Queenslanders and Victorians with particular chronic illnesses may now be eligible to join New South Wales medicinal cannabis trials, due to start mid next year.
The three states will collaborate on the development of medicinal cannabis, its regulatory framework and clinical research to explore the safety and benefits of the product among three key groups:
- children with severe epilepsy who haven’t responded to traditional medicine
- adults with painful terminal illnesses
- cancer patients with severe nausea from chemotherapy.
This welcome move comes after many years of lobbying to reverse the embedded opposition to medicinal cannabis and recognises the product as a valid way of relieving the suffering caused by some distressing conditions.
So, how would such a scheme work in Australia? And what hurdles must first be overcome?
Countering the opposition
Some opposition to medicinal cannabis is based on a lack of understanding of the science of cannabis and emerging practices internationally. As cannabis has been illegal, there has been a shortage of pharmaceutical evidence of the kind usually accompanying the introduction of new treatments.
Many others oppose medicinal cannabis on irrational grounds, preferring to see any cannabis use as “immoral”, and have no interest in looking at the evidence.
Free and excessive use of cannabis certainly causes problems. This is especially true for young people using cannabis while their fore-brain is still developing, between the ages of 15 and 25. Heavy users drop out of education and lessen their intellectual capacity, curbing career options for life.
Hastened onset of psychosis occurs in the small number of users with a genetic predisposition. However, it is irrational to see this as a reason to reject medicinal cannabis when carefully planned processes to guard against these problems are under consideration in the three trial states.
What is medical cannabis?
Pain specialist and lecturer Michael Vagg recently wrote on The Conversation that medicinal cannabis was no more than treatment of patients with tetrahydrocannabinol (THC). THC is known to accelerate psychosis in people with certain genetic tendency to it.
This ignores mounting evidence that a second important component, cannabidiol (CBD), plays a critical role. It opposes the effects of THC on the brain’s endogenous cannabinoid receptor CB1.
Illicit “skunk” cannabis, currently favoured in Australia, does have a high content of THC and little or no CBD, responding to market demand from people seeking to feel “stoned” with heavy use.
“Hash” cannabis, however, has large amounts of CBD, frequently more than THC. Popular in London, it has been shown to have no association with psychosis. This indicates the ready possibility of providing a “safe” product.
CBD does not produce excitement of the kind experienced with high-dosage THC, but has a calming influence, relieves pain and has, in recent years, been shown to improve symptoms in people developing psychosis.
CBD is reportedly the key component in new strains of c.sativa, bred specifically to produce relief for intractable forms of juvenile epilepsy called Dravet or Lennox-Gastautsyndromes. Clinical trials with concentrates of CBD are in progress.