The Rise of Medicinal Cannabis in Australia: What You Should Know

Melbourne: In recent years, the prescription of medicinal cannabis in Australia has surged. Following changes to regulations in 2016, there have been over 700,000 approvals for cannabis prescriptions. This increase reflects growing interest and demand for cannabis as a therapeutic option for various health conditions.

Medicinal cannabis includes products derived from the cannabis plant, particularly cannabinoids like THC (tetrahydrocannabinol) and CBD (cannabidiol). These products can take various forms, including oils, capsules, dried flowers (often used in vaporizers), sprays, and edibles such as gummies.

Statistics on Chronic Pain in Australia

Chronic pain has become a pressing health issue affecting approximately one in five Australians aged 45 and over. The vast majority of medicinal cannabis approvals—around half—are granted for chronic pain unrelated to cancer, highlighting a significant prevalence of pain management needs in the population.

Current Evidence on Medicinal Cannabis for Chronic Pain

A 2021 review assessed 32 randomized controlled trials involving nearly 5,200 patients suffering from chronic pain. The findings indicated slight improvements in both pain and physical functioning when medicinal cannabis was compared with a placebo. Specifically, to realize a 30% reduction in pain for one individual, it was necessary to treat 24 patients with medicinal cannabis.

Additionally, this review noted modest improvements in sleep quality, while other quality of life metrics showed no significant benefit. It’s crucial to understand that while some individuals experience relief from medicinal cannabis, the overall effectiveness appears limited and varies from person to person.

Regulatory Insights

The Therapeutic Goods Administration (TGA), Australia’s regulatory body, remains cautious regarding the efficacy of medicinal cannabis in treating chronic non-cancer pain. They emphasize that patients should exhaust other standard therapies before considering medicinal cannabis. For safety reasons, pharmaceutical-grade products are preferred over inhaled cannabis, which has raised concerns regarding safety.

Understanding Personal Experiences

Despite the mixed findings in research, many patients report substantial relief from medicinal cannabis. Individual responses can differ widely based on a variety of factors, including health conditions and personal beliefs. Some patients may notice significant improvements in their pain management, sleep, or overall well-being, particularly when traditional treatments have failed.

Side Effects and Risks of Medicinal Cannabis

Like any medication, medicinal cannabis comes with potential side effects, which can range from mild to moderate. Common side effects include:

• Drowsiness or sedation
• Dizziness
• Impaired concentration
• Dry mouth
• Nausea
• Cognitive slowing

Higher-potency THC products, which are increasingly common, tend to have a higher incidence of side effects. Alarmingly, research indicates that more individuals typically experience side effects than derive benefits from medicinal cannabis.

Potential drug interactions are another consideration, especially with medications such as opioids, some mental health medications, blood thinners, and immunosuppressants. Even non-intoxicating CBD can lead to significant interactions. With many doctors prescribing cannabis without a thorough understanding of their patients’ complete medical histories, the potential for harmful interactions is elevated.

There is a risk of developing cannabis use disorder. A study from 2024 found that 25% of patients using medicinal cannabis may develop some form of dependence, leading to withdrawal symptoms and increasing tolerance levels over time.

Comparative Effectiveness

General consensus indicates that the effectiveness of medicinal cannabis for chronic pain management is modest and should not be viewed as a standalone treatment. Evidence suggests that alternatives such as exercise, cognitive behavioral therapy, and self-management education can be effective with potentially fewer risks. However, accessibility and affordability vary significantly, particularly for individuals residing outside urban centers.

Conclusion: What Does This Mean for Patients?

The increasing usage of medicinal cannabis in Australia underscores the urgent need for effective pain management solutions. While positive anecdotes exist, the prevailing evidence points to limited benefits for most patients, which must be weighed against associated risks. Engaging with a healthcare provider knowledgeable about your medical history is crucial in determining the most appropriate treatment for chronic pain management.

Written by Suzanne Nielsen, Professor and Deputy Director, Monash Addiction Research Centre, Monash University and Myfanwy Graham, NHMRC Postgraduate Scholar.