In New South Wales (NSW), medical cannabis encompasses products derived from the cannabis plant as well as synthesized compounds that imitate its active ingredients, known as cannabinoids. Over 100 cannabinoids are identified, but tetrahydrocannabinol (THC) and cannabidiol (CBD) are the primary ones studied for therapeutic use.

 

In NSW, these compounds have been the subject of significant research and clinical evaluation. THC, the main psychoactive element of cannabis, has potential applications in pain management and nausea control, reflecting the diverse medical needs of the state's population. CBD, lacking the psychoactive properties of THC, has been investigated for its potential benefits in treating a wide array of conditions such as epilepsy and anxiety disorders.

 

The government-funded Centre for Medicinal Cannabis Research and Innovation in NSW supports the scientific exploration of these compounds, reflecting the state's commitment to understanding and utilizing medical cannabis within a rigorous regulatory framework.

 

Cannabis as Medicine

 

Cannabis medicines include products derived from the cannabis plant or synthetically created compounds that mimic the effects of cannabinoids. Of the 104 unique cannabinoids in the plant, tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most studied. These cannabinoids are the active ingredients in medical cannabis.

 

Registered Cannabis Medicines

 

Currently, two cannabis medicines are registered in Australia:

 

• Epidyolex® (CBD) for seizures in Lennox-Gastaut syndrome or Dravet syndrome.
  
  
  
• Sativex® (nabiximols) for multiple sclerosis spasticity.

 

Unregistered Cannabis Medicines

Most cannabis medicines in Australia are unregistered but may still be prescribed under specific circumstances. Some examples include Marinol® and Cesamet®, used in the US for anorexia in AIDS patients and chemotherapy-induced nausea.

 

 

Who is Eligible for Medical Cannabis in NSW?

In New South Wales (NSW), eligibility for medical cannabis is confined to patients suffering from one of over 130 chronic conditions, who have also undergone other treatments without success for a minimum duration of three months.

 

Medical cannabis serves as a potential treatment alternative for a wide array of chronic conditions in NSW. These include but are not limited to ailments such as cancer, anxiety, PTSD, epilepsy, and autism.

 

NSW Cannabis Medicines Prescribing Process

In 2018, the Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE) was the recipient of funding from the New South Wales (NSW) Government's Clinical Cannabis Medicines Program. This substantial support was channeled into the creation of the NSW Cannabis Medicines Prescribing Guidance.

 

This initiative was intended to furnish NSW medical practitioners with the necessary interim information to guide the prescription of cannabis medicines for conditions wherein cannabinoids have been identified to offer potential therapeutic benefits.

 

The Prescribing Guidance is an essential suite composed of six (6) distinct documents, each meticulously developed and focusing on particular medical indications where cannabis medicines might be applied. These include:

 

1. Anorexia Cachexia in Advanced Cancer: Guidance for managing weight loss and appetite issues in terminal cancer patients.
   
   
   
2. Chemotherapy-Induced Nausea and Vomiting (CINV): Providing detailed strategies for handling nausea and vomiting resulting from chemotherapy.
   
   
   
3. Nausea in Palliative Care: Comprehensive recommendations for utilizing cannabinoids to alleviate nausea in end-of-life care settings.
   
   
   
4. Dementia: Exploring the evidence-based applications of cannabinoids for symptoms associated with dementia.
   
   
   
5. Non-Cancer Pain: Investigating the use of cannabis medicines for chronic pain not related to cancer, including the potential benefits and limitations.
   
   
   
6. Spasticity: Detailing the options for using cannabis medicines to alleviate muscle stiffness or spasms, commonly associated with conditions like multiple sclerosis.

 

The NSW Cannabis Medicines Prescribing Guidance documents serve as an interim roadmap to aid medical practitioners in navigating the complexities of prescribing and managing cannabis medicines for NSW patients. They fall within the existing regulatory frameworks and align with clinical practice standards.

 

Moreover, the guidance aligns with the conventional methods of communicating the utilization of novel therapeutic products to prescribers. This ensures that these guidelines maintain cohesion with existing medical protocols and provide an authoritative reference in the rapidly evolving landscape of medical cannabis utilization.

 

 

Types of Medical Cannabis

Medical cannabis can be prescribed in various forms, ratios, and THC concentrations. Factors for doctors to consider include:

 

• The ratio between THC and CBD.
  
  
  
• The specific cannabis cultivar or strain.
  
  
  
• The method of administration, such as capsules, lozenges, ointments, oils, or vaporised flowers.

 

Costs and Access

In New South Wales, the cost for medical cannabis typically ranges from $250-$300 per month but can vary based on factors such as medical condition, dosage, and choice of products. Government initiatives like the Special Access Scheme and Authorized Prescriber Scheme provide pathways for access, though they can be complex, necessitating assistance from dedicated cannabis clinics.

 

The NSW government's Medicinal Cannabis Compassionate Use Scheme also offers funding support for terminally ill patients. Access may be restricted in some regions due to the limited number of prescribing doctors, leading to an increase in telemedicine services.

 

Ongoing research, facilitated by organizations like the Centre for Medicinal Cannabis Research and Innovation, continues to shape the evolving landscape of costs and accessibility for medical cannabis within the state.

 

 

Conclusion

Medical cannabis in NSW offers a new avenue of treatment for various chronic conditions. Though still in its infancy, research continues to explore the potential benefits and risks. Patients interested in exploring this treatment option should consult with a knowledgeable healthcare provider.

 

For more detailed information, you can visit the NSW Centre for Medicinal Cannabis Research and Innovation.