What is medicinal cannabis?
Medicinal cannabis refers to the medical use of chemicals found in the cannabis plant to treat or relieve illness and health conditions.
These chemicals – phytocannabinoids – can be extracted from the cannabis plant or synthetically produced in a laboratory.
Like other medicines, medicinal cannabis products are legally produced to strict quality standards and taken under the supervision of a medical practitioner. These products contain known doses and concentrations of the active chemicals that are adjusted to increase the therapeutic benefits and reduce potential side effects.3
Illegally produced cannabis, on the other hand, is often taken for enjoyment and to get ‘high’.4 There’s no control over the type or amount of active chemicals in illegally produced cannabis products and it’s also illegal in all states and territories in Australia. In the ACT, cannabis is illegal but use and possession of small quantities has been decriminalised.5
How do medicinal cannabis products work?
The cannabis plant contains up to 100 different cannabinoids, which act on the body’s natural cannabinoid receptors that regulate functions like pain, appetite and memory.6
The two main cannabinoids with known therapeutic benefits are:
- delta-9-tetrahydrocannabinol (THC)
- cannabidiol (CBD).7
THC is a psychoactive (mind altering) substance that gives people the ‘high’ when it is smoked or eaten and is why many people use cannabis for non-medical purposes.
CBD is not a psychoactive substance and may moderate the ‘high’ caused by THC.8
THC and CBD can be used together, or independently, in the treatment of different conditions. For example, CBD-only products are often used to manage childhood epilepsy and seizures.9
Are medicinal cannabis products safe and effective as medicine?
Legally produced medicinal cannabis products are highly regulated in Australia by the Therapeutic Goods Administration (TGA).
Pharmaceutical quality medicinal cannabis is required by law to meet Australia’s high quality and safety standards.
The TGA does not recommend medicinal cannabis products for:
- people with a psychotic or anxiety disorder
- pregnant or breastfeeding women
- people with unstable heart disease.10,11
Most research for medicinal cannabis has focused on five health conditions:
- chronic non-cancer pain
- nausea and vomiting
- palliative care
- multiple sclerosis.12
Ongoing and emerging research into the benefits of medicinal cannabis products for other medical conditions is also underway both here and globally.
- Australian Institute of Health and Welfare (AIHW). Emerging topic: Medicinal Cannabis [Accessed 23 August 2021].
- Therapeutic Goods Administration. Medicinal cannabis: Role of the TGA [Accessed 20 September 2021].
- Arnold J. A primer on medicinal cannabis safety and potential adverse effects. Australian Journal for General Practitioners. 2021;50:345-50.
- National Academies of Sciences Engineering and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington (DC): National Academies Press (US); 2017.
- ACT Government. Cannabis [Accessed 19 August 2021].
- Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. 2018;19(3):833.
- Stith SS, Vigil JM, Brockelman F, Keeling K, Hall B. The Association between Cannabis Product Characteristics and Symptom Relief. Scientific Reports. 2019;9(1):2712.
- National Cannabis Prevention and Information Centre (NCPIC). Role of general practitioners in provision of brief interventions for cannabis use-related difficulties [Accessed 18 August 2021].
- Lattanzi S, Brigo F, Trinka E, Zaccara G, Cagnetti C, Del Giovane C, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-804.
- NPS Medicinewise. Medicinal cannabis: what you need to know [Accessed 25 August 2021].
- Therapeutic Goods Administration. Guidance for the use of medicincal cannabis in Australia: Overview. Australian Government Department of Health; 2017.
- Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, et al. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. Jama. 2015;313(24):2456-73.
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: Overview [Accessed 22 August 2021].
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis for the prevention or management of nausea and vomiting in Australia. Australian Government Department of Health; 2017.
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in the treatment of epilepsy in paediatric and young adult patients in Australia. Australian Government Department of Health; 2017.
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in the treatment of chronic non-cancer pain in Australia. Australian Government Department of Health; 2017.
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in the treatment of multiple sclerosis in Australia. Australian Government Department of Health; 2017.
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in the treatment of palliative care patients in Australia. Australian Government Department of Health; 2017.
- Australian Centre for Cannabinoid Clinical and Research Excellence. Prescribing cannabis medicines for management of anorexia-cachexia in patients with advanced cancer [Accessed 24 August 2021].
- Meissner H, Cascella A. Cannabidiol (CBD) [Accessed 26 August 2021].
- Harvard Health. Cannabidiol (CBD) - what we know and what we don't [Accessed 26 August 2021].
- Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: Patient information [Accessed 26 August 2021].
- Schlag AK, Hindocha C, Zafar R, Nutt DJ, Curran HV. Cannabis based medicines and cannabis dependence: A critical review of issues and evidence. J Psychopharmacol. 2021;35(7):773-85.
- Hay GL, Baracz SJ, Everett NA, Roberts J, Costa PA, Arnold JC, et al. Cannabidiol treatment reduces the motivation to self-administer methamphetamine and methamphetamine-primed relapse in rats. J Psychopharmacol. 2018;32(12):1369-78.
- Arnold JC, Nation T, McGregor IS. Prescribing medicinal cannabis. Aust Prescr. 2020;43(5):152-9.
- Senate Standing Committee. Parliament of Australia. Current barriers to patient access to medicinal cannabis in Australia 2020.
- Pain Australia. Proposed amendments to the poisons standard – down-scheduling of cannabidiol (cbd) [Accessed 26 August 2021].
- Australian Pain Management Association. Submission to the Inquiry into the current barriers to patient access to medicinal cannabis in Australia. 2020. Contract No.: 26 August 2021.
- Therapeutic Goods Administration. TGA warns consumers about potential harm from unlawfully supplied medicinal cannabis [Accessed 25 August 2021].