longer if a constituent of medicinal cannabis was added to their chemotherapy treatment."
"Cannabidiol is already approved for use in clinics, which means we can quickly go on to test
this in human clinical trials," he said.
"If we can reproduce these effects in humans, cannabidiol could be in use in cancer clinics almost immediately, compared to having to wait for authorities to approve a new drug."