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Patient Information: Medicinal Cannabis

Please read this document carefully. There is a lot of public information about medicinal cannabis; whilst most of the public information reports positive benefits for the use of medicinal cannabis for different medical conditions, it is important to know that medicinal cannabis is not for everyone. The only way to know if medicinal cannabis will be beneficial for you/your condition, will be to give it a trial. Your trial/treatment will be individualized as each patient's care is unique.

Below is a list of conditions, the Therapeutic Goods Administration (TGA) has approved medicinal cannabis for, where clinically appropriate:

  1. Alzheimer's Disease
  2. Anorexia
  3. Anxiety
  4. Attention Deficit Disorder with Hyperactivity (ADHD)
  5. Autism Spectrum Disorder (ASD)
  6. Cachexia
  7. Cancer symptom management
  8. Cancer-related pain
  9. Chemotherapy-Induced Nausea and Vomiting (CINV)
  10. Chronic non-cancer pain
  11. Crohn's Disease
  12. Dementia
  13. Depression
  14. Endometriosis
  15. Epilepsy
  16. Inflammatory Bowel Disease (IBD)
  17. Insomnia
  18. Irritable Bowel Syndrome (IBS)
  19. Mood Disorder
  20. Multiple Sclerosis
  21. Neuropathic Pain
  22. Osteoarthritis
  23. Palliative Care
  24. Parkinson's Disease
  25. Post-Traumatic Stress Disorder (PTSD)
  26. Seizure Management
  27. Sleep Disorder
  28. Spasticity
  29. Spasticity-associated Pain

Just as with any treatment, if the risks of treatment with medicinal cannabis outweighs the benefits, the treatment will be reviewed, modified or withdrawn. The two main ingredients in medicinal cannabis are cannabidiol (CBD) & tetrahydrocannabinol (THC). A key difference between CBD & THC, is that CBD is non-psychoactive, whereas THC has potential psychoactive properties. Medicinal cannabis is available in different forms and administered through different routes. Common routes are oral for gummies/pastilles and inhalational route for cartridges and dried flowers. Your doctor will discuss these with you.

Risk and Side Effects

1. Like all prescription medicines, medicinal cannabis products can have side effects &/or drug interactions. Potential risks/side effects associated with the consumption of medical cannabis and this may include but not limited to the following:

  1. Distortion of perception (sight, sounds, time, touch)
  2. Impairment of memory and/or learning
  3. Headache, confusion, sedation, disorientation and/or fatigue
  4. Dry mouth, nausea, vomiting, diarrhea, stomach upset, increased or decreased appetite
  5. Hallucinations, delusions, paranoia or convulsions
  6. Psychosis or cognitive distortion; bipolar or manic episodes
  7. Impairment of coordination; Impaired thinking, judgement and/or problem-solving skills
  8. Increase heart rate and/or reduces blood pressure
  9. Anxiety, fear, depression or panic
  10. Tolerance, dependence, cannabis misuse and/or addiction
  11. May have potential drug interactions with other prescribed medicines, over-the-counter medicines and supplements.

2. If I experience any unwanted side effects as may be set out above (or any other unwanted side effects), I understand that I should report this as soon as reasonably possible to my prescribing doctor as well as my regular general practitioner.

Driving, Operating Machinery & Work/Occupation

3. I have been informed that:

  1. If any medical cannabis that is prescribed to me contains THC, I must not drive a motor vehicle or operate machinery while using the medical cannabis.
  2. I may be committing a criminal offence if I drive or operate machinery & THC is detected in my system.
  3. THC can be detected in saliva and urine several days to weeks after the last dose of a medicine containing THC has been used.
  4. Depending on my workplace and/or the relevant state/territory regulations, there may be restrictions/penalties imposed if I test positive to THC on a saliva or urine test at work or the road side. It is my responsibility to check my work place regulations & the relevant state/territory regulations on the use of THC containing medications regarding work place & driving respectively.

General cautions/contraindications

4. Medicinal cannabis products may not be appropriate for some people and maybe contraindicated in some patients, particularly those who:

  1. Have a history of hypersensitivity to any cannabinoid;
  2. Have unstable cardiovascular disease e.g. angina or myocardial infarction;
  3. Have previous or current psychotic, manic or bipolar disorder;
  4. Are pregnant / breastfeeding;
  5. Have severe renal or liver disease;
  6. Have previous or current history of drug misuse or addiction; or
  7. Are taking narcotic or sedative medications (such as opioids or benzodiazepines);

5. If any of the issues set out above in [4] apply to me I will notify my doctor and my regular general practitioner immediately.

General information

6. There is considerable debate and a lack of consensus about:

  1. The effectiveness of medicinal cannabis for use in different medical conditions.
  2. The appropriate dosage for medical cannabis product;
  3. Whether and the extent to which there are long term adverse health and psychological effects associated with the use of medical cannabis;

7. There is limited high-quality systematic evidence for the safety and efficacy of medicinal cannabis; the Australian Government medicines regulatory unit (Therapeutic Goods Administration – TGA), currently considers the use of medicinal cannabis to be an experimental medicine.

8. I am aware that the above listed medical concerns are compounded by the lack of consistency and uniformity in available medical cannabis products.

9. I agree to obtain medical cannabis in accordance with the requirements of my prescription. I am aware that if I possess and or use cannabis acquired from other sources, I may be committing a criminal offence.

10. I am aware that consuming medical cannabis at the same time as other substances, especially alcohol, nicotine/tobacco, sedatives or central nervous system depressants, may cause harm and possibly even death.

11. I will inform my doctor of all medications that are prescribed to me by my regular general practitioner(s) or other regular medications that I take. I understand that I must inform my primary care doctor or regular general practitioner that I am being prescribed medical cannabis.

12. I agree to have a medical assessment performed by my medicinal cannabis prescriber and regular general practitioner as frequently as I will be advised.

13. For female patients - I am aware that the use of medical cannabis is not recommended during pregnancy and breastfeeding. I agree to inform my doctor if I am pregnant. If I become pregnant while being treated with medical cannabis, I will immediately consult with my doctor and or my regular general practitioner or other health professional.

Medical, Collegiate reasons to terminate your care with us

Whilst we endeavour to work together to individualize your medicinal cannabis treatment to achieve the best health outcomes for you, we want you to understand that we also have a responsibility to practice safely and to best applicable standards. If at anytime during your care with us, it is determined that the risk of medicinal cannabis therapy outweighs the benefit, your treatment will be discontinued. If at anytime during your care with us, your doctor(s) form the opinion that continued engagement with the practice will not be in the best interest of the practice staffs and/or yourself, your treatment will be discontinued and you'll be advised to seek care elsewhere. Your cooperation will assist us in working harmoniously together.

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