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February 22, 2018

Medicinal, recreational and synthetic cannabis use

Medicinal, recreational and synthetic cannabis

What’s the difference?

Cannabis use is one of those issues that sparks the community’s imagination and gets a regular run in the media. But with recent changes in some parts of Australia governing the cultivation and use of various forms of cannabis, it’s timely to look again at this drug.

The various chemicals in cannabis?

To understand the differences between ‘recreational’, ‘medicinal’ and ‘synthetic’ cannabis it’s first important to understand a bit about the main chemicals in cannabis.

Cannabinoids are the chemicals which give the cannabis plant its medicinal or recreational properties. Cannabinoids like THC (delta-9 tetrahydrocannabinol) and CBD (cannabidiol) work by interacting with different receptors in the body to produce the various effects, such as feeling ‘high’ or alleviating nausea. THC acts on specific receptors in the brain known as cannabinoid or CB1 receptors.1, 2

THC is the cannabinoid that has a psychoactive effect (meaning it produces a ‘high’) whereas, CBD does not. CB1 receptors are found in high concentrations in the brain, and are the pathways that are responsible for the psychoactive effects of THC. The reason that CBD is non-psychoactive is due to its lack of connection or rather affinity with CB1 receptors.2

Recreational cannabis use

In Australia, recreational cannabis usually comes in the form of the dried leaves and flowers of the plant. It is usually smoked or eaten. Recreational cannabis use, or smoking cannabis for medical reasons, is still prohibited in Australia.3

Medicinal cannabis use

In comparison, medicinal cannabis is a product/s that is prescribed by a GP or specialist to relieve the symptoms of a medical condition, such as epilepsy. Some medicinal cannabis products are only CBD, some only THC, while some are a mixture of both. What a person is prescribed is dependent on the condition they have.

In pharmaceutical cannabis products the active components (THC and CBD) are altered to maximise the drug’s therapeutic benefits and minimise side effects.2

A number of plant-derived and synthetic cannabinoids have been developed for medical use, these include:

  • pharmaceutical cannabis products that are approved by the Therapeutic Goods Administration (TGA) such as the oral spray Sativex®; or
  • capsules and oral liquids such as Dronabinol®, which are currently not approved by the TGA but can be accessed through the TGA’s Special Access Scheme.3

According to the TGA’s website “a variety of products are currently available through import from Canada or Europe. These include raw (botanical) cannabis, which for medicinal purposes should be vaporised but not smoked, cannabis extracts in oils, and solvent extracts such as tinctures, and oro-mucosal sprays”.3 Access to these medicinal cannabis products can only be arranged through a registered medical practitioner.

In the USA, unregulated cannabis (in other words recreational cannabis) is often considered a ‘medicinal’ form of cannabis.4

Synthetic cannabis use

In recent years a wide range of ‘synthetic cannabis’ products, claiming to have similar effects to cannabis, have become available in Australia. They are usually sold in small sachets or zip-lock bags. They look like dried plant matter, with one or more synthetic cannabinoids (i.e. manmade) that have been added.

Synthetic cannabis is usually smoked, with these products marketed as having similar physical and psychological effects as recreational cannabis.

But the reality is that they can have more unpredictable effects and are potentially more harmful than recreational cannabis.

These products are also often marketed as safe and legal. However, their use and sale is prohibited in most states and territories in Australia. The potential for harm from a synthetic cannabis product will depend on the specific chemicals that it contains, and many products contain more than one chemical.5, 6

Please note: The information given on this page is not medical advice and should not be relied on in this way. Individuals wanting medical advice on this issue should consult a health professional.

References
  1. Victorian Law Reform Commission (2015). Medicinal Cannabis.
  2. Cannabis Support and Information (2017). Weeding out the differences between THC vs CBD.
  3. Australian Government Department of Health, Therapeutic Goods Administration (2017). Guidance for the use of medicinal cannabis in Australia: Patient information.
  4. Belackova V, Ritter A, Shanahan M, Chalmers J, Hughes C, Barratt M and Lancaster K. (2015). Medicinal cannabis in Australia: framing the regulatory options.
  5. Alcohol and Drug Foundation (2018). Synthetic cannabis facts.
  6. Cannabis Information and Support. (2017). Synthetic cannabis.