Over the past decade Australia’s medical authorities have adopted a more open approach to the medical use of cannabis. For those who suffer chronic pain, some in the final stages of life, cannabis has been, they claim, a godsend.
But there are those, including Australia’s official drug regulator, who believe its use has gone too far. As a result, they fear that a boom in cannabis prescriptions may end up causing more harm than good.
According to government data, 291,469 new patients began medical cannabis treatment through authorised prescribers between January and June this year. That’s a huge increase on the 3086 new patients recorded for the same period three years ago.
While that may seem like a good thing, such huge numbers have turned the process into one using little more than a rubber stamp. Applications by GPs to prescribe cannabis are meant to be vetted by health bureaucrats. However, this prescription deluge has led to those deemed as low risk now being bulk approved.
Why is GP-prescribed cannabis a problem?
In fact, not everybody believes the prescription cannabis boom is a problem at all. But the Therapeutic Goods Administration (TGA), which granted the original consent for its use, has serious concerns.
The TGA recently stated: “Access of medicinal cannabis products is pushing the boundaries of the intention of these schemes.” That intention it says, was “to provide access to goods for use in rare and extenuating circumstances.” Such circumstances requires that, “the patient has exhausted approved and available treatments in Australia.”
Is pushing those limits really a cause for concern? Yes, says Professor Rachelle Buchbinder, who conducts pain research at Monash University. In 2021 Prof Buchbinder wrote a review of data in which she suggested that cannabis does not work for pain.
The trial evidence showed there was only a small or very small to no benefit in pain, she said. There was similar evidence regarding function and sleep quality.
“It’s very concerning. And I’m worried about an opioid epidemic just being replaced by a medical cannabis epidemic,” Prof Buchbinder said. “This is another commercially driven treatment where the harms are going to be outweighing the benefits.”
Professor Michael Vagg at the Australian and New Zealand College of Anaesthetists, echoed Prof Buchbinder’s concerns. He believes the cannabis boom to be “ethically more concerning” than opioid use. Opioids were at least shown to be effective in treating pain, he said.
An alternative view of an alternative medicine
Not all academics share the views of Profs Buchbinder and Vagg, however. Prof Iain McGregor, academic director of the Lambert Initiative for Cannabinoid Therapeutics, is one who vehemently disagrees. Prof McGregor cites self-reported data showing significant quality of life benefits.
“Sensory measures of pain may not change that much with cannabis,” he said. “But what does seem to change is people’s ability to get on with and enjoy their lives. And that’s fantastically useful.
Prof McGregor believes comparing cannabis to opioids to be misrepresentative. “To try to equate medicinal cannabis uptake with the opioid epidemic is grotesque,” he said. “Opioids kill people. Cannabinoids do not.”
Prescription opioids such as OxyContin have been the subject of civil lawsuits seeking many millions of dollars in recent years. Many of these cases revolved around addiction and overdoses.
Because very few forms of cannabis have official TGA approval, the responsibility of its use falls to doctors and their patients
The “use of an unapproved therapeutic good for a patient is a clinical decision made at the discretion of the medical practitioner”, said a TGA spokesperson. “The prescriber and their patient take full responsibility for the use of the unapproved product,” he said.
Have you use medicinal cannabis for pain management? What difference has it made for you? Let us know via the comments section below.
Also read: Mild painkillers match opioids for treating fracture pain: study
Health disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.